Concussions are at the forefront of many of discussions involving football injuries these days.  And, rightfully so!  Football is a dangerous sport no matter how we look at it. The object of the game is to prevent the other team from moving down the field by any means necessary. This results in players being hit, shoved, thrown into each other and down on the ground. Sports injuries such as bruises, cuts, scrapes, and muscle pulls are a natural part of the game along with the occasional broken bone.  Every so often, we hear about more serious injuries such as ACL (anterior cruciate ligament) tears.  ACL tears have our attention, however.  The beast lurking in the shadows is the closed head injury, or concussion.

In 2013 over 4,500 former NFL football players successfully sued the league for concealing the long-term dangers of blows to the head and repeated concussions. Many of these players now have dementia, Alzheimer’s disease, and chronic traumatic encephalopathy due to head injuries during their career.  The long-lasting neurologic deficit seen among pugalists/boxers is lovingly referred to as ‘punch drunk’.

If these types of injuries can happen to seasoned and trained professionals, what are the impacts of head trauma of those playing youth football? In order to identify the risks involved with impacts to the head a study was conducted by the Wake Forest’s Kinematics of Impact Data Set, also known as KIDS

. They chose 24 youth football players, ages 16-18 to assess over a season. Before the study, the players had MRI scans, known as diffusion tensor imaging, which shows the inner structure of white brain matter, called axons, which transmit information in the brain.

During the season, the players were given helmets mounted with accelerometers called HITs (Head Impact Telemetry System) that detected the number of times the player was hit, the direction the of the blow, and its severity. Based on the data from the helmets, the youth were put into one of two groups: heavy hitters, of which there were 9, and light hitters, the other 15. When the season was over, the players had another MRI to detect any changes that might have occurred in their white brain matter.

Those that were considered heavy hitters had much higher abnormalities of the white matter in areas usually found after traumatic brain injuries. This was shocking in that not one of the players had a concussion during the season.

brain

Those players that were termed “light hitters” or those who did not get hit as much or as hard as the others, also had brain changes in their MRI, although not as significant as the heavy hitters. Out of all the blows, 66% of the impacts for youth football players, occurred during practice, rather than games. Study author, Joel Stitzel, professor at Wake Forest University and chair of biomedical engineering, notes the grim fact that most, if not all, youth teams are lacking a medical professional, such as an orthopedist, who is trained to look for concussions.

Because not all concussions result in loss of consciousness, a player may not even realize he has a concussion.

Signs of a concussion can include nausea, vomiting, confusion, memory issues, dizziness, drowsiness, headaches, and blurred vision. If a concussion is suspected, an orthopedic surgeon specializing in sports medicine is the best bet for care and answers.