Hockey, Lacrosse and Concussions


There is no logical reason why the concussion issue should be limited to football.  So it should be no surprise that it applies to other sports as well.

A new article in Science Daily describes a pediatrician’s experience with boys and hockey.   The writer extends the findings to include lacrosse, although does not quote data separately for that sport.

In a study of 13-to-18 year olds, concussion is the most common injury for ice hockey players, affecting 15% of all 13-16 year olds and 25% of male high school players.

The youngest players  take 40% longer to recover from concussions.  Gender and weight affect recovery time.  Lighter-weight males and heavier females have longer recovery times.

The recommendation of the article is that “collision sports” be limited to children who are past the freshman year in high school.    That’s a more rigorous recommendation than has been made for football to date, which currently is for past age 12.

The concussion issue needs to be on the agenda for all state athletic associations and part of training for coaches and all recreational sports.  The concussion discussion may start with football, but it can’t end there.

I’d like to see intelligent discussions and actions before we have lawsuits that simply shut down valuable sports programs.

Football and Concussions — a modest proposal


Should colleges with football programs be required to provide athletes with long-term care (LTC) and long-term disability insurance in case they sustain permanent injury while playing for the school?

LTC policies exist but would have to be repriced for this type of insured.  This would require a fundamentally different type of disability policy than exists today as student athletes have no income per se.

There are several reasons why this approach makes sense:

(1)  Many athletes who go out for football are from less affluent families what cannot afford the financial burden from serious injury.  The athletes themselves have no resources that they can use to meet unexpected expenses or replace lost income.

(2)  The fact of signing for these policies may make players and their families aware of the seriousness of these risks.

(3)  Policy requirements may force schools to do serious physical screenings for incoming athletes.  We may find out about heart defects before players die on practice fields.

(4)  These policies may help to eliminate cases like the subject of my previous post — someone who gets lost in the system, and goes to an early death due to depression and drugs resulting from injury.

(5)  It fits with the philosophy of holding both individuals and institutions responsible for decisions they make.  Medicaid programs shouldn’t be on the hook for caring for injured athletes.  Right now, government is challenged to provide adequate care for veterans.  Those who create the risk need to bear responsibility for cleaning up the mess when it occurs.

The cost of these policies might force schools with unprofitable football programs to close their programs.  That’s certainly a possibility, but is that in fact a bad thing?

Football and Concussions — the right to “informed decisions”


Informed consent has just become much more complicated.

I wrote about this issue in a post in December.  The occasion of that post was meeting a young man on a plane who was playing football and only superficially aware of the concussion issue.

My argument was and remains that someone making a commitment to anything needs to understand the risks associated with that commitment. That still seems to make logical sense.

However, an article published on 4 January only by JAMA Neurology complicates this discussion.  Doctors McKee and Mez of the Boston University School of Medicine and their co-authors document the case of a young man, deceased at age 25, who suffered from chronic traumatic encephalopathy (CTE) due to repetitive head impacts.

The young man had started with football at age 6 and played into his junior year in college in a Division I program.   Symptoms of brain injury —  including headaches, neck pain, difficulty with concentration and memory, and depression — led to the end of his football career as a junior and to his dropping out of school as a senior.

He experienced “more than 10 concussions while playing football.”  The kicker is that the first concussion came at age 8, way too young for informed consent in anything.  The parents need to be informed about these risks.

Recent rule changes designed to avoid head injuries in 10-12 year olds are helpful, but this case shows that focus should include younger children.  Further, those rules are only valuable to the extent that coaches and parents understand the risks and actively support enforcement.  There are too many stories of parents trying to relive glory days through their kids and both exhibiting and encouraging overly aggressive behavior on the field in the younger grades.  There remain some coaches who are overly concerned with winning at younger ages.

I’m not against American football.  I believe there could be

  • Further changes in rules and equipment to protect players
  • Education for parents and players and
  • Better training or coaches and league administrators.

The young man died from a heart attack related to Staphylococcus aureus endocarditis.  That’s an infection of heart tissue found among recipients of prosthetic heart valves, hospitalized patients, and drug users.  Substance abuse may have been a byproduct of family history and his brain injuries.  Age 25 is just way too young.