New research suggests that high school football coaches are getting a lot better at spotting a concussion and managing the problem, although there is still room for improvement.
"Our knowledge about concussions is expanding rapidly,” says Steve Broglio, Ph.D., at the University of Illinois Urbana-Champaign. He studies concussions in high school athletes.
"The traditional idea was that 'getting a bell rung' was not serious, but those symptoms can be a sign of a concussion and need to be evaluated," Dr. Broglio continues.
Symptoms of concussion include dizziness, headache, poor concentration, vision disturbances, balance disturbances, amnesia, and loss of consciousness.
Each year, more than seven million high school students participate in interscholastic sports in the US, and there are approximately 1.4 million sports injuries, according to a 2006 national sports injury survey.
The good news is that injury rates have dropped by half in the last decade as sports medicine techniques have improved, along with a growing awareness of the importance of preventing and treating injuries, says Dawn Comstock, Ph.D., at the Ohio State University.
She administers the survey which tracks sports-related injuries at 100 high schools throughout the country.
But the injuries reported today are more serious.
Dr. Comstock says, "There are more fractures, severe knee injuries, and the proportion of injuries requiring surgery is higher."
This could be due to a jump in chronic overuse problems - more young athletes are playing one sport year-round, using the same muscle groups over and over.
But the increase could also be due to improved sports medicine techniques - earlier diagnosis and treatment of many injuries before they become serious, leaving the more serious ones for the statistics charts, notes Dr. Comstock.
Whatever the reasons, the emerging data and new research into sports injuries among high school athletes is bringing needed attention to what athletic professionals say has been a long neglected area.
"There are 1.2 million high school football athletes, compared to 38,000 college and 1,700 professional football players," says Dr. Broglio. "At the high school level, where there are the greatest number of injuries, there is the least amount of medical attention - one athletic trainer for 300 to 500 children, compared to three or four for one college football team of 120."
Tight school budgets are part of the reason, explains Jon Almquist, the athletic training program administrator for the Fairfax County, Va., Public Schools. Schools necessarily focus on educational priorities rather than athletics.
But a second reason for the lack of attention, according to Dr. Comstock, has been the wrong assumption that high school sports injuries are inevitable.
"There's a general perception that sports injuries are just the price you have to pay for playing, which isn't true," she says.
At a meeting of the National Athletic Trainers Association (NATA), Dr. Broglio presented the results of a study that measured the varying speeds at which high school football players took hits to their heads, and where on the head the hits occurred.
The findings will not only help researchers pinpoint how and when concussions are most likely to occur, they should help coaches retool a player's on-field technique to avoid unnecessarily risky moves.
Also at the meeting, certified athletic trainer Erin O'Donoghue reported that high school coaches in a survey she conducted scored an average of 80 out of 100 points on questions testing them on their expertise in recognizing concussions.
Those who had attended workshops about concussions - approximately one-fifth of the coaches - or had a Centers for Disease Control and Prevention (CDC) published kit about concussions were the most informed.
"Our educational efforts have been effective," she says.
To further improve safety for young athletes, NATA has published a summary statement with 11 strategies for anyone - coaches, athletic directors, and parents - interested in providing comprehensive medical care to high school athletes.
Among the recommendations:
1. Organizations that sponsor high school athletics should put in place a healthcare team to ensure timely and appropriate care for all athletes.
2. Those same organizations need to develop an emergency action plan to ensure that injuries and illnesses are treated promptly.
3. Students participating in sports should have a physical exam to detect any health problems that might be aggravated by physical activity.
"Our hope is that the summary statement and strategies will together provide an opportunity for all high school athletes to get appropriate medical treatment whenever and wherever they play sports," says Almquist, who chaired the task force and is lead author of the statement.
Always consult your physician for more information.
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In the US, about 30 million children and teens participate in some form of organized sports, and more than 3.5 million injuries each year, which cause some loss of time of participation, are experienced by the participants.
Almost one-third of all injuries incurred in childhood are sports-related injuries. By far, the most common injuries are sprains and strains.
Obviously, some sports are more dangerous than others. For example, contact sports such as football can be expected to result in a higher number of injuries than a non-contact sport such as swimming.
However, all types of sports have a potential for injury, whether from the trauma of contact with other players or from overuse or misuse of a body part.
The National SAFE KIDS Campaign and the American Academy of Pediatrics (AAP) say more than 3.5 million children ages 14 and under get hurt annually playing sports or participating in recreational activities.
Although death from a sports injury is rare, the leading cause of death from a sports-related injury is a brain injury.
Sports and recreational activities contribute to approximately 21 percent of all traumatic brain injuries among American children.
Almost 50 percent of head injuries sustained in sports or recreational activities occur during bicycling, skateboarding, or skating incidents.
More than 775,000 children ages 14 and under are treated in hospital emergency rooms for sports-related injuries each year.
Most of the injuries occurred as a result of falls, being struck by an object, collisions, and overexertion during unorganized or informal sports activities.
Playground, sports, and bicycle-related injuries occur most often among young children, between the ages of five and 14 years old.
The highest rates of injury occur in sports that involve contact and collisions.
More severe injuries occur in individual sports and recreational activities. Most organized sports-related injuries (62 percent) occur during practice.
Sports statistics include:
baseball and softball
in-line and roller skating
Always consult your physician for more information.