Monday, October 05, 2015
Two weeks ago, a New Jersey high school quarterback, Evan Murray, got injured and died following a game. He took a hard hit, seemed in distress, but then got up and left the field on his own power. This was not a concussion, rather a body strike that lacerated his spleen leading to critical internal bleeding. The media picked up this story immediately and it appeared on the Today Show, CBS Evening News and CNN. Additionally, the press also covered this story, most notably USA Today’s Kristine Meldrum with her article, “Are abdominal injuries the next concussion story?” This was essentially a repeat of a story on NBC News that appeared in August, one month before the New Jersey quarterback’s death. The story followed an incident that happened in 2008 when Brian Haugen went up for a pass and got “sandwiched” between two players. He wobbled off the field and was rushed to the hospital, but his liver had been crushed and he died. In the wake of this tragedy, his parents began a foundation in his name that is one of dozens throughout the United States dedicated to addressing internal injuries for youth players.
As parents of preteen and teen players, we hear about the dangers in playing contact sports yet have a desire to put our heads in the sand. None of us want to be the parent who knowingly places our child in harm’s way, while we also intuitively understand that we have to weigh risks against benefits in everything we do. We regularly drive our kids to practices and games knowing full well that people die or are severely injured in car accidents. We fly to our vacations with the understanding that occasionally planes crash. Our kids bike ride (sometimes without helmets), run around with pointed sticks, climb trees, eat unusual foods, wrestle with friends, and play dodgeball. All these things have inherent risks that we accept and try not to think too much about. So how dangerous are youth sports?
The Center for Disease Control estimates that 30 million people under 20 years old play organized sports in the United States. Safe Kids Worldwide reports that in 2013, 1.24 million of these players were seen in emergency rooms with sports-related injuries; the largest percentage, 37 percent, are players in the 13-to-15 age range. That translates into nearly 460,000 kids – a rather staggering number. However, according to Youth Sports Safety Statistics, there were only 120 sports-related injury deaths of young players in 2008, 49 in 2010, and 39 in 2011, showing that education and preventive measures have been helping, creating a reassuringly miniscule .00013 percent of players dying due to sports in 2011. In comparison, the CDC reported that 895 children ages 5-to14 were killed in car accidents in 2010 and the Insurance Institute for Highway Safety recorded 2,524 deaths for teenagers. That means that a child is far more likely to be die on the trip to a game than in the game itself, though even those numbers aren’t scary. Somehow we don’t depend on statistics basing our fear of serious injury or death during a game on stories played out in the evening news. Everything – cars, planes, bikes and sports – can be made safer, but calamity can’t be eliminated. The question is how much risk we will tolerate in various activities.
Statistics should set our minds at ease. Although the results of catastrophic injury during sports activity are tragic, they are infrequent. We do need to keep in mind that youth players (those under age 19) have less developed musculature around their rib cage and abdomen to resist hard hits, and the younger the player, the more vulnerable his or her brain is to injury. Adults fare much better. Despite their larger size and power when making contact with one another, they have the advantage of natural body protection, longer training in avoiding serious injury, and access to protective wear that has been traditionally only been available to college and professional players. In fact, most high schools don’t offer any specialized protective gear, but many schools are now providing educational programs that give parents the option to learn about and purchase protective gear choices. In fact, Brian Haugen was given this option a day prior to his accident, but that information wasn’t passed on to his parents, who stated they would have bought the gear in a heartbeat. Now the Haugens have provided 1,500 EVO Shields, also known as “rib shirts,” which protect against internal torso injuries, to high school players and hope to double that amount this year. More importantly, they are funding research at the University of West Florida (UWF) into how often serious internal injuries occur in youth players, what those outcomes were, and whether the injuries could have been mitigated or decreased in severity through preventive measures. As John Todorovich, chair of the UWF health, leisure and exercise science department states, “We now have national…concussion data, but we just don’t have the same type of information around the torso area.” Safety gear is available in all sports, but making parents aware of what’s available and getting kids to wear it can be difficult to achieve. At Robbie’s soccer game last weekend, the opposing team’s goalkeeper wore a protective head gear, which is the first I had seen at a recreational game. These aren’t regularly sold at soccer stores, so parents may not know they are available or how they protect. Likewise, kids might feel shielding equipment makes them look dorky, which is why it’s difficult to get them to wear bicycle helmets and knee and elbow pads. However, the more kids do it, the more players there will be who find it cool to follow the trend.
The unfortunate fall-out from the heavy media focus on anecdotal cases is that people see them as far more inclusive that they actually are. As a result, schools have begun to have discussions about ending football programs and other sports based on injury concerns. This alarmist approach isn’t responsible or reasonable. Certainly, if you are the parent of a child who suffers severe injury or god forbid death while playing, then the statistics just fly out the window. Nevertheless, we don’t all stop driving because we read about a fatal crash. We don’t even ban teen driving even though the clear statistics show that 15 and 16-year-olds have the highest percentage of driving accidents and fatalities. With far less disastrous outcomes in youth sports, it’s a bit surprising to see the reaction encouraging throwing the sport out. But it’s happening. Ohio football dipped from a high of 55,392 players in 2008 to 45,573 in 2013. Michigan football participation has dropped 10.5 percent since 2007, this year recording its lowest numbers since 1995. Nationally, high school football numbers have dropped 250,000 in the last five years. Individual high schools across the country have abandoned football for fears of injury and under pressure from parents who encourage their children to choose less “dangerous” sports. Soccer has substituted for these programs including being the center stage for homecoming celebrations. However, as football declines and soccer increases, so too will the concerns about injuries suffered by soccer players. In a decade, we may see the same arguments being put forth for the dissolution of soccer as has been forwarded for football. For example, concussion risk among female athletes is highest in soccer with 6.7 incidents per 10,000 athletes. Soccer is also where the highest incident of ACL injuries occur among females, which are not life-threatening, but can be career-ending.
Interestingly, another reason for abandoning some contact sports is a fear of lawsuits. Despite the Illinois High School Association (IHSA) being hit with a concussion lawsuit this year, only one high school football program has dropped out, but if the IHSA lose, it may be more inclined to reduce football state-wide. The lawsuit charges that the IHSA didn’t do enough to protect players from concussion, and the next court hearing is set for Oct. 16. Statistics on injuries will play a large part in how the case is decided. It will be interesting to see how the court rules concerning the IHSA’s responsibility, if any, in concussions suffered by players. As schools come under threat of lawsuits, they do a cost benefit analysis and decide to eliminate the things that lead to suits, primarily contact sports such as football, soccer, rugby and hockey. Naturally, there are risks to playing sports, and some of those risks are serious, though occur minimally. However, it may be more cost-effective to institute greater safety precautions and provide safety equipment which reduce injury. Schools may choose to require headgear for soccer players and rib shirts for football players. Coaches and trainers will need to be up to date on protocols not only for concussions but also for internal injuries, being able to detect the symptoms and severity of those damages. When a child is hit in the chest by a fast pitched ball and his heart is ruptured, he might have been saved by a “heart guard” which is a pad many leagues are now requiring baseball players to wear. However, the more protection that is available, the more parents may believe that their player can avoid injury. So when a child dies or gets a catastrophic body blow, the parents want to sue, believing the school or league could have done more to protect them.
The truth is that no magic solution exists. Injuries and fatalities will occur in cars, sports and household accidents. Unless we envelope our kids in bubble wrap, tie them to a feather bed, and keep them isolated from all germs and bacteria, we can’t protect them from everything. It’s good for them to get out and play, and parents can continue to educate ourselves on ways to make that play safer, though never free of risk.