Concussions in NFL players have caused a major shift in rules and safety standards for California school sports. Now, the state’s doctors are changing the way they care for student athletes after hard blows to the head.
This month the U.S. Centers for Disease Control and Prevention released new federal guidelines for youth traumatic brain injury. They recommend fewer brain scans, more tailored questions about symptoms and longer talks with families about when —- if at all —- patients should return to sports.
Physicians from the University of California, Los Angeles who helped write those guidelines said it’s an overdue document, and that children have long been overlooked in concussion research. That’s despite the fact that kids are more likely to receive hard hits, and less likely to properly manage their recovery, said Dr. Chris Giza, a pediatric neurologist at UCLA.
“A lot of the focus has not been on children,” he said. “And it’s important because they’re at particular risk, and we have an obligation as a society to make sure they meet their potential.”
Youth sports concussions have been a growing concern for parents in recent years, as aging NFL players revealed the long-term effects of blows to the head. After examining the brains of deceased players, UC Davis pathologist Dr. Bennet Omalu discovered Chronic Traumatic Encephalopathy, a disorder that impairs memory and motor function. It occurs when blows to the head over time damage protein tangles in the brain. That research was the focus of the 2015 film Concussion, in which Will Smith starred as Omalu.
When it comes to child concussion risk, it varies by sport. Research over the past decade has shown that boys are most likely to incur concussions in football, ice hockey, lacrosse, wrestling and soccer, while girls are most at risk while playing soccer, lacrosse and basketball.
The increased awareness spurred a 2016 California law requiring sports coaches to be trained spot concussions. The law also details the how long a student athlete must rest before returning to school, light physical activity, and game play.
And doctors say they've seen an influx of student athlete patients since then. Because of that, Giza said it’s important to have consistent guidelines for treating these injuries.
“So that clinical care providers who are actually taking care of these patients can do something,” he said. “Not just white coat research in the ivory tower.”
He said recent concussion science has changed the thinking around how children should recover from a hard hit. Doctors are moving away from prescribing “brain rest” — keeping children out of school and in dark, quiet places — to letting children do focused tasks and light exercise within a few days of an injury.
“They should gradually ease back into safe activities,” he said. “I always say no one has ever gotten a concussion from doing homework.”
The guidelines also include tips for doctors about how to ask children about concussions, because they often have trouble accurately describing their symptoms to doctors. He said a concussion test is on the horizon, and could change the game for diagnosing these injuries.