Concussions in children are a public health issue, but preventable by instituting game and rule changes that eliminate head contact, Canadian doctors say.
"Our children should have the right to play at all levels of skill in an environment without fear of brain injury from intentional 'win at all costs' violence, or unrecognized repetitive trauma," say Dr. Ross Upshur of the Dalla Lana School of Public Health at the University of Toronto and Dr. Paul Echlin of Elliott Sports Medicine Clinic in Burlington, Ont., in a commentary titled "Sport-related minor traumatic brain injury: A public health ethical imperative to act."
The commentary appeared Wednesday in Neurosurgeon, an online publication of the American Association of Neurological Surgeons, on Wednesday.
Previous studies suggest concussions represent 5.5 per cent to 22 per cent of all high school athletic injuries.
In Canada, two studies of young adult hockey players suggested that mild traumatic brain injury were three to seven times higher compared to published evidence by age, sex and skill level.
Upshur and Echlin advocate for minor traumatic brain injury or concussions to be viewed as a public health issue, instead of strictly an educational one that focused on better training for coaches or a research issue geared towards better understanding.
Making concussions a public health issue would lead to precautionary steps to prevent further injury, they said.
They also suggest:
- Game and rule structure changes to eliminate intentional head contact.
- Minimizing incidental head contact in all children's sports.
- Increasing the size of playing surfaces.
- Decreasing the number of participants on the field of play.
- Considering eliminating the use of the head in games like soccer.
- Enforcing significant suspensions to participants or supervising adults in games in which head injuries occur.
"There's no helmets, or mouth guards or safety devices that can change this; it is about a shift in the way that we allow our youth to play games," Echlin said.
The commentary also recommends publicly funded education programs on concussions for young athletes, parents and educators.
Alison Macpherson, an assistant professor of kinesiology and health sciences at York University in Toronto, agreed that action is needed to prevent sports-related concussions among children and youth. But she urged parents not to pull their children from sports altogether, because they play a big role in healthy development.
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