It’s September, which means youth, high school, collegiate, and professional football are all in full swing, and there have been two publications regarding concussions. One from the Centers for Disease Control and Prevention, and the other from the Aspen Institute, a non-profit organization.
Earlier this month, the CDC published their “Guidelines on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.” The purpose of the paper was to “provide a guideline based on previous systematic review of the literature…toward developing clinical recommendations for health care professionals.” While the other publication by the Aspen Institute, published in the Wall Street Journal, highlighted the recommendation for children to avoid tackle football before age 14, focusing on flag football instead.
What the CDC Has to Say
Within the CDC guidelines are 19 recommendations regarding diagnosis and management of mTBI (Mild Traumatic Brain Injury, aka concussion). These include recommendations against routine use of CT, skull/facial X-rays or MRI in the evaluation unless and intra-cerebral injury is suspected, as well as the use of blood biomarkers. They also share guidelines for using validated neuropsychological testing tools, gradual exertional protocols, gradual return to school, and proper sleep hygiene.
Leaning into Flag Football
The Aspen Institutes’ paper, compiled from discussions with panelists, including retired NFL players, Dr. Robert Cantu, football coaches, and Dr. Andrew Peterson from the American Academy of Pediatrics and current research data, concentrated on a transition of starting tackle football at age 14. Similar to USA Hockey’s non-checking leagues for younger players, providing the opportunity for children to play flag football longer, allows them to learn the game and the skills needed without repetitive contact, which may be beneficial in the long term.
As a sports medicine physician, sports-related concussions have been a growing part of my practice. I have seen the spectrum of injury from the young motocross rider at age 7 to the weekend mountain biker to the collegiate athlete. I realize this is a controversial topic with some parents minimally concerned and others very concerned about the potential risk of early repetitive trauma.
It’s good to stay informed on the topic and understand there is inherent risk with any sport. If our goal is to protect the next generation, it’s the appropriate diagnosis, evaluation, and safe return-to-sport that is the foundation of sport-related concussion treatment. So, if you feel like you or your child has suffered from a concussion, please have them evaluated and talk to your doctor about the best plan to move forward.