Concussions in sports have taken up a majority of injury related headlines in the last decade or so and in the explosive entertainment industry that is professional sports. As the dangers and risks of concussions become more apparent, we more frequently find new and novel devices being sold in sporting goods stores that claim to prevent or reduce concussions. But how do .

we reduce concussions, if first we don’t educate people on what a concussion really is?

            A concussion is a form of traumatic brain injury typically suffered following an impact or whipping motion that results in a forceful impact on the brain itself. Concussions can happen a number of ways and in a number of sports, but according to an article published in The Journal of Pediatric medicine by Kerr et al looking at the highest rates of concussions, specifically in high school sports, the top 3 were: boys’ football, girls’ soccer and boys’ hockey. In the study, the three sports had rates of 10.4, 8.19 and 7.69 concussions per 10,000 athletes. Also, the study found that 63.7% of all of sport related concussions happened during competitions rather than during practices.

            So now the question is, what do we make of these staggering numbers and how do we prevent concussions in sports from happening? While the number of concussions reported has caused some parents and youth athletes to be removed from a dangerous sport in their entirety, it’s unfeasible to ban sports all together, especially with the profit sports tend to bring to their respective communities. Another option has been to change rules of certain sports to prevent concussions from happening. The US Soccer Federation has placed a ban on players under the age of 11 using their head during games in an attempt to decrease the amount of trauma on children and their developing brains. The NFL has recently made changes to kick-off rules as well as becoming more stringent as far as penalizing players for dangerous hits involving the helmet or the head.  While changing rules is effective to a point, in some cases concussions or head trauma can be impossible to avoid. So, what other preventative measures can be performed in order to decrease the likelihood of a concussion? Many experts have many differing opinions as far as how to avoid concussions. A review by Schneider et al, published in the British Medical Journal, looked at novel devices such as mouth guards, helmets stated to decrease concussions and even concussion preventative programs to see if any were effective in preventing concussions. Not a single device or piece of equipment was effective in preventing concussions in the athletes, but the study found that their true effectiveness was in preventing superficial head injuries. Another study performed on high school athletes by Collins et al, found increased neck strength to be indicative of decreased risk of concussions and suggested implementations of exercises for athletes in order to increase the size of neck musculature. This article and its findings have been subject to controversy, as other studies have called into question the effectiveness of increasing neck strength. These other studies have suggested that instead of increasing neck strength, athletes should focus on increasing the reaction time of their neck musculature in order to avoid harmful impacts to their heads (Eckersley et al). A study in the American Journal of Sports Medicine describes that athletes with necks that display more stiffness and rigidity following a push or a shove actually had increased resistance to concussive forces, rather than overall neck strength. 

So, what does this all mean for our athletes? For now, we must take a knowledgeable and cumulative approach to prevention of concussions. While research still needs to be performed in order to determine exactly what steps organizations and schools should take in order to avoid concussions and their long-term effects, we should combine what we do know in order to help our high school athletes. While concussion specific protective equipment may not have shown a prevalence for decreasing concussions, the proper use and fit of protective equipment is vital in protecting the athlete. Athletes should also strengthen areas surrounding the head and neck as well as practice avoiding traumatic collisions involving the head or neck area. In the instance that a traumatic hit does occur, athletes need to be informed on the urgency of the situation and athletic trainers and coaches should be informed on the best way to approach the athletes and the appropriate steps to take next. 

Deven Pfister, SPT

Dr.Brandon Cruz PT,DPT

Board Certified in Orthopedics

Board Certified in Sports

Fellow American Academy Orthopedic Manual Physical Therapy 

Certified Strength & Conditioning Specialist

References: 

Collins, C. L., Fletcher, E. N., Fields, S. K., Kluchurosky, L., Rohrkemper, M. K., Comstock, R. D., & Cantu, R. C. (2014). Neck strength: a protective factor reducing risk for concussion in high school sports. The journal of primary prevention, 35(5), 309-319.

Eckersley, C. P., Nightingale, R. W., Luck, J. F., & Bass, C. R. (2019). The role of cervical muscles in mitigating concussion. Journal of science and medicine in sport, 22(6), 667-671.

Kerr, Z. Y., Chandran, A., Nedimyer, A. K., Arakkal, A., Pierpoint, L. A., & Zuckerman, S. L. (2019). Concussion incidence and trends in 20 high school sports. Pediatrics, 144(5).

Schmidt, J. D., Guskiewicz, K. M., Blackburn, J. T., Mihalik, J. P., Siegmund, G. P., & Marshall, S. W. (2014). The influence of cervical muscle characteristics on head impact biomechanics in football. The American journal of sports medicine, 42(9), 2056-2066.

Schneider, D. K., Grandhi, R. K., Bansal, P., Kuntz, G. E., Webster, K. E., Logan, K., ... & Myer, G. D. (2017). Current state of concussion prevention strategies: a systematic review and meta-analysis of prospective, controlled studies. British journal of sports medicine, 51(20), 1473-1482.