What Can be Done to Prevent Youth Level Concussion In Sports?

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There are over 3,000 results highlighted in a Google search into the research and studies dealing with concussion in a collision sport, with rugby being the main focus sport. A good portion of these results deals with youth incidents and the the effects of serious head knocks.

These research papers have been written by people far smarter than me with expertise in the fields of neurosurgery and brain trauma. From reading some of these findings, parents have every right to feel as though things could be better when faced with the potential of a life altering injury, be it soft tissue, bone or brain trauma.

Rugby is a popular sport and a religion to many, so it isn’t surprising that a good majority of young people want to play the game. But is it safe? Rugby, by its very nature, is a dangerous game if not administered properly and with professional support systems.

I had written and article in October 2014 that suggested that we begin to coach the youth the proper technique early in their introduction to sport, as it would lead to better prepared players in the future. I still believe in this approach but with new evidence and further research, I now would back such an argument with better support from sideline officials. Better coaches at school grade level are the key to a safe and successful season but for them to do their jobs, they need to have the resources and tools to keep their players safe. Unfortunately, not all injuries can be prevented but they can be detected and assessed properly and have the correct and adequate care given.

In the studies conducted by Australian universities and shared with other research institutes, it has been concluded that the current equipment approved by World Rugby (formerly IRB) isn’t sufficient enough to protect against injury, specifically head knocks. Field studies of the effectiveness of headgear concluded that wearing said equipment doesn’t prevent concussion compared to a player without the headgear. Personally I wore one to avoid scarred and disfigured ears knowing full well that I could suffer a concussion. In fact, studies have suggested that wearing headgear may be more harmful as players suffer from a phenomenon called “risk compensation” (Andrew McIntosh PhD, et al, University of New South Wales, 2007). This phenomenon could actually increase the injury rate. Up to 15% of rugby injuries occur within the head region with most of them being concussion related which begs the question of how to reduce these type of injuries in youth rugby.

As I said before, correct coaching needs to be at the forefront of the change, but there are other factors that can contribute to the safety of players. Regardless of how well a player is coached, when a 60kg 15-year old has to tackle a 80+kg player in the opposing team, things can get a little worrying. It is regarded as fact that people from different ethnic backgrounds develop at different rates so it is possible to have a large spectrum of sizes within the same age range. This is where some imaginative thinking needs to be applied. There are some unions and countries that already apply a weight limitation on youth leagues with New Zealand and Scotland both having guidelines that are quoted on the World Rugby website.

This approach to youth rugby can help prevent physical injury and reduce the likelihood of concussion, but head knocks can still happen, regardless of weight and size. It has been found that scrum caps do little to prevent concussion as they are only a layer of polyethylene. This does not reduce the impact on the head.

One alternative is to wear hard shell helmets as the NFL players do, but again the studies of concussions in the NFL have cited that helmets do not prevent brain trauma and in fact the studies done on former players created a massive fallout of litigation and rule changes. Another piece of equipment that is used in the belief of preventing concussion is the mouthguard.

The studies of concussion prevention using the mouthguard have concluded that wearing such a piece will not reduce brain injury. It will however protect teeth and lacerations around the mouth but studies that have been conducted so far regarding concussion haven’t proven that it could be reduced.

Personally I never took to the field without wearing a mouthguard. It is clear that more research and studies need to be conducted to find better solutions to protect players without completely transforming the game’s ethos. Even with hardened equipment, head injuries occur which leads to the point of proper techniques that should be coached.

One of the first techniques that I was ever taught as a young player was proper head placement in a tackle and contact areas. Techniques were coached first and foremost but things have changed in the past 20 years and now a support network needs to be in place. Coaches and the supporting staff need to be trained and kept up to date with current studies and many unions now have smart rugby programs that can be done online. They can further their understanding more by attending coaching clinics and workshops held by World Rugby representatives. This type of knowledge is also very important for match officials as the referee has to control the game and would need to be able to identify a dangerous situation before it happens.

The referee has a very important role in the safety of the game and having inadequate referees on the field is equally as dangerous as having improper coaching. With this knowledge that they would acquire, coaches and referees can identify any dangerous situation and act upon it before serious consequences happen.

If the unfortunate situation of an injury occurs, the sideline staff need to be trained well in the treatment of injuries. In my school days, we always had an ambulance service at the grounds so that any injury that did occur, an emergency technician was on hand to assess and treat injuries including concussions. Unfortunately, not all schools or age grade games have this option, so it is up to the sideline staff to be trained in injury assessment and have the tools to treat known injuries. Another study that was conducted involving parents and looked at their knowledge of what a concussion is and how to treat it. (S John Sullivan PhD et al, Clinical Journal of Sports Medicine, 2009). A majority of parents understood concussions and the risks but lacked follow up knowledge of the injury.

If a parent has a child that plays a collision sport, they too should take the responsibility to understand and learn about the potential injuries and any follow up treatment that relates to injuries. At this time, there is no sure way to prevent injuries on the field of play unless a parent completely withdraws their child from the activity, but as long as children play the game of rugby, the schools and clubs, the coaches and support staff, and parents need to all be aware of what needs to be done to create a safer playing environment. Whether it be to contribute to a fund that would allow medical technicians to be present at games or funds to send coaches to clinics and workshops or attending lectures, there are many ways that we all can prepare ourselves.