NEW YORK (Reuters Health) - High school football players have more than three-times the risk of having a catastrophic head injury compared with players at the college level, a new study shows.
While the injuries are rare, with about seven occurring in US high school and college players every year, the analysis revealed that 39 percent of the athletes injured were playing with neurological symptoms from a previous head injury, “an unacceptably high percentage,” Dr. Barry P. Boden of The Orthopaedic Center in Rockville, Maryland and colleagues write in the American Journal of Sports Medicine.
Boden’s group defined catastrophic head injuries as injuries resulting in death, permanent disability or serious injuries without permanent disability. All of the head injuries were considered “direct,” a result of participation in the sport, rather than “indirect,” not associated with systemic failure secondary to exertion during the game.
“The bottom line is that I think we need to be a little bit more careful with these younger athletes,” Boden told Reuters Health. “I think they need more attention, and I think concussions need to be taken more seriously so that these players aren’t going on to have a more serious injury.”
Boden and his team reviewed a series of 94 cases reported to the National Center for Catastrophic Sports Injury Research between September 1989 and June 2002. There were 0.67 injuries per 100,000 high school football players, and 0.21 per 100,000 college players.
Among the 54 cases for which the researchers were able to gather detailed information, 59 percent had suffered a previous head injury, with 71 percent of these injuries occurring in the same season that the catastrophic injury occurred. And in 39 percent of cases, the athletes were playing with symptoms from these injuries.
There are several possible reasons behind the increased rate of injury seen among high school players, Boden continued. College players have much more medical supervision on the field, he noted, and younger players’ brains seem to be more vulnerable to damage, possibly due to blood vessels tearing more easily or because of thinner skulls.
Awareness is growing about the long-term consequences of concussions, which appear also to increase a person’s vulnerability to future head injuries, Boden added.
Given the “tough it out,” “macho” ethic of football, he said, many players may be encouraged to return to the field without having fully recovered from a head injury.
Parents of young players should be aware of the symptoms of concussion, and be sure their child gets appropriate care, Boden said. And to players he advises: “If you have a concussion, you need to get medical treatment, and you shouldn’t be playing football.”
SOURCE: American Journal of Sports Medicine, July 2007.