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"Youth football has never been safer," concussion expert says
By Greg Bach
A renowned concussion expert has a message for parents: “Youth football has never been safer,” says Dr. Joseph Maroon, who has been the team neurosurgeon for the Pittsburgh Steelers since 1981 and is the vice chairman of the Department of Neurological Surgery at the University of Pittsburgh Medical Center.
Earlier this year Maroon and Dr. Julian Bailes, Jr., a founding member and director of the Brain Injury Research Institute, authored an editorial in the Washington Times (you can read it HERE) in which they wrote:
The incidence and severity of brain injury is one of the hottest topics in sports media today, and it is creating a storm of near-panic in youth sports — especially football. We worry that the public’s misunderstanding of the available medical research is the gravest threat facing organized contact sport at the youth and high school levels.
SportingKid Live caught up with Maroon, a leading neurosurgeon, sports medicine expert, author, Ironman triathlete and mountain climber (he scaled Mount Kilimanjaro last year while serving as the medical advisor on a special trip featuring 10 amputees) to get his insights on the serious and complex issue of concussions in youth sports:
SKL: It’s confusing to read all the studies and research floating around regarding concussions. Is it safe for kids to step on the football field?
MAROON: There’s so much hyperbole about this. Youth sports have never been safer in terms of prevention and management. This was in the New England Journal of Medicine: The No. 1 cause of concussions and head injuries of kids between ages 6 and 14 is automobiles; No. 2 is bicycle riding; No. 3 is playgrounds; and No. 4 is self-propelled scooters. These form at least a third of all head injuries in kids. Should we eliminate bikes? Should we eliminate scooters? Should we keep kids off of playgrounds? These are much more dangerous venues in terms of serious injuries than football fields.
SKL: Should parents be afraid of the studies coming out regarding Chronic Traumatic Encephalopathy (CTE)?
MAROON: It’s not justified. If you start with the proposition that it’s bad to get hit in the head as a kid, or at any age, you can’t deny that. It’s like being in court – do you believe that getting hit in the head can cause problems? Yes. What’s happening though is some are extrapolating the findings of CTE which was first recognized in about 1954 in boxers. In football it was recognized in 2002 and in the last 13 years there have been approximately 70 football players that have been diagnosed with this. There is, however, a selection bias here. How many people have played football over the course of the last 40-50 years? You’re talking about 50 to 70 million that participated in football at all levels and there are 70 reported cases of this and almost all in the pros.
SKL: Why are you so passionate about this?
MAROON: I’m a very big proponent of the value of sports. I wouldn’t be talking to you if I hadn’t played youth football. (Maroon played college football at Indiana University and was a Scholastic All-American.) I’ve spent most of my career trying to prevent head and neck injuries in athletes; I’ve seen the benefits of sports. I’ve seen the incredible development of character, of leadership, of teamwork; it’s affected my whole life. I’ve written many peer-reviewed papers on this subject in terms of athletic injuries and how to prevent head and neck injuries in all sports, and how to diagnose concussions. It’s been a major professional and personal commitment.
To see what is happening with obesity in this country in kids, and the incidence of diabetes and hypertension, and we’re talking about the fear of CTE, which is rare when one considers the number of participants. And when I read what is being propagated with at times poor science it disturbs me. It’s bad for kids, it’s bad for sports.
SKL: More than 20 years ago you and Dr. Mark Lovell developed ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) to assess the presence and severity of concussion symptoms. How did that idea evolve and how effective has it been?
MAROON: We developed this test when (Steelers head coach) Chuck Noll told me that if I wanted to keep someone from playing football and keep him out of the game he wanted objective data, not just a regular exam. ImPACT™ is now the standard of care in the United States and we have baselined over 11 million kids over the years.
SKL: Does football get more dangerous as the kids get older?
MAROON: I think that youth football is clearly the safest. The forces generated at the high school, college and pro level are certainly much greater. I think that the fear of concussions is understandable but I think the key is prevention; and No. 2, proper management when they do occur. Should parents be concerned? Yes. They should not only be concerned, they should be involved. What I mean by that is that almost all states have passed the Lystedt law where coaches, parents and trainers need to be educated on concussions, what they are and how they are to be managed.
Editor’s note: The Lystedt Law was first passed in Washington in 2009. It’s named after Zack Lystedt, who as a 13-year-old suffered a debilitating brain injury because his concussion wasn’t properly detected or treated. He underwent two emergency surgeries after collapsing during a middle school football game. He was hospitalized the next three months and has spent years in physical therapy that continues to this day. The law requires that athletes under the age of 18 who are suspected of having sustained a concussion are removed from practice or a game and not allowed to return until cleared by a medical professional. The law also requires coaches to receive education about concussion symptoms and for athletes and parents to sign a concussion information form.
SKL: What’s your message to parents and volunteer coaches?
MAROON: My message is we are absolutely focused on safety and preventing concussions by proper coaching, proper techniques and being aware of concussions. And then if a concussion does occur the critical thing is that it is being managed properly from the onset. The kids don’t return to the game, they don’t return to play, and they are managed properly. We must not lose sight of the physical, mental and social benefits of organized sports and continue to make it even safer.
A child’s first coach wields enormous influence and can be the difference between a child loving – or leaving – the sport. Just ask Prim Siripipat, whose love of tennis was forged by an incredibly supportive and caring coach
She excelled on the basketball courts and soccer fields of her youth, and the lessons learned all the way through her collegiate playing days are used often in the high-pressure world of live television
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