High school sports and brain injuries

In recent years, we've heard a great deal about brain injuries in sports, particularly among children. So it might come as a surprise to learn that we know next to nothing about exactly how those injuries are caused.

This is precisely what neurosurgeon Michael Cusimano and his colleagues at St. Michael's Hospital in Toronto are trying to do. In a study published in the current issue of the open access journal PROS One, they used data from the Canadian Hospital Injury Reporting and Prevention Program to determine the cause of brain injuries among 5- to 19-year-olds playing ice hockey, soccer, football, basketball, baseball and rugby between 1990 and 2009.

And about one-third of all brain injuries in hockey occurred from being checked into the boards, while another 10 percent resulted from being checked from behind.

It suggests that we must seriously consider the advisability of any form of body checking, particularly among younger children.

Physical contact was also the primary cause of injuries in soccer, though the form of contact was somewhat different.

In many cases, head-to-head collisions produced brain injuries, while in others, injuries occurred as a result of being kicked in the head. Hence the authors note that greater efforts to reduce contact and stricter penalties for high kicks might help to reduce soccer-related brain injuries.

Contact-based injuries were also common in football, basketball and rugby, but contact with fixed structures such as goalposts or backboards were also common in football and basketball.

And in baseball, the most common cause of brain injuries was being hit by an implement -- either a baseball or a bat.

It's clear, therefore, that different sports need to be targeted in different ways.

For example, ensuring padded and mobile fixed structures, along with reduced contact, might be beneficial in football, basketball and rugby, while enforcing no-stand zones and the possible use of helmets might help in baseball.

But Cusimano and his colleagues also suggest one thing should help with all sports: education. The authors suggest that sport-specific education be aimed at players, coaches, trainers, officials and parents at all levels. Among other things, this could help to increase support for rule changes, something that is sorely needed.

Finally, Cusimano and his colleagues suggest that independent bodies monitor rates of brain injury and efficacy of our efforts to reduce those rates.

Clearly, then, reducing brain injuries will require a multi-faceted approach.

-- The Vancouver Sun