With media attention focused on the brains of former hockey players, the impact that sports can have on mental health is back in the limelight. But most of that attention has been focused on one segment of the at-risk population: boys.
In fact, when you control for the type of sport and the amount of time played, girls get more concussions than boys do, said Nicole LaVoi, associate director of the University of Minnesota's Tucker Center for Research on Girls and Women in Sports. Because boys play concussion-prone sports in greater numbers than girls, the number of concussions is still far greater for boys.
The point, the researchers say, is that everyone is vulnerable.
"Boys and girls are much more similar than they are different," LaVoi said. "We must protect both."
Besides not participating, there's no easy way to do that. But LaVoi and Diane Wiese-Bjornstal, associate professor of sport and exercise psychology at the U and a mother of two athletes, have studied the issue extensively.
Signs and symptoms. "A lot of primary-care physicians are not concussion experts," LaVoi said. "Parents take their kids to the doctor, and the doctor says they're just fine -- and sometimes it turns out they weren't. You need to go to a neurologist or somebody trained in concussions, but a lot of parents don't think about that."
Parents, players, coaches and teachers should be educated about the symptoms of concussions -- and be willing to report them. A state law went into effect this past fall that requires all coaches to undergo concussion education and ensure that information about concussions is available to athletes and parents. It also mandates that coaches sideline athletes who show signs of concussion until they get a medical OK to return to play.
Impact test: Online baseline concussion tests, taken before a concussion occurs, can be helpful in determining whether a concussion has taken place and helpful in evaluating when an athlete should return to play. In Minnesota, no one is yet requiring the test, although some leagues offer them, said Lori Glover, community sports medicine director for the Institute for Athletic Medicine.
Sportsmanship: Since a significantly higher percentage of concussions and head injuries result from illegal play, "officiating and enforcement become really important for prevention," Wiese-Bjornstal said.
Rule changes: "Heading is a risk factor for long-term cognitive function," Wiese-Bjornstal said. "Soccer purists tell me that it fundamentally changes the game. I would not hesitate to give it up personally." Raising the age for checking in boys' hockey helps, too.
Practice quality: At St. John's University in Collegeville, Minn., coach John Gagliardi runs practices where tackling is not allowed. He is the winningest football coach in history. "He proved that you don't have to sacrifice the wins," Wiese-Bjornstal said. "Instead of relying on sheer volume, focus on five quality touches." The accumulation of hits has been shown to be a risk factor of cognitive function.
Protective gear: So far, protective gear hasn't been shown to prevent concussions. Helmets can help prevent head and skull injuries, but concussions often occur from the snapping of the head, Wiese-Bjornstal said. Improvements could eventually play more of a role, however.
In the end, parents have to decide what's best for their kids.
"I haven't gotten to the point where I don't let him play [soccer]," Wiese-Bjornstal said about her son. "I'm educated; I know what to do if he's acting strangely or complaining about fatigue or nausea. And we tried to get him good technique coaching. I'm not usually a nervous mother, but I'm a nervous mother about the heading."
Sheila Mulrooney Eldred is a Twin Cities freelance writer.