As temperatures rise, so do the number of head injuries, including traumatic brain injury and concussion, head lacerations, and skull fractures.

Weeks of vacation and sultry weather make outdoor sports more popular, and whenever people get active, there are bound to be injuries. This week, the American Association of Neurological Surgeons (AANS) issued a reminder to enjoy summertime sports safely.

Over a one-year period from 2008 to 2009, the numbers of head injuries rose for nearly every sport (the single exception: Trampoline!). Heading the list (pun intended) are bicycling, water sports, baseball and softball. Cyclists suffered the most head injuries–more than 85,000 were reported in a single year, up from about 71,000. And the number water-related head injuries more than doubled, from 11,200 to than 28,700.

“By taking a minute or two to use your head, you can help prevent potentially life-altering and tragic consequences,” Dr. Gail Rosseau, a Chicago-area neurosurgeon and AANS spokeswoman, said in an association news release.

Surprising and Preventable Causes

When it comes to cycling, the AANS reports that at least part of the blame for the increase in injuries comes from–get this: use of cell phones! “Sidetracked cycling” is is as dangerous as “distracted driving.”

The AANS offers the following safety recommendations:

• To prevent biking accidents, the organization encourages riders to use helmets, obey traffic signals, avoid uneven surfaces, wear bright colors and reflectors at night, and avoid cell phone use.
• To increase water safety, AANS advocates for adult supervision of young children, careful diving in conjunction with accurate water-depth information, keeping gates locked around backyard pools, avoiding alcohol consumption during water-related activities, following posted instructions at public places, and enforcing a strict ban on potentially dangerous rough play.

And don’t forget that using cell phones while supervising young children around swimming pools could also be dangerous. If attention is needed, give attention. Of course, if you’re a glass-is-half-full kind of person, you could take the AANS report as a license to turn off the cell phone and enjoy your time outdoors. Summer, sports, and safety–that’s having it all!

Concussion is finally gaining respect as a serious injury. Doctors have begun calling it “mild traumatic brain injury,” which more fully and accurately defines what concussion really is. High schools and high school sports organizations have begun setting more stringent standards for evaluating a student athlete after a head injury–no matter how minor the injury may initially seem to be. And doctors are weighing in with guidelines for when the injured athlete can return to play.

This week, a press release from C.S. Mott Children’s Hospital (part of the University of Michigan Health System) reports on a recent poll, and talks about the next step in recognizing concussions: parents.

According to the article, two-thirds of parents of young athletes worry that their children will get a concussion while playing school sports, but 50% don’t know if their children’s school has a concussion policy. One-third of parents are unaware of the dangers of repeated concussions, which can include permanent brain injury, early dementia, or even death.

Experts believe that a young athlete who suffers a concussion should not return to play for at least two weeks, and some brain injury specialists believe that injured players should sit on the sidelines for three full months to give the brain a chance to heal.

It can be difficult to diagnose a potential concussion on the field. Contrary to popular belief, most concussions do not result in a loss of consciousness…and symptoms may not occur for several hours after the injury. Young athletes may not recognize that they are hurt, or they may be afraid to mention symptoms for fear of losing playing time or of disappointing a coach or a parent.

What parents should know

Parent involvement in guarding against repeat concussions is critical.  Any time you suspect that your child has received a head injury, watch for these common signs and symptoms of concussion:

• confusion
• loss of memory (amnesia)
• headache
• dizziness
• a sensation of the world spinning (vertigo)
• imbalance
• lack of awareness of surroundings
• nausea and vomiting

If these symptoms appear after a head injury, consult a medical professional promptly for a full evaluation. Don’t allow a coach to pressure your child into playing before he or she has recovered. When in doubt, talk with a doctor.

For more information, click here:   “Concussion in Sports” from the Centers for Disease Control and Prevention (CDC)

To read the full C.S. Mott Children’s Hospital press release, click here: “Parents Ill-Prepared to Reduce Kids’ Concussions Risks”

If you have legal questions about concussion and brain injury, go to the HensonFuerst dedicated Brain Injury page. At HensonFuerst, if you have questions, we have answers.

For girls and young women, one sport accounts for more than 65% of of all high school catastrophic injuries, and more than 70% of all collegiate catastrophic injuries. (For the record, “catastrophic injuries” are life changing events, including traumatic brain injury, paralysis, and death.)  Less severe injuries are also common–each year, this sport sends more than 25,000 female students to hospital emergency rooms.

The sport?  Cheerleading.  And compounding the tragedy of injury is the fact that only 20-25 states list high school cheerleading as a sport… the NCAA doesn’t recognize cheering as a championship sport… and unless the number has changed since December 2009, only 3 colleges consider cheering a sport–none in North Carolina. (Statistics from Journal of Athletic Training 2009)

Call a Sport a Sport.

While “recognition” might seem like a minor point, it has major ramifications for safety.  A “sport,” performed competitively and for entertainment, requires strict guidelines to ensure the safety of athletes. In 1980, when cheering was still primarily about leading the crowd in cheers, there were fewer than 5,000 emergency room visits. Today, cheering involves highly skilled gymnastics (as well as being tossed in the air and trusting that someone will be there to catch you).

Without the sanction of being a sport, cheerleaders often have to practice in areas that make injuries more likely, such as an asphalt parking lot or a team member’s backyard.  A “sport” requires coaches to have a certain level of training and certification; a “sport” puts limits on the risks required of the participants; and a “sport” makes training and safety an integral part of practice and performance. Unfortunately, in most schools, cheering lacks safety, limits, and trained coaches.

Gimme an A-C-T-I-O-N.

One of cheering biggest and most vocal supporters is Frederick O. Mueller, Ph.D., Director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill (UNC-CH). The group’s 26th annual report devotes a special section to cheerleading injuries, which describes the current state of cheering as a sport, details specific catastrophic injuries and how they occurred, and suggests sample guidelines that could help prevent cheerleading injuries. As quoted from the report (available here):

“Is cheerleading an activity that leads the spectators in cheers or is it a sport? If the answer is to entertain the crowd and to be in competition with other cheerleading squads, then there must be safety guidelines initiated. The authors of this research question why it is called cheerleading, when competitive cheer has nothing to do with leading the crowds at athletic events in cheering for the athletic teams on the playing field. Following are a list of sample guidelines that may help prevent cheerleading injuries:

1. Cheerleaders should have medical examinations before they are allowed to participate. Included would be a complete medical history.
2. Cheerleaders should be trained by a qualified coach with training in gymnastics and partner stunting. This person should also be trained in the proper methods for spotting and other safety factors.
3. Cheerleaders should be exposed to proper conditioning programs and trained in proper spotting techniques.
4. Cheerleaders should receive proper training before attempting gymnastic and partner type stunts and should not attempt stunts they are not capable of completing. A qualification system demonstrating mastery of stunts is recommended.
5. Coaches should supervise all practice sessions in a safe facility.
6. Mini-trampolines and flips or falls off of pyramids and shoulders should be prohibited.
7. Pyramids over two high should not be performed. Two high pyramids should not be performed without mats and other safety precautions.
8. If it is not possible to have a physician or certified athletic trainer at games and practice sessions, emergency procedures must be provided. The emergency procedure should be in writing and available to all staff and athletes.
9. There should be continued research concerning safety in cheerleading.
10. When a cheerleader has experienced or shown signs of head trauma (loss of consciousness, visual disturbances, headache, inability to walk correctly, obvious disorientation, memory loss) she/he should receive immediate medical attention and should not be allowed to practice or cheer without permission from a physician.
11. Cheerleading coaches should have some type of safety certification. The American Association of Cheerleading Coaches and Advisors offers this certification.
12. The NFHS should make cheerleading a sport, which will place cheerleading under the same restrictions and safety rules as all other high school sports. The NCAA should follow this same recommendation.”

HensonFuerst commends the research and activist efforts of Dr. Mueller and his team. We represent the interests of far too many children and young adults whose lives have been shattered due to head trauma or other catastrophic injury. There are few things in life as heartbreaking as broken potential. We agree that it is time to let recognition and regulations catch up to this fast-moving, physically demanding sport. Yes, sport. Let’s at least make an effort to stop the hemorrhage of young, enthusiastic lives.

To report a cheerleading injury to make statistical reporting more accurate, go to www.cheerinjuryreport.com, sponsored by the National Cheer Safety Foundation. For more information about traumatic brain injury, or to request a legal consultation for a cheer injury, visit our dedicated web page. If you have questions, HensonFuerst has answers.

(Related and interesting articles can be found here: Flying without a net: Cheer injuries on rise. MSNBC and Cheerleading is leading cause of catastrophic injury in young women, ScienceDaily.)

Young athletes are suffering more and more sports injuries, everything from brain injury to broken feet.  Of most concern is the increase in mild traumatic brain injury (MTBI), what used to be known as concussion.

According to an article from the University of California, San Diego Health System:

Sports concussions are especially problematic in those under 18 years of age because of “second-hit” or “second-impact” syndrome. If an athlete returns to play too soon and has not allowed the brain to fully heal, then a second blow to the head could result in a life-threatening situation.

There is an organization that has launched an educational campaign to raise awareness and promote prevention of injuries in young athletes. STOP Sports Injuries was created by a coalition of organizations, corporations, and medical professionals. (The all-volunteer medical steering committee includes Dr. David Martin of Wake Forest School of Medicine in Winston-Salem, NC.)

The website offers educational tools for parents, coaches, athletes, and healthcare providers…concussion and injury-specific information…and injury prevention resources for specific sports, including baseball, basketball, cheerleading, dance, running, soccer, and many others.

Check out the site: http://stopsportsinjuries.org. The brain you save could be your own… or your child’s.

HensonFuerst Attorneys remain committed to combating brain injury. We are proud supporters of the Brain Injury Association of North Carolina (BIANC). If someone you love has suffered a brain injury and you are wondering what to do next, give us a call. If you have legal questions, HensonFuerst has answers.

University of Michigan researchers have reported that a simple test that measures reaction time can help detect and diagnose concussion in athletes.

In the study, athletes were tested once at the beginning of their sport season—they had to catch a weighted cylinder dropped by their coach. Their reaction time was measured. Then, if one of those athletes received a concussion during the season, there reaction time was measured again several days after the injury.

The researchers discovered that athletes with concussion had a 15% longer reaction time. This demonstrates that concussion carries effects that linger even after the initial headache and dizziness go away. And it dovetails with recent suggestions we reported that athletes with concussion should remain sidelined for  at least three months. Such a simple test…and yet, if it is adopted by high school and college coaches, it may help save the brains of our young athletes.

One of the world’s leading brain injury researchers recommends that children under age 18 should sit out of sports participation for three months after suffering a concussion. This statement was made by Dr. Bennet Omalu, co-founder of the Brain Injury Research Institute at West Virginia University, on February 1, 2010, while testifying at a House Judiciary Committee hearing on the impact of injuries in collegiate and youth football. (See AP story here.)

Dr. Omalu was the expert who discovered the condition called chronic traumatic encephalaopathy (CTE), a form of degenerative, permanent brain damage which can be caused by repeated concussions.

In an earlier committee meeting (January 2009), Dr. Omalu explained that concussions cause damage to brain structures at the cellular and sub-cellular levels. After concussion, some genes get “turned on” and cause a type of protein (APP, or amyloid precursor protein) to accumulate in brain cells and nerve fibers. APP is strongly associated with Alzheimers disease and other degenerative brain disorders.

So concussion increases APP. And APP is related to brain degeneration.

Here’s the kicker:  After a concussion, it take 3 months for all the extra APP to disappear. That’s why Dr. Omalu recommends that children stay out of sports (and other vigorous activities that could reinjure the brain) for 3 months. Adults should probably also be sidelined for that long, but it would be next to impossible to regulate when a 250-pound star football player can run back out onto the field.

Logical, right?

Except that the sports most likely to result in concussion are the same ones that value toughness and a certain degree of violence. According a report in the New York TImes (12/10/2009),

“…one day after the N.F.L. decided that no player showing any significant sign of concussion could return to a game, several players at Tustin High School in California admitted they still wouldn’t tell a trainer if they got hurt.”

And, from the DailyMe…

In the immortal words of U.S. Representative Ted Poe, R-Texas, “I mean if Congress gets involved, it would be the end of football as we know it…. We would all be playing touch football out there.”

It’s one thing to voluntarily damage your brain if you’re an adult, but we need to protect kids from activities that could cause them a lifetime of misery…or even a premature death. A single concussion can have devastating consequences. A Bellevue, Washington boy, Zachery Lystedt, is still learning to walk again after a severe concussion he got playing football when he was 13.

It is imperative that doctors, schools, coaches, and parents all cooperate for the health of our children. Concussions need to be diagnosed properly–as mild traumatic brain damage–and treated with the same care, respect, and time we give to other serious injuries. A broken collarbone means 3 months of down-time from sports. A child’s brain deserves at least the same amount of time to heal.

(For more info on APP and neurodegeneration, click here.)

Reducing the number of sports-related head injuries remains a goal and a passion for the lawyers at HensonFuerst. I recently ran across this list of the sports with the highest number of head injuries treated in U.S. hospital emergency rooms in 2008 (as reported by the U.S. Consumer Product Safety Commission).
We urge all parents and participants of sporting activities to take proper precautions to prevent brain injuries. If you do sustain an injury, make sure you receive prompt medical attention.

The Top 15 Sports for Head Injury

• Cycling: 70,802
• Football: 40,825
• Basketball: 27,583
• Baseball/Softball: 26,964
• Powered Recreational Vehicles (ATVs, Go-Carts, Mini bikes, Off-road): 25,970
• Soccer: 19,252
• Skateboards/Scooters: 18,324
• Fitness/Exercise/Health Club: 14,713
• Horseback Riding: 11,749
• Winter Sports (Skiing, Sledding, Snowboarding, Snowmobiling): 11,723
• Water Sports (Diving, Scuba Diving, Surfing, Swimming, Water Polo, Water Skiing): 11,239
• Golf: 8,420
• Gymnastics/Dance/Cheerleading: 6,364
• Trampolines: 5,971
• Hockey: 5,272