Brain Injuries in Sports

A recent study published in the American Journal of Public Health noted a significant decrease in recurrent concussions among high school athletes following the implementation of laws in many states relating to sports play.

As reported by Temple University Center for Public Health Law Research, these laws aim to reduce harm from brain injuries occurring during youth sports activities. They address such factors as removal from play following injury, requirements for return-to-play clearance after a concussion, and education of coaches, parents, and athletes.

According to the Centers for Disease Control and Prevention, up to 300,000 youths suffer traumatic brain injuries (TBIs) or concussions while playing sports each year. TBIs can cause serious health consequences in children, which may be short-term or lifelong.

In response to these injuries, all states have passed laws for the purpose of reducing brain injuries during youth sports play. Data is now available to analyze the possible impact of those laws on reducing brain injuries in children.


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Chronic traumatic encephalopathy (CTE) was found in 110 of 111 (99 percent) brains of deceased former National Football League players that were donated to scientific research, according to a study published in the medical journal JAMA. CTE, a neurodegenerative brain disease, was also neuropathologically diagnosed in 177 of the 202 players studied across all levels of play (87 percent). It was found in three of the 14 high school players and 48 of the 53 college players.

CTE is typically found in individuals who have been exposed to repeated head trauma, including veterans and football players. CTE can only be diagnosed with an autopsy. The JAMA study focused on football as the primary exposure to head trauma, whether or not the individual had exhibited symptoms while living. The study acknowledged the lack of a comparison group without which the study cannot offer an estimate on the overall risk of brain injury due to participation in football.


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Increasing evidence suggests that professional athletes in contact sports are suffering brain damage as a result of concussions. For many years, doctors believed that chronic traumatic encephalopathy (CTE) was limited to boxers. In that context, it was referred to as “punch-drunk syndrome.” However, pathologists are reporting similar brain damage among other athletes.

The biological processes leading to CTE may start many years before recognizable symptoms appear; however, there is no reliable test to detect CTE in its earliest stages. Often an athlete’s confusion or memory loss that is related to CTE is only confirmed following an autopsy.


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Concussions among children playing sports are not a new phenomenon. In the decade leading up to 2009, an estimated 173,285 children and adolescents 19 and younger were treated during emergency department visits for sports and recreation-related traumatic brain injuries (TBIs). That represented a 62 percent increase in a decade. It is estimated that sports and recreational activities result in approximately 21 percent of TBIs among children in the U.S.

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The University of Nebraska-Lincoln released a study involving a new equation used to evaluate post-concussion injuries among high school athletes and its corresponding impact on concussion research.

The Nebraska study outlines a new approach for identifying more athletes who play “impaired” on the Immediate Post-Concussion Assessment and Cognitive Testing, or ImPACT. That computerized tool consists of eight subtests that gauge neurocognitive performance. Using the new equation to combine the multiple subtest scores into one evaluative score could make it more difficult for the athlete to “fool” evaluators by providing minimal effort or “sandbagging,” says the recent study.


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Have you ever wondered what happens within a person’s skull when he/she suffers a traumatic brain injury?

The New York Times recently published a wonderful interactive article about brain injuries. The article describes and demonstrates what happens within a football player’s skull when he suffers a concussion.

Using a mouth guard developed by bioengineer

The theory of neuroplasticity holds that the brain will change and adapt to different conditions including to childhood injuries. This theory is often challenged and sometimes referred to as a “myth.” However, a new study by Seena Fazel and colleagues from the Department of Psychiatry at University of Oxford in the United Kingdom delivered data that supports the claims of neuroplasticity theorists. Fazel’s conclusions reveal that the later a mild TBI is sustained, the worse the health and social outcome is for the patient. The study also found a causal effect between childhood Traumatic Brain Injuries (TBIs) and the risk of brain impairment and social dysfunction at later stages in life.

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A new study published in the Journal of Head Trauma Rehabilitation calls into question whether acute cognitive and physical rest improves concussion recovery times. Thomas A. Buckley, EdD, ATC of the Department Kinesiology and Applied Physiology at the University of Delaware conducted a study to determine if rest after concussion would result in a shorter recovery time in a population of college-aged student-athletes.

This hypothesis was based on the 4th International Consensus Statement on Concussion in Sport which recommends rest after injury as “a corner stone for acute concussion treatment” and outcomes. The authors noted that “rest” was achieved by discontinuing “school attendance, academic work, electronics usage and [any] exercise.” Prescribing rest was also believed to reduce the risk of repeated concussion and the “rare, but potentially fatal, second-impact syndrome.”


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Symptoms of concussions often disappear within 7-10 days of an injury–prompting medical release back to sports play. However, preliminary results of a new imaging study presented at a recent American Academy of Neurology conference showed that brain changes caused by “temporary” concussions may last six months or more after the injury. The study, which is ongoing, used diffusion tensor imaging (DTI) to exam connective brain tissue or “white matter” in eighteen students with concussions. White matter brain changes are also associated with stroke and Alzheimer’s.

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A study by doctors at Montefiore Medical Center and Albert Einstein College of Medicine provides additional support that use of Diffusion Tensor Imaging (DTI) may be clinically helpful to patients with mild Traumatic Brain Injuries (TBI) because it shows possible evidence of brain repair in post-injury patients. Scans conducted one year post-injury show that patients