Brain trauma up in youth basketball as other injuries drop
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The number of children and adolescents who are injured playing basketball has declined in recent years, but the injuries they are suffering are more severe, concluded a study published this week in the journal Pediatrics.
Basketball-related injuries declined by 22 percent between 1997 and 2007, said the study, which was conducted by physicians affiliated with Nationwide Children's Hospital in Columbus, Ohio. But the incidence of traumatic brain injuries was up 70 percent in kids and teens.
"The kids today who are playing sports are bigger and faster. That's probably got something to do with it," said Michael "Micky" Collins, assistant director of UPMC's Sports Concussion Program, one of the nation's leading authorities on concussions.
Along with Mark Lovell, director of the UPMC Sports Concussion Program, Dr. Collins developed ImPACT, a test now used by most professional, college and high school sports teams nationwide to determine the extent of impairment after a concussion. They refined and computerized a concept originated by UPMC's Joseph Maroon, team neurosurgeon for the Pittsburgh Steelers.
Injuries may be becoming more severe because "intensity and specialization of sports is happening at a younger age," said Dr. Jeanne Doperak, a primary care sports medicine physician at UPMC.
"When I played YMCA soccer, it was a bunch of kids who were 12 years old getting together to have good time," she said. "The typical 12-year-old soccer player today is playing year-round on three different teams, preparing for a career in soccer.
"As a result, the fun game becomes more competitive," Dr. Doperak said. "The increased competition results in increased injury."
When bigger kids collide at a faster speed, more damage can be done. But Dr. Collins said probably the main reason why the Pediatrics study shows more brain injuries is because "awareness is increasing at warp speed."
"These injuries probably have been happening for a very long time," he said. "But the spotlight on these injuries is iridescent right now."
Dr. Barbara Gaines, director of trauma and injury prevention at Children's Hospital, said "the overall numbers [for basketball injuries] here have been pretty much the same, but we are seeing more kids with concussions. Concussion is probably the most common injury we see in kids admitted with basketball injuries."
Dr. Gaines agreed with Dr. Collins that greater awareness likely is a factor.
"One of the reasons there could be a bit of a shift is because coaches are beginning to have an increased awareness of concussions, and are reporting them to medical personnel more," she said.
"Awareness has evolved dramatically over the last five years," Dr. Doperak said. "I cover a lot of sporting events with young athletes. It's pretty unusual for parents not to have an awareness about concussions."
"Ten years ago, people only defined concussions as loss of consciousness," Dr. Collins said. "Ninety percent of concussions do not have loss of consciousness."
Memory loss, which is one of the things that can be measured by the ImPACT test, is a better indicator of the seriousness of a concussion than is loss of consciousness, he said.
"With memory loss, you are four to 10 times more likely to have a serious problem than by loss of consciousness," Dr. Collins said.
Better technology may be another reason why more concussions are being reported, Dr. Doperak said.
"We may be better at diagnosing more severe injuries because we have the means to do so," she said.
The study published in Pediatrics said strains and sprains are the injuries basketball players are most likely to suffer. They account for 30.3 percent of all injuries.
Boys were more likely to sustain lacerations and fractures, while girls were more likely to suffer concussions and knee injuries.
Children aged 5 to 10 were more likely than older children to suffer concussions.
Adolescents age 15-19 were more likely to sustain injuries to their legs, knees and feet. Children age 5-10 were more likely to injure their upper extremities than their lower bodies, the study said.
First Published September 15, 2010 12:00 am