Concussions in Young Athletes: Are There Long Term Effects?

Concussions in Young Athletes: Are There Long Term Effects?

Recently, the movie Concussion was released, focusing on the efforts of a doctor named Bennett Omalu to link a degenerative brain disease known as Chronic Traumatic Encephalopathy (CTE) with NFL football players. These players suffered from problems such as depression, memory deficits and violent outbursts, before dying, typically at a young age and often from suicide.

Since the time of this initial discovery, figures from the Department of Veterans Affairs and Boston University report that 87 out of 91 brains of former NFL players have tested positive for CTE. In addition, late last year the United States Soccer Federation issued guidelines to limit heading in youth soccer and the American Academy of Pediatrics published a policy statement entitled Tackling in Youth Football.

All of this may cause a lot of parents to wonder exactly how safe contact sports are for kids and if concussions suffered during childhood/adolescence carry the risk of long term consequences.

I think the short answer to both questions is that we don’t really know. While the statistic referenced above is certainly concerning, the study sample is somewhat skewed. The results could be biased to overestimate the prevalence of CTE.

  • Currently the only way to definitively identify CTE is with an autopsy after death and subjects or their families must agree to donate brains to be studied.
  • It stands to reason that those whose brains are being examined likely suffered from neurologic symptoms for which they were looking for an explanation.
  • People showing no neurologic symptoms are probably less likely to want their brains examined after death.

Another difficult theory to prove is that playing in the NFL (or playing contact sports at all, for that matter) actually leads to CTE. It is possible that these study subjects had something else in common that led to the disease – a genetic link, exposure to certain medicines or other substances, or other behaviors.

Even if you accept the idea that playing in the NFL led to the CTE, other questions remain:

  • Does it take a certain number of years of playing professional football or a certain number of concussions to develop the disease?
  • Does participation limited to other levels of football: Pee-Wee, middle school, high school, and college, lead to the same findings of CTE?
  • How many documented concussions did these athletes suffer and how were they treated at the time?

Remember, in general, concussions are treated much differently now than they were decades ago. In the past it was common for professional athletes to continue playing after experiencing a concussion. It is certainly possible the brain is more susceptible to long term damage (such as CTE) if it continues to suffer trauma while attempting to recover from an initial injury.

I do not mean to imply that concerns about CTE are invalid. I think increasing awareness about possible long term negative impacts of playing football (professional or otherwise) and other contact sports is very important and further investigation is crucial. My point is that we still have a long way to go in connecting all the dots between sports and CTE, especially as it relates to today’s young athletes.

Currently there is no evidence to suggest concussions in young athletes that are treated appropriately will lead to problems later in life, but studies tracking long term outcomes of pediatric and adolescent concussions are certainly needed. To learn more about concussions and access free resources for your family, download our free concussion guide.

 

Steven Cuff
Dr. Steven Cuff is a Sports Medicine physician and co-director of the Sports Concussion Program at Nationwide Children’s. He is an Assistant Professor in the Department of Pediatrics at The Ohio State University College of Medicine. Dr. Cuff is board certified in pediatrics and sports medicine by the American Board of Pediatrics. He currently serves on the Ohio AAP's Home and School Health committee as co-chair of the Sports Medicine Sub-committee. He is also a member of the American Medical Society for Sports Medicine and serves on their Education committee. Follow Sports Medicine at Nationwide Children’s Hospital on Facebook and Twitter. @NCHSportsMed

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