When Is the Right Age for a Child to Specialize in a Sport?

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

How many times have you seen parents running their kids from one sporting event to the next? Parents and kids feel the pressure to stay on the best team, with the best trainer, and the best coach to continue to progress in their sport.

At what age should a child or teen begin to specialize in a sport? Should kids go the route of gymnastics and figure skating and focus exclusively at an early age or should specialization be held off until high school or college when bodies and minds begin to fully form and develop?

An excellent article on the Steve Nash Basketball Blog addresses these questions and more.

Sports-Kids

Having been in the military, I had the benefit of having my children participate in school systems and sports programs up and down th
e Eastern seaboard. School systems and sports programs are not all the same. The culture within these communities created by principals, athletic directors, teachers, coaches, athletes and parents were a direct result of their collective focus and values.

As a psychologist, what I have found interesting is that the value system of sports and athletics tends to mirror one another. Within one community, children are not cut from a sports team – all children up to 9th grade may be able to try out and play on any team without getting cut. In the same community, children may not receive letter grades – or “competitive grades” – until the 8th grade.

Elsewhere, however, I’ve seen children cut from teams and competing for spots as early as 1st grade, when they also begin receiving competitive letter grades.

As with many things, the trick is in finding the right balance. Children in 1st grade cognitively can’t keep score and focus on the tasks of what they need to do on the field. What does a “D” in reading really mean to a first grader? A summary letter grade is an abstract concept that doesn’t teach very young children that they need to read more to improve their proficiency. The same applies to sports. An older child can understand the causes and consequences of a low letter grade, be it in academics or sports. But is waiting until 9th grade to be cut from a team too long to teach the lesson that life is competitive?

Another factor to consider are that traumatic brain injuries (concussions) will interrupt an athlete’s season and training. The type of community a child is living in and the focus of the coach, parents, athletic trainers, administrators, and other adults working, training and living with these young athletes can affect treatment outcomes in case of a concussion. Is your community one that is fostering hyper-competition that is focused on the top one percent or does it focus on age-appropriate health and well-being of all its children and how they all can benefit from athletic competition?

World Cup Again Brings Up Concussion Debate

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

It’s no secret in my family that I’m a die hard sports fanatic. I count the U.S. Women’s National Soccer Team’s win over China in 1999 as one of the greatest sporting events in our country’s sporting history – rivaled only by the win of the U.S. Hockey team over the Russians at the 1980 Olympics. Naturally, I was glued to the TV over the past few weeks while our U.S. Women’s National Soccer Team again clinched the World Cup championship last week.

Backtracking to the team’s semifinal game against Germany, analysis stated the U.S. did a great job on offense and defense, although the Germans came out hard with a flurry of shots and dominated the first 20 minutes of the action. Then, iIn the 28th minute, Germany’s Alexandra Popp went to head a ball on a free kick and USWNT’s Morgan Brian was having none of that and went up to meet her. The action happened so fast you could really tell what happened until FOX sports showed the replay. It turned out that Popp’s and Brian’s heads had violently collided.

Jun 30, 2015; Montreal, Quebec, CAN; United States midfielder Morgan Brian (14) and Germany forward Alexandra Popp (18) collide attempting a header during the first half of the semifinals of the FIFA 2015 Women's World Cup at Olympic Stadium. Brian and Popp were injured on the play. Mandatory Credit: Eric Bolte-USA TODAY Sports ORG XMIT: USATSI-230278 ORIG FILE ID:  20150630_ajw_bb5_045.jpg

Jun 30, 2015; Montreal, Quebec, CAN; United States midfielder Morgan Brian (14) and Germany forward Alexandra Popp (18) collide attempting a header during the first half of the semifinals of the FIFA 2015 Women’s World Cup at Olympic Stadium. Brian and Popp were injured on the play. Mandatory Credit: Eric Bolte-USA TODAY Sports ORG XMIT: USATSI-230278 ORIG FILE ID: 20150630_ajw_bb5_045.jpg

We all know the showmanship that sometimes appears in soccer when players grab a shin or a knee and throw themselves to the ground only to be up and running about at full speed moments later. But, when players are truly injured, their teammates are taught at a young age that whomever has the ball should kick it out of bounds so the hurt players can be attended to by medical personnel. The Popp-Brian collision was the first time I can ever remember the referee stopping the play prior to the ball actually going out of bounds.  After slamming heads, both Popp and Brian fell awkwardly to the turf.

Medical personnel from both teams game out and examined both players for 4 minutes and both teams played 10-on-10 for several minutes before both players returned to play the remainder of the game. Although neither player was knocked unconscious, the mechanism of injury was serious enough to have warranted a full 24 hours of observation before they should have been permitted to return to play.

Actions that FIFA can take to help teams and doctors make play safer for the players could include:
– have an impartial doctor on the sidelines, much like the referees who are from countries other than the teams playing, who can help assess injured players and protect the organization from future lawsuits; and
– add a substitute for teams in case a FIFA doctor rules that an injured player can’t return to the game to eliminate some of the pressure to keep playing.

Injuries like the Popp-Brain collision help drive home the point that kids younger than 14 shouldn’t be using their heads in recreational games until they are taught the right techniques and when their bodies have fully developed.

I’ve always said the benefits of sports far outweigh the risks, but that precautions need to be taken seriously. The risk of a head trauma is that athletes returning too quickly to play can suffer a second injury that could prove to be career-ending or, in the worst possibly case, fatal. Clinicians, parents, coaches and league administrators need to continue to evaluate the rules of sports collisions to ensure the safety of our children, the vast majority of whom will need their brains for something other than headers in the World Cup.

Is Discussion About Concussions in Youth Soccer Being “Gagged” by Officials at the Highest Level of the Sport?

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director
and Ann-Marie Sedor, HeadFirst Concussion Care Marketing

A recent story out of Louisville, Ky., is that US Youth Soccer is trying to “gag” its state officials from having public conversations about concussions in their sport. US Youth Soccer is the largest member of the United States Soccer Federation, the governing body for soccer in the United States, and has 3 million registered players between ages five and 19.

Unfortunately, leaders of US Youth Soccer have declined to discuss why the organization issued a memo encouraging soccer leaders not to talk to the media both generally and specifically concerning upcoming concussion stories. However, a statement on their website says they are not trying to ‘muzzle’ their membership but instead to create one singular communication channel to avoid inaccurate or conflicting information.

The president of the Kentucky Youth Soccer Association President said the request came from the United States Soccer Federation, their parent organization, and was sent out as a precaution because of the pending lawsuit filed in California that seeks only to change playing rules rather than monetary damages.

Soccer officials at the state level aren’t buying it. Oliver Barber, a lawyer who is chairman of the Kentucky Soccer Referee Association and a volunteer coach was quoted as saying “I don’t like US Youth Soccer telling us not to address such an important issue. We have a whole lot more work to do to keep players safe.”

Like many sports today, soccer administrators at all levels of the sport, including youth, high school, college, Olympic and pro, are experiencing pressure from parents, athletes, referees, and the community to address the issue of concussions. Over the past year or so, soccer officials have been struggling with rule changes such as whether or not to let players head the ball under the age of 14. Two of the top proponents of avoiding ball heading at a young age include former U.S. international soccer star and World Cup champion Brandi Chastain and Dr. Robert Cantu, a leading expert on head trauma in sports and a clinical professor of neurosurgery at Boston University School of Medicine.

Girl Heading Soccer Ball - 2

A number of studies have shown that soccer players have developed CTE (chronic traumatic encephalopathy) and experience cognitive changes from frequent heading of the ball. The damage occurs, not as a result of a single concussive injury (although these injuries also occur in soccer), but as a number of cumulative hits in which the brain moves. These hits are called subconcussive trauma, and while scientists don’t have a handle on the defined threshold before injury appears, there is clear evidence in their research that heading the ball over time produces structural changes which can be observed in neuroimaging.

As soccer administrators in the United States continue to formulate rule changes to protect our children and protect the integrity of the game, parents can and should continue to be their child’s best advocate with regards to safety.

Parents can:

Concussion Concerns Raised Again in the World Cup Finals

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Germany may have won the 2014 World Cup, but their team wasn’t immune to head injury. In Sunday’s final game when Germany won against Argentina, German midfielder Christoph Kramer was hit hard in the face with a shoulder charge and knocked right off his feet. He was slow to get up and clearly disoriented but continued playing for another 14 minutes before slumping and needing help off the field. Even then, Kramer had difficulty maintaining his balance and appeared dazed despite attempting to shrug off the injury.

World-Cup-204-Kramer-Concussion

Hassan Ammar/AP Photo

For the International level and professional level, games committee members will need to change the rule to allow an immediate substitution for a suspected concussion that doesn’t count against a team’s three-substitute rule for the entire game. Coaches and doctors can then immediately recommend subs to relieve the injured players.

For college, high school, club and recreational athletes playing soccer, the hits and concussions seen over the course of the World Cup have been good learning lessons about concussions. For coaches, the World Cup injuries are clear examples of when a child needs to be removed from a game and be evaluated and cleared by a medical professional prior to returning to practice or games.

With the action of the World Cup being, quite literally, on the world’s stage, we hope concussions finally get the attention they deserve.

That’s a Red Card!

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Most of the globe is currently watching the World Cup and although football gets the lion’s share of the headlines about concussions, the June 19 soccer game between Uruguay and England is sure to land FIFA in some hot water. During the second half of the match, Álvaro Pereira, one of the stars of Uruguay’s national team, laid unconscious (below) on the field after taking a knee to the head. He fell to the turf and took at least 15 seconds before he showed any signs of consciousness.

Image

Richard Heathcote / Getty Images

It was clear to everyone—the players, the referee, the TV commentators—that Pereira was unconscious. At this stage, there’s no further diagnosis necessary. You will often read that doctors disagree about when to diagnosis a concussion or mild traumatic brain injury but once there is a loss of consciousness all doctors agree that a concussion or mTBI has occurred.

Pereira should not have been let back onto the field. His coach, his team physician and the FIFA physician all should have stopped him. But Pereira insisted on returning to play for the remainder of the game over the objections of his team’s doctor, while FIFA doctors didn’t even examine him until after the game was over.

Sure, any player would be upset but irritability and mild aggression are normal responses following a head trauma. Pereira should have been lead off the field and if the team didn’t get him off the field, they should have been issued a yellow card.

FIFA needs to do more in terms of educating international coaches, players, fans, and their medical staff. Mr. Pereira was cleared an hour after the game by FIFA physicians as being apparently concussion free; no return to normal cognitive activity and no return-to-play protocols needed. That’s a red card!

Concussion Crisis Growing in Girls’ Soccer

This evening at 9pm (EST), NBC Rock Center, hosted by Brian Williams, will report on the staggering numbers of concussions sustained by adolescent girls playing soccer. Female contact sports means concussions are no longer an issue just affecting boys. Read the full article here for more information about tonight’s program. Check out your local listings for the channel.

Courtesy NBC News