How Concerned About Brain Injury Should We Be?
In high school stadiums across the country, a certain contagious frenzy is generated by the playing of a high school band and the shouting of cheerleaders as the home team takes the field. High school athletics, with their clashes between cross-town rivals, have long been a favorite American pastime—a pastime that is serious business for high school athletes who hope to receive college scholarships and then pursue professional careers. Is the intense pressure to perform exposing more young athletes to the possibility of permanent brain damage? Many think so, causing high school athletic departments to take a closer look at the growing concern over high school athletes sustaining brain injuries.

The Brain Injury Association, founded by parents and health professionals concerned about the safety of children and student-athletes, reports that in any given season 20 percent of all high school football players sustain some type of brain injury. Even more ominous is its finding that football players who have suffered from a brain injury are six times more likely to sustain additional such injuries in their careers. Other sports such as soccer, wrestling and lacrosse have also been targeted as activities that put high school athletes at risk for brain injury.

The Most Common Brain Injury
Concussions are the most common head injuries sustained by athletes involved in school sports. The effects of a concussion vary from disorientation to temporary amnesia and the loss of consciousness. The brain is protected by a layer of cerebrospinal fluid that suspends the brain within the skull. This fluid acts as a shock absorber and allows the brain to move freely without hitting the sides of the skull. In what is referred to as an “acceleration/deceleration” injury to the head, a person’s body is traveling at such a rapid speed that when the head comes to a sudden stop, the fluid is unable to protect the brain. When this occurs, the brain crashes into the skull, often damaging brain tissue. Another type of brain injury that can result in a concussion is a rotational injury. In this instance, the rotating movement of the brain within the cerebrospinal fluid is so sudden that it can strip brain nerve cells. Rotational injuries usually occur after a traumatic hit to the head such as when a quarterback is sacked by his opponent, hitting his head violently against the ground.

There are three grades of concussions: mild (grade 1), moderate (grade 2), and severe (grade 3). With mild concussions, a person who suffers a sudden blow to the head does not lose consciousness but suddenly becomes confused. With moderate concussions, a person may or may not lose consciousness, but will experience amnesia immediately or soon after the injury. According to the Psychology Center of Sports/ Concussion Services, severe concussion has occurred when a person loses consciousness for any length of time.

Long-Term Effects of Brain Injuries
Doctors are not entirely sure what long-term effects brain injuries will have on their patients. There are many factors to consider, such as whether the injury was sustained through an accelerated or rotational blow, whether it is the patient’s first or second concussion, and finally whether or not the patient was wearing proper equipment at the time of the injury. The most frequently observed consequences of a brain injury are loss of memory, hearing, vision, sudden occurrence of seizures, migraine headaches, and changes in behavior. Brain injuries can affect a person’s intellectual functions and cause short and long-term disturbances in personality. The most severe consequences of a brain injury are permanent physical and mental disability or even death. These are most likely to occur in the case of “second impact syndrome,” which occurs when a person is hit for a second time close to the location of the first concussion. In rare cases, a second concussion can cause the brain to swell so that it hinders the its ability to heal from the first concussion.

Who Is Most At Risk?
Most high school sports carry some risk of brain injury. Football, however, puts student-athletes at the most risk, especially linebackers, running backs, and quarterbacks who are more frequently involved in high-speed collisions. In soccer, brain injuries occur most often from the intense strikes on the head caused by heading the ball. Running into unpadded goal posts and head to head contact has also been reported to cause brain injury among soccer players. Wrestling, baseball, and basketball, along with recreational sports like in-line skating or skiing, also present some risk.

The National Athletic Trainer Association (NATA) conducted an injury surveillance program focusing on 235 U.S. high schools during one or more of the 1995-1997 academic years. The purpose of this study was to determine whether or not high school athletes are at a high risk of sustaining brain injuries during their high school athletic careers. A group of 246 athletic trainers recorded data for the following varsity sports: boy’s football, wrestling, baseball, field hockey, basketball, soccer, and girl’s volleyball, softball, basketball and soccer. They reported that there were 23,566 total injuries in ten sports over a three-year period. Out of these, 1,219 were mild traumatic brain injuries. One hundred and thirteen of these brain injuries occurred in football, 128 in wrestling, 76 in girl’s soccer, and 69 in boy’s soccer. As reported in the Journal of American Medical Association, NATA has, based on this data, estimated that 62,816 head injuries occur annually among high school varsity athletes across the country.

Steps to Prevent Brain Injuries
Banning high school sports is not the answer to decreasing the number of brain injuries young athletes sustain each year. But there are ways that parents, coaches, and students can work together to decrease the risk. The best way to prevent a brain injury is to make sure the athlete is wearing proper sports equipment such as helmets and pads. Also, when a student receives a major blow to his or her head during a practice or competition, he or she must not be permitted to “shake it off” and continue to play. If a sudden trauma does occur, a neuropsychological exam is advised. These exams can more accurately measure brain functioning. Most importantly, if an athlete has already experienced any degree of brain injury, doctors, parents, and coaches should work together to make sure that a student has fully recovered before competing again.

In sum, coaches, parents and young adults have an obligation to do all they can to effectively prevent and treat brain injuries. For more information, and to order palm cards with crucial facts about the effects of brain injuries and how to treat them, contact The Brain Injury Association at