Sydney neurosurgeon Dr Richard Parkinson explains the special problems of sports injuries among children.
One of the key problems we face with talking about sports injuries among children is the lack of data. There are quite likely many more incidents than we know about, but if the player isn’t concussed, then it’s unlikely they’ll be taken to the doctor. I suspect there’s many times that kids who have recurrent concussions aren’t brought to medical attention. And that is a matter of some concern. Another problem with kids’ sport injuries is sometimes you just don’t see what happened—unlike professional sports, where every move is scrutinized from every angle – something can happen in a scrum at the children’s level that no-one sees.
Usually if I was asked to see a young person it would be because they had recurrent concussions, and I would be asked to provide an opinion about whether they should continue to play that season. And the reality is, the neurosurgeons’ answer will almost always be ‘No, they shouldn’t continue to play for that season,’ and I’m simply the rubber stamp. You just don’t want to risk the possibility of chronic traumatic encephalopathy (CTE). CTE is a condition that has received a lot of attention in the United States, particularly among elite sports people, and the condition develops as a result of repeated low-level concussions. It’s also an area I’m studying at a professional level among NRL players here in Sydney.
There isn’t any evidence to suggest children are directly under threat of developing CTE, but we just don’t have enough data to say with confidence what’s going on.
Having said that, I think kids tend to bounce back from injuries very quickly. The brain has much better powers of recovery in pre-adulthood. That doesn’t mean a knock on the head should be ignored. Your brain can also swell more easily when you’re young, and its response to injury is different. So it’s not necessarily a good thing to be young in all situations. For example, there is a situation with a recurrent concussion, if you’re a pre-adult, that the swelling in the brain can be worse than you’d expect in an adult, and you sustain more injury. Whatever the case, then, it’s something that we need to look at.
One thing I do think we need to do is look beyond personal reporting, and start finding ways of looking at what’s going on during the game. It’s also true that many sporting bodies, such as the Australian Sports Commission and the various sporting codes, take the issue of kids injuring themselves in sport very seriously. We know that kids aged between 5 and 14 are most likely to get injured, and that about 50 per cent of injuries are preventable. If you are concerned about your kids and sports, I’d recommend you look at sites like Smartplay, which has good advice on approaching sport in a way that will minimize the risk of injury.
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Dr Parkinson is a highly qualified neurosurgeon with extensive experience in neurosurgery. He has studied under, and worked with leading neurosurgeons in the USA performing ground breaking surgeries. He is also involved in developing educational tools for both surgeons and patients.