Time To Rethink How Practice is Conducted?

Practice gives greater exposure to concussive and sub-concussive forces than the games themselves. As reported in the New York Times, recent studies conducted on three NCAA Division I teams, a football team will encounter more than 2500 significant blows to the head that are in excess of 50g’s of force and approximately 200 head blows that are above 200g’s. These are just the blows that are of significance and are considered great enough for the athlete to sustain a concussion. The sub concussive forces that occur every time there is contact with another athlete or the ground are too great in number to count. The deaths of Chris Henry (Cleveland Bengals) and Owen Thomas (University of Pennsylvania) have shown the importance of limiting the exposure to sub concussive forces to the brain, not just those significant enough to create injury.

There have been some important research findings in the past few months that, if taken seriously, will lead to safer sport. Until recently, purposeful heading of the ball in soccer was considered a non-issue in regards to brain trauma. According to the American Academy of Pediatrics (AAP), the rate of concussions among soccer athletes in both recreation and elite leagues is similar to football and hockey. With the recent evidence of Tau protein formation resulting from multiple sub concussive hits to the head, the AAP has recently (released September 2010) altered their position that the “contribution of purposeful "heading" of the soccer ball to both acute and potential long-term concussive effects, such as cognitive dysfunction, seems less controversial today than previously.” (Clinical Report Injuries in Youth Soccer) The AAP is waiting for more definitive evidence to actually site the relationship between purposeful heading and long term brain damage. But the sport of soccer (or any of the contact and contact/collision sports) should not wait for long term studies to come to fruition before action is taken. Currently Chronic Traumatic Encephalopathy (CTE) can not be definitively diagnosed except through an autopsy of the brain.

Heat Illness is Preventable

Heat illness is preventable [period]. This also means that the associated complications that arise from a heat illness situation are also preventable. There is more to take into consideration than just temperature and hydration. With the proliferation of medications, dietary supplements and energy drinks, it is important to understand the effects and side effects of what the athlete is ingesting. Common side effects with many supplements and energy drinks include diuretic effects and increased core body temperature. This means that more emphasis needs to be placed on hydration and physically cooling the body. Heat illness and dehydration can also play a significant role in a condition known as exertional rhabdomylosis, a rare but serious condition resulting in increased levels of CK (creatine kinase) that may cause muscle and kidney damage. (Exertional rhabdomylosis is a major concern with athletes who carry the sickle cell trait.)

Knowledge of heat illness prevention and recognition is important knowledge for all levels of sport coaching. A football coach the state of Kentucky was arrested (also acquitted) for negligent homicide in the heat illness death of one of his athletes. Two Middletown, CT football coaches were charged with reckless endangerment (charges were also dropped) after an athlete collapsed from dehydration. While these cases resulted in the respective charges being dropped, this emphasizes the need to prevent preventable conditions such as heat illness.