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Research provides insights into youth football injuries

The study of 97 local football players ages 9 to 13 represents the largest study of youth football players’ brain activity to date.

In March 2016, Wake Forest’s and Winston-Salem State’s athletes and trainers joined a 30-university study, along with Wake Forest Baptist Medical Center researchers.

The Concussion Assessment, Research and Education (CARE) consortium is sponsored by the Naiad U.S. Defense Department.

The $30 million study that began in 2014 is considered as the largest of its kind related to concussions. To date, the study has collected more than 25 million data points from more than 16,000 athletes. That number is expected to increase to 25,000 athletes.

Universities also participating from the Atlantic Coast Conference are Miami, North Carolina and Virginia Tech.

The focus on concussions usually has been on football players, but the prevalence of concussions is growing among other athletes, especially girls’ soccer players.

Parents and coaches trying to determine the right starting age for playing youth football may gain some perspective from a recent study by Wake Forest Baptist Medical Center researchers on blows to the head.

The study of 97 local football players ages 9 to 13 represents the latest update from researchers at Wake Forest Baptist. It also represents the largest study of youth football players’ brain activity to date.

The players’ parents gave permission for their children to participate. Although the majority of players were measured for one season, 16 players were followed from 2012 through 2015.

With the increase in awareness of concussions in youth sports, most prominently in football, but also in girls and boys soccer, wrestling and basketball, there’s a growing debate about when is the right time to allow children to play sports.

For example, many youth soccer associations don’t allow players younger than 12 to head the ball in hopes of reducing the potential impact of blows to the head jostling their still-developing brains.

Wake Forest Baptist researchers determined that age, size, coordination and tackling techniques matter in individual helmet impacts, and hits to the head for younger players tend to occur at a 30 percent to 50 percent higher rate during practice than games.

“We’re not out to demonize football or say football is bad,” Joel Stitzel, the chairman of Wake Forest Baptist’s biomedical engineering department, said about the research.

“The jury is out on when to start playing tackle football because it is such a complex issue,” Stitzel said, noting such variables as the intensity of practices, the quality of how tackling is taught, the conditioning of the players.

Stitzel said most of the local parents and coaches “are of the same mindset to make playing football as safe as we can.”

Findings of study

Each youth player wore a properly fitted Riddell Youth Speed helmet with sensors that collect the number and location of impacts, as well as how much jostling the impacts cause to the brain.

The sensors are similar to those used by researchers in their study of helmet impacts with 40 players at Reagan High School and players at Virginia Tech.

The study of Reagan players, released in December in cooperation with University of Texas Southwestern Medical Center, found that the gray and white brain matter of 24 players was altered because of contact, though none was believed to have experienced a concussion during the season.

Video recorded all helmet impacts by local youth players during active play.

The players were divided into three categories: Level A (players 11 and under weighing up to 124 pounds), Level B (players 12 and under weighing up to 139 pounds), and Level C (players 13 and under weighing up to 159 pounds).

“By recording more than 40,000 head impacts, this study represents the largest collection of biomechanical head impact data for youth football to date,” said Jillian Urban, the study’s author and assistant professor of biomedical engineering at Wake Forest School of Medicine.

There were 12,890 head blows received by Level A players, 15,987 by Level B players and 11,661 by Level C players.

Some of the difference in blows can be explained by Level B players being involved in longer practices and games than Level A, while Level C players typically showed more experience and coordination with tackling techniques.

Researchers found the front of the helmet received the most blows during the study, similar to what was experienced by the high school and collegiate players.

Benefits versus risk

Investigators found that Level C had significantly greater accelerated brain jostling than Levels A and B, and that the accelerations were significantly greater during games as opposed to practice in Levels B and C.

Although two-thirds of all head impacts in the three levels occurred during practice, the percentage of high-magnitude impacts was higher in games, and the number of such impacts in games increased with the level of play.

Researchers said, “More effort is needed to reduce exposure to high-magnitude head impacts in practice, particularly at lower levels of play.”

Urban suggested study results could be used to recommend changes in practice structure and game rules.

Stitzel said the study shows that teaching proper tackling technique should become a practice priority of youth football coaches and leagues.

The study was published in the June issue of the Journal of Neurotrauma.- by Richard Craver, News & Record (Greensboro, North Carolina)

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