Parents

We provide materials to help you make informed decisions about your child’s health and safety.

Active kids are healthier children and lead longer, healthier lives. Our educational materials explain the benefits of being active and the risks that come with different sports. They also provide information to help you participate in decisions about your child’s treatment, return to school and return to sports if your child is injured.

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Concussion
Exercise & Health
Nutrition & Hydration
Sudden Cardiac Arrest
Injuries & Prevention
Female Athlete
Pain Management

Concussion Key Facts

A concussion is an injury to the brain. Recognizing it is critical for a full recovery.

All injuries to the brain are potentially serious. The signs and symptoms of concussion may include headache, dizziness, memory loss, confusion, loss of balance, nausea and more.

An athlete with a possible concussion should immediately be removed from play.

If a sideline check suggests a concussion, the athlete should not return to play on the same day, and should see a licensed healthcare professional who is knowledgeable about concussions right away. Returning to play too soon can be dangerous or even deadly.

Getting better after a concussion usually just takes time.

Treatment normally involves stopping exercise and sports as well as mental activities that make symptoms worse, then gradually returning to activities.

Most athletes improve quickly after concussion.

Most athletes can safely return to school and sports within a week or two, although younger athletes often take longer. Some athletes may take months or more to fully recover. By law, a healthcare provider must approve an athlete’s return to play.

If symptoms persist, see an expert.

If the signs and symptoms continue to linger beyond 10-14 days in an adult or a month in a child or adolescent, see a licensed healthcare provider who is an expert in diagnosing and treating athletes with concussions.


Concussion Basics

A concussion is a brain injury that changes the way the brain works. It is often caused by a direct hit to the head, face or neck. A sudden jolt to the body or a hard fall to the ground can also send enough force to the head to cause a concussion.

Nearly four million athletes and active people suffer a concussion every year. Because all concussions are potentially serious, it is important to recognize and properly treat them early.

This information is for you if you want to learn more about concussions, including knowing the signs and symptoms, and what to do when you recognize one.

Why It Is Critical To Report Concussions

Many athletes don’t report their symptoms, and many coaches fail to recognize them.

It is important to report a concussion both to speed an athlete’s recovery and to prevent a potentially more devastating repeat concussion. The risk of a repeat concussion appears to be highest in the first 10 days after a concussion, and this heightened risk may continue for some time. During this period, the brain is more vulnerable to injury, even from minor hits or impacts.

The Treatment Is Usually Just Time

Recovering from a concussion is usually just a matter of time. Some people will improve almost immediately, while others take longer. Every athlete is different.

Experts recommend an initial period of brief rest followed by a gradual return to increasingly more demanding activities.

Deciding Whether to Go Back to Sports

Deciding whether a child can safely return to sports—or whether sports risk too much harm—is the responsibility of a trained healthcare provider judging the individual circumstances of a particular young athlete. Informed athletes and parents are their critical partners.

Their choices usually include:

  • Returning the athlete to the same sport after full recovery
  • Returning to a different sport or activity that has a lower risk of concussion
  • Stopping sports and activities that pose even a small risk of concussion

To participate in the decision-making conversation, parents will need to understand the risks and benefits of returning to play, and discuss with their child’s healthcare provider how they feel about them.

Concussion Prevention: What Works, What Doesn’t

Concussions are preventable. But the number of effective strategies is slim.

Changes to rules and policies show the most promise, while equipment and headgear currently offer little protection in most sports.

Concussion FAQs

What activities cause the most concussions in young people?

A 2016 report from the Centers for Disease Control and Prevention found that among children and adolescents with concussions, the activities most responsible for visits to hospital emergency departments were soccer among females and football among males. Young cyclists and basketball players were the next most likely to seek emergency care for concussions.

The report tallied total number of concussions (not rates) from each type of activity. As a result, it was not able to show which activities caused the most concussions per 1,000 kids participating in the activity. By that standard, lower-participation sports such as rugby, ice hockey or horseback riding would rank higher on the list.

Source: Coronado VG et al., Centers for Disease Control and Prevention 2016
Can blood tests or imaging scans diagnose a concussion or detect recovery?

Blood tests and genetic tests can’t yet reliably diagnose a sports-related concussion or track the brain’s progress toward recovery. Imaging tests are usually not recommended for the same reason. Researchers continue to explore new technologies, but there is no perfect test.

If symptoms worsen or don’t improve as expected, a healthcare provider who specializes in the diagnosis and treatment of concussions might recommend magnetic resonance imaging (MRI) or computed tomography (CT). These imaging tests can identify dangerous conditions such as a skull fracture or bleeding in the brain (called a hematoma). But these situations are unusual and imaging is undertaken with caution, in part because CT scans expose athletes to potentially harmful radiation.

What is the chance that a youth athlete will have a concussion?

Scientific evidence on concussions in athletes younger than high-school age is scarce. No organized method exists for collecting data across age groups and sports. Despite these limitations, two studies shed some much-needed light on the risk of concussion in youth football. Together they suggest that up to five out of 100 youth athletes who play football for a full season may have a concussion.

In a 2015 study, researchers enrolled more than 3,000 football players ages five to 14 from 118 teams in six states. Athletic trainers attended each practice and game, and diagnosed the injuries. They documented players’ concussions during two seasons:

  • Out of 100 youth athletes who played football for a full season, three had a concussion and 97 did not.  The authors reported similar rates of concussion at all three levels of football—youth, high school and college.

In a more recent study, colleagues at the Seattle Children’s Hospital and The Sports Institute at UW Medicine followed 863 football players ages five to 14 for two years. Athletic trainers attended every game, and documented potential concussions.

  • Out of 100 youth athletes who played football for a full season, five had a concussion and 95 did not.

smaller study of 351 female middle-school soccer players reported a considerably higher rate of concussions. Over the course of four years, parents used a sideline symptom checklist to diagnose injuries and report them through an online surveillance system. Among these elite players, 13 out of 100 had a concussion each season. The researchers believe the rates reported in other studies may be artificially low because many athletes do not report concussion symptoms to their coaches or athletic trainers.

Sources: Chrisman 2018, Dompier 2015

What is the chance that a high school or college athlete will have a concussion?

Reported rates of concussion in high school and college vary widely. Estimating the true risk is difficult. In part, that’s because definitions of concussion vary from place to place and methods of collecting data are uneven. It’s also because many concussions are never reported.

Researchers have conducted several large studies that examined concussion data in male and female athletes.

  • Overall, out of every 100 athletes who played a sport for a full season, up to five had a concussion. On average, 95 or more did not have a concussion.

A large study of high school athletes in Michigan, for example, enrolled more than 190,000 boys and girls who played 15 sports.

  • Out of every 100 athletes who played a sport for a full season, about two had a concussion and 98 did not.
  • The sport with the highest rate was football, where about four in every 100 players had a concussion each season.

Another study looked at 32,156 college athletes who participated in 13 men’s and women’s sports.

  • On average, about four out of 100 had a concussion and 96 did not.
  • The rate of concussion in football was about 5 in 100. The rates of concussion in men’s and women’s ice hockey and men’s wrestling were a bit higher, up to 8 in 100.
  • The lowest rates were in men’s baseball, women’s softball and men’s soccer.

Other studies have reported higher rates. For example, among high school athletes who play football or girls’ soccer for a full season, as many as 10 out of 100 have reported a concussion.

Sources: Bretzin 2018, Kerr 2017, McCrea 2013
Which high school and college sports have the highest and lowest risk of concussion?

The rate of concussion in specific sports varies widely from study to study, so it is difficult to rank sports from highest risk to lowest with true precision.

Risk in men’s sports. Most research shows that the risk of concussion among men is highest in rugby, football, ice hockey, lacrosse, soccer and wrestling.

Risk in women’s sports. Among women, soccer, lacrosse, ice hockey and basketball usually have the highest rates of concussion.

In sports where men and women play the same game by similar rules (for example, soccer and basketball), women generally have a higher rate of reported concussions than men. This may have to do with differences in physical characteristics or playing styles. It is also possible that women simply are more likely to report their injuries. To the surprise of some, the risk of concussion among women soccer players appears to be similar to that of male football players.

In virtually every sport, the rate of concussions is substantially higher during competitions and games than during practice. But injuries in practice are just as serious and deserve the same amount of medical attention.

The table below provides a rough estimate of concussion risk across a variety of high school and college sports.

Concussion risk in high school and college sports

(Sources: Zuckerman Am J Sports Med. 2015; Black Clin J Sport Med. 2016; Willigenburg Am J Sports Med. 2016; Graham IOM 2014; Marar Am J Sports Med 2012)

Why do some people take longer to recover than others?

Although research shows that concussion symptoms go away within a week or two for most athletes, they sometimes take longer. The risk that recovery will take longer may be greater in athletes who:

  • Had a greater number of symptoms at the time of their concussion (four or more)
  • Had more severe symptoms at the time of concussion, such as loss of consciousness (blacked out) or amnesia (memory loss)
  • Did not immediately report symptoms of a concussion and continued to play
  • Had a previous concussion
  • Had a recent concussion

Athletes ages 13 through high school may also take longer to recover than college-age athletes, especially if they have had more than one previous concussion.

And recovery may be more difficult for people with certain medical conditions that they had before their injury. These include migraine headaches, depression, anxiety or panic attacks, learning disabilities and attention deficit/hyperactivity disorder, although some recent research has raised questions about these risk factors.

Athletes in certain sports seem to be at greater risks of prolonged recovery. In one large, careful study:

  • Lacrosse players had more than twice the risk of a long recovery compared to soccer or football players
  • Ice hockey players had three times the risk of a long recovery

The current evidence suggests that male and female athletes are at similar risk for experiencing persistent symptoms and a prolonged recovery.

What should I do if the symptoms don’t go away?

A few athletes have symptoms that linger for weeks or months. In a study of high school and college athletes, about two out of every 100 athletes with concussions reported symptoms that lasted longer than one to three months.

Athletes with lasting symptoms report continued headaches, disturbed sleep, fatigue, slowed thinking and other problems. These can take a heavy emotional toll. Athletes may feel frustrated, irritable and restless.

If symptoms persist, athletes should seek help from a comprehensive concussion program or a healthcare provider who specializes in the diagnosis and treatment of concussion. Healthcare providers who specialize in concussion management include:

  • primary care sports medicine physicians
  • physiatrists
  • pediatricians with sports medicine training
  • neuropsychologists
  • neurosurgeons
  • neurologists
Do helmets prevent concussions?

The short answer? No.

Helmets can prevent skull fractures, bleeding in the brain and other head and face injuries. But they can’t absorb the full force of a jolt that disrupts the brain and causes the many problems experienced by an athlete who has a concussion.

Do helmets lessen concussion severity? Research suggests that among athletes who have concussions, those who play sports with helmets and those who play without helmets have similar outcomes in the first few days after injury.

To the extent that helmets help, older helmets in good repair seem to offer the same level of protection as newer ones.

For further reading on concussion prevention, see Concussion Prevention: What Works, What Doesn’t


Myth: ‘Cocoon Therapy’ Helps a Concussion

Two recent guidelines from U.S. and international experts have introduced new but subtle recommendations that undercut a style of treatment for sports concussion known as “cocoon therapy.”

Returning to School After a Concussion

Almost all athletes recover without problems after concussion, and quickly return to full participation in their schoolwork. But some face challenges. Read these common-sense tips to help return to learning following concussion.

Is Heading In Soccer Dangerous?

In boys’ and girls’ soccer, most concussions happen during collisions between two players—not between a player and a ball. A critical review of the research suggests heading is unlikely to lead to short- or long-term brain damage.

Are Concussions In Soccer Preventable?

The popularity of soccer has soared in part because parents perceive it to be safer than other sports. Yet injuries occur, including concussions. Efforts to make the sport safer include stricter rules enforcement, padded headgear, neck strengthening and more. Some of these measures may help, but many await stronger proof of effectiveness.

Learning Center

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Heads Up: Hoja informativa para los deportistas y sus padres acerca de las conmociones cerebrales

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Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children. Web page with links to the 2018 concussion guideline, the first for children, as well as assessment tools, patient resources and more

Centers for Disease Control and Prevention, Caring for Your Child’s concussion. A 4-page handout that explains in simple terms what a concussion is, including its signs and symptoms, and recommends steps for returning to school and other activities after a concussion.

Centers for Disease Control and Prevention, How Can I Help My Child Recover After a Concussion. A 4-page handout that describes practical tips for helping a child recover from symptoms that affect physical abilities, thinking and remembering, social and emotional concerns, and sleep problems.

Concussion management video A 15-minute video on the importance of understanding concussions and guidelines for removal from play and return to play after a concussion. Stanley Herring, M.D., senior medical advisor at TSI, serves as host.

What Should I Know About Concussion? A one-page pamphlet summarizing the chances that your child will have a concussion, concussion symptoms, the potential long-term outcomes of a concussion, and a graduated return-to-play guide.

Concussion Recognition Tool 5 . A sideline tool to help parents, coaches and athletes recognize a concussion and know when a brain injury is an emergency.

Heads Up: Concussion resources for parents of school athletes. An extensive set of resources from the Centers for Disease Control and Prevention that include:

Heads Up: Built for tablets and smartphones, “Rocket Blades” is a visually appealing experience with fun gameplay that entertains kids 6-8 while teaching about concussions.

Heads Up: Concussion fact sheet for parents

Heads Up: Facts about Concussion and Brain Injury. A 20-page brochure about concussion, its signs and symptoms, tips for healing and where to get help.

Heads Up: Your Child’s or Teen’s Helmet. Video and fact sheets for 11 sports and recreational activities, from cycling and snowboarding to hockey and football.

U.S. Soccer, Let’s Take Brain Injuries Out of Play. A one-page handout with concussion facts, including signs and symptoms and an explanation of the critical importance of reporting concussions.

U.S. Soccer Concussion Guidelines. Outlines rules implemented in 2016 that eliminate heading for children under age 10, limit heading to practice only for children 11 to 13, and allow players to be evaluated for concussion during games without penalty.

U.S. Soccer Recognize-to-Recover. Player health and safety program with information on concussion, heat illness and dehydration, sudden cardiac arrest and prevention of other injuries.

Doctors Often Skip Discussing Dangers of Driving After Concussion

Most doctors who treat young athletes for concussion know that the injury increases the risk of having a car accident, but barely half counsel their patients against driving, a U.S. study suggests. (Reuters Health)

Read More

High School Coaches, Players Know Little About Concussion

Most high school coaches, players and parents do not know that a concussion is a brain injury. But they generally understand the importance of being symptom-free before returning to play and the potential effects of repeated concussions. (HealthDay)

Read More

Faulty Positioning in Rugby Tackles Boosts Injury Risk

Head, neck and shoulder injuries during rugby tackles are more common when the tackler’s head is incorrectly positioned in front of the ball carrier. Athletes employing recommended techniques had significantly fewer injuries. (Reuters Health)

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State Laws Have Reduced Concussion Risks In High School Kids, Study Finds

Laws spearheaded by the director of UW Medicine’s Sports Health and Safety Institute, Stan Herring, MD, and colleagues have led to a noticeable nationwide decline in repeated concussions among teenage athletes. (Washington Post)

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Movement, play and sports: What are the benefits?

The sports and activities children love often come with risks. But sports, movement and play also yield abundant benefits, and can enhance the physical, mental and social health of children long into the future.

The benefits of physical activity

  • Physical activity in childhood and adolescence can increase muscular strength, improve the ability to perform complex movements, build bone, improve mood, and increase heart and lung fitness.
  • Physical activity can help prevent inactivity-related diseases that occur in childhood, including Type 2 diabetes, asthma, high blood pressure, atherosclerosis (fatty buildup in blood vessels), asthma, sleep apnea and depression.
  • Physically active children are more likely to be physically active adults—and less likely to meet an early death or develop heart disease, breast and colon cancer, diabetes, obstructive lung disease, depression, anxiety or osteoarthritis.
  • Physical activity can help to prevent obesity and aid in its treatment.
  • Physical activity leads to better brain structure and function. It can improve thinking and mental performance, including focus, memory, attention and academic achievement.

SPORTS, MOVEMENT AND PLAY CAN ENHANCE THE PHYSICAL, MENTAL AND SOCIAL HEALTH OF CHILDREN LONG INTO THE FUTURE.

Learning Center: Movement, play and sports

For more information and resources – on how much exercise children need, strategies to make physical activity a part of every child’s life, and more – connect with our Learning Center

Understanding heat stroke in 7 steps

Athletes can develop life-threatening exertional heat stroke for a variety of reasons, but virtually none is acceptable among trainers and coaches who put player safety first. Summer training deaths from heat stroke serve as regular, harsh reminders of the importance of knowing how to prevent, recognize and properly treat this devastating condition.

Cold water baths for heat stroke: Every minute counts

Cooling an overheated athlete fast can be the difference between life and death. The most effective method is cold water immersion. Know how to be prepared for this medical emergency.

Beat the summer heat

In this compilation of stories, find out what science says about training in the summer. Learn what you need to know about proper hydration in the heat, avoiding and treating debilitating heat cramps,  and the prevention, recognition and treatment of life-threatening heat stroke.

Learning Center: Training in the heat

For additional in-depth information, tips and tools on the prevention, recognition and treatment of exertional heat illness, check out our Learning Center.

Recent News
& More

Tommy John’s Son Wants to Help Kids Avoid Sports Surgeries Like the One Named for his Dad

In the U.S., costly travel leagues and private training foster early sports specialization and year-round participation. The result is that children are experiencing the kind of overuse injuries once found primarily in professional athletes. (Washington Post)

Read More

What Happens to Your Body When You Train in Hot-Weather Conditions?

Training in the heat can actually work to your advantage. This inside look explains how athletes use a lab to acclimatize to hot training conditions. (Adventure Sports Network)

Read More

‘This Was Preventable’: Football Heat Deaths and the Rising Temperature

Most states rank poorly on heat safety for their high school football players. Too many teens have paid the price, and temperatures are only getting worse. (InsideClimate News)

Read More

Exercise Can Help Treat Mood Disorders. Here’s Why, and How to Get Started.

A growing body of research shows that exercise can be as effective as medication and psychotherapy in treating mood disorders, depression and anxiety—without the side effects. (Washington Post)

Read More

The States That Exercise Least

The CDC found that the percentage of people who get enough exercise varies greatly by state, from a low of 13.5 percent of adults in Mississippi to a high of 32.5 percent in Colorado. (The Atlantic)

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You Can Get Even More Out of Strength Training Than Killer Abs

People who strength train for at least two non-consecutive days a week have significantly fewer symptoms of mild to moderate depression, according to a recent review. (Runner’s World)

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Commutes on Foot or Bike Tied to Lowered Risk of Heart Attack or Stroke

People who regularly add walking or cycling into parts of a longer commute or journey may reduce their risk of a heart attack or stroke, according to a study from the United Kingdom that followed more than 350,000 people for seven years. (Reuters Health)

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America’s Fittest Cities

The 11th annual American College of Sports Medicine fitness index ranked U.S. cities for their residents’ healthy behaviors. The top 5: Arlington, VA; Minneapolis, MN; Washington D.C.; Madison, WI; and Portland, OR. Seattle came in one-tenth of a point behind Portland at #6. (King5)

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Using Behavioral Science to Build an Exercise Habit

Fewer than half of Americans exercise as much as they should. Thankfully, the field of behavioral science has solutions to offer. (Scientific American)

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Hydration in the heat for young athletes

Young athletes, parents and coaches frequently ask about safe ways to hydrate in the heat. They want to know how much—and what—to drink to safely perform at their best.

The answers aren’t simple. The scientific research is inconclusive, and experts disagree.

To help sort out the science and provide practical advice, we talked to E. Randy Eichner, M.D., professor emeritus of medicine at the University of Oklahoma Medical Center and former team internist for the Oklahoma Sooners football team. Eichner spent 14 years caring for Sooners football players in dauntingly hot conditions. And for three years he also served as a physician for the Hawaii Ironman, one of the longest, most grueling, and hottest athletic competitions in the U.S.

Muscle cramping in the heat

Muscle cramping is the bane of athletes playing in the heat. This painful problem can range from annoying to disabling. Find out why they happen, and how to prevent them from happening again in the future. Experts urge players who are at risk to salt their food and eat healthful salt-rich foods. Fad remedies can delay proper care.

Learning Center

Hydration. This site includes videos and information on hydration, including how to know if an athlete is hydrated, how much to drink and what to drink. (Korey Stringer Institute)

Hydration Kit. This two-page handout lists hydration supplies, from electrolyte freezer pops to pumper-style cooling stations. The handout provides prices and links to websites where individuals or teams can purchase them. (Korey Stringer Institute)

Guidelines on fluid replacement. This 2017 position stand provides evidence-based recommendations on best hydration practices for active people. (National Athletic Trainers’ Association)

Nutrition and athletic performance. Guidance on food, fluids and supplements to take for peak health and performance across a range of training and competition scenarios. (American College of Sports Medicine and American Dietetic Association)

National high school guidelines on hydration and training in heat. This position stand describes how to hydrate before, during, and after physical activity, as well as risk factors for overheating. (National Federation of State High School Associations)

NCAA guidelines on training in the heat. The NCAA Sports Medicine Handbook includes detailed recommendations on the prevention and treatment of exertional heat illness. See Guideline 2C: Prevention of heat illness, pp. 39-42 in the current edition. (National Collegiate Athletic Association)

Recent News
& More

Young Athletes Should Stay Hydrated, But Too Much Water Can Be Deadly

Overzealous obedience to hydration advice has uncovered a dark underbelly to superior hydration practices: overhydration. Drinking too much water or sports drinks dilutes blood salt levels below the normal range, triggering brain swelling, headaches, vomiting and potentially death.  (CNN)


For Questions About Dietary Supplements, NIH Website Offers Clear Answers

When it comes to dietary supplements, there are often more questions than answers. Although many Americans report using them, their benefits can be questionable. The website of the National Institutes of Health’s Office of Dietary Supplements addresses such issues. (Washington Post)

Read More

Off Your Mental Game? You Could Be Mildly Dehydrated

A growing body of evidence finds that people who are just a little dehydrated don’t do as well on tasks that require complex processing or a lot of their attention. (NPR)

Read More

That Spitting Thing at the World Cup? It’s Probably ‘Carb Rinsing’

Players are notoriously cloistered during the World Cup and are especially loath to speak about their fitness secrets, so the contents of their bottles are not known. But they may be employing a technique called “carb rinsing” or “mouth washing.” (New York Times)

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Getting Kids to a Good Weight by 13 May Help Avoid Diabetes

Overweight boys who get to a healthy weight by age 13 have the same risk of developing diabetes in adulthood as someone who never weighed too much. (US News)

Read More

Year-long Diet Study Finds It’s What You Eat, Not How Much

Research from Stanford University shows that neither low-fat nor low-carb diets are key to sustained weight loss among overweight adults. Instead, it’s back to basics: avoid refined wheat and sugar, and eat more vegetables. (University of Washington)

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Why Is It so Hard to Lose Weight and Keep It Off?

Why exactly are some people able to maintain a healthy weight while others can try and try with no luck? The process of weight gain and weight loss involves a complicated combination of genetics, complex body systems and the environment. (University of Washington)

Read More

Dangers of Energy Drinks for Kids

Energy drinks may be dangerous for kids and young adults, a new survey found. The most common problems included a fast heartbeat, insomnia and headaches. (MedPage Today)

Read More

‘Raw water’ Is the Latest Health Craze. Here’s Why Drinking It May Be a Bad Idea

By shunning recommended water safety practices, raw water purveyors may also be selling things you don’t want to drink that can make you sick. (Washington Post)

Read More

Sudden Cardiac Arrest: Six Key Facts

Sudden cardiac arrest is the number one cause of sudden death in exercising young athletes.

It usually strikes without warning in individuals with a structural or electrical abnormality of the heart, often inherited. Males, African-Americans and male basketball players are at increased risk.

No method of detecting heart problems in athletes is perfect.

A comprehensive medical history and physical exam is required for all young athletes before they participate in sports. Some medical experts are adding a screening electrocardiogram (EKG) to the standard pre-participation physical exam.

In some cases, warning signs or symptoms can help identify an athlete at risk of a sudden cardiac arrest

Signs of a potentially risky heart condition include fainting or passing out during exercise; excessive shortness of breath or chest pain with exercise; palpitations (heart racing) for no reason; and unexplained seizures.

Until proven otherwise, you should suspect sudden cardiac arrest in any collapsed and unresponsive athlete.

Unless effective emergency steps are taken immediately, death or serious disability will occur.

Every team should have—and practice—an emergency action plan for sudden cardiac arrest.

It is critical to review and practice your emergency action plan in the preseason with all personnel who may be involved in the emergency response.

Life-saving measures include calling 9-1-1, immediate chest compressions (cardiopulmonary resuscitation), and shocking the athlete with an AED as soon as possible.

Early initiation of all of these measures is important. Early defibrillation (shock) with an automated external defibrillator (AED) is the most important factor for survival. A few minutes’ delay can be the difference between life and death.


Sudden cardiac arrest: Know the danger

Every two to three days in the U.S., a young athlete dies as the result of sudden cardiac arrest. In fact, sudden cardiac arrest is the number one cause of sudden death in exercising young athletes.

In most cases, the arrest occurs with no warning. In the midst of play or practice, the athlete suddenly collapses. And if appropriate action is not taken within minutes, the athlete will die or be left with serious brain damage.

This information is for you if you want to learn about the causes of sudden cardiac arrest, the athletes who are at greatest risk and the critical importance of an emergency action plan. Being aware of the danger is the first step in preparing to save an athlete’s life.

Learning Center

Resources

Sudden Cardiac Arrest (video). A seven-minute course to prepare youth coaches and league administrators for an acute sudden cardiac arrest emergency (planning, recognition, screening and four steps to survival). USA Football developed the course, but the information is relevant to basketball, baseball and other sports in which sudden cardiac arrest can occur. The video features University of Washington and Seattle Seahawks team physician Jonathan A. Drezner, M.D.

American Heart Association

American Medical Society for Sports Medicine

National Athletic Trainers Association

Sudden Cardiac Arrest Foundation

UW Medicine Center for Sports Cardiology

 

Screening Fails to Predict Most Heart Deaths In Young Soccer Players

Examinations of more than 11,000 adolescent soccer players in the UK over 20 years have found that routine heart testing prevented very few sudden heart-related deaths during exercise. (Reuters Health)

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A Hoop Player’s Sudden Return from Sudden Cardiac Arrest

Fewer than 8 percent of those who suffer cardiac arrest outside a hospital survive. But this high school basketball player did—because there was an automated external defibrillator on hand and people who knew how to use it. (Rivard Report)

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Surprisingly High Number of NBA Players Have Abnormal Heart Scans

Heart data from elite basketball players show that a surprising number have abnormalities—but these results are likely false positives that don’t take into account how the heart changes during training, according to researchers. (The Verge)

Read More

Cardiac Arrest Rare In Young Athletes but Tough to Predict

Young athletes have a very low risk of suffering a fatal cardiac arrest. But more important, researchers found that more than 80 percent of cases probably won’t be caught through “pre-participation screening” that includes electrocardiograms to detect electrical abnormalities in the heart. (HealthDay)

Read More

This Mistake Can Cost the Lives of Athletes in Cardiac Arrest

Athletes are dying from cardiac arrests that occur during play because teammates, coaches and other bystanders don’t know how to best save their lives, a new study claims. (Chicago Tribune)

Read More

Heart Screening for Teens May Cause More Problems than It Solves

Dozens of not-for-profit organizations have formed in the past decade to promote free or low-cost heart screenings for teens. The groups often claim such tests save lives by finding abnormalities that might pose a risk of sudden cardiac death. (NPR)

Read More

Olympic Athletes Have Heart Problems, Too

Some Olympic athletes could be at risk while training and competing because of heart defects or dysfunction that they may not even know about, Italian researchers say. (Reuters Health)

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Myth: Specialize Early to Become an Elite Athlete

Mounting evidence challenges a deeply held conviction among youth sports participants that specializing in a single sport at a young age is critical to success.

Recent research suggests that early specialization is not necessary to achieve elite levels of performance. Compared to other athletes, athletes competing at the highest levels more often postpone specialization until later in adolescence and compete in more sports.

Play More Than One Sport to Be a Better, Healthier Athlete

Young athletes who play more than one sport into their adolescence appear less likely to develop overuse injuries or to burnout from sports. They may also have more fun, develop into better athletes and enjoy longer sports careers.

“Playing multiple sports should not be viewed as falling behind,” suggests an expert panel, “but rather as building the foundation for future success.” When is the right age to specialize?

Do Single-Sport Athletes Have More Overuse Injuries?

Youngsters who specialize in a single sport appear to be at greater risk of developing overuse injuries than athletes who play multiple sports, even after accounting for the extra hours they often devote to training.

High training volumes increase the chance of developing overuse injuries. Single-sport specialization appears to create additional problems of its own.

Four Keys to Minimizing Injuries and Maximizing Potential in Growing Athletes

Guidelines issued by several medical societies and sports governing bodies in recent years have reached an unusual level of consensus about four key elements of sports participation that seem to lessen the risk of overuse injuries and burnout in growing athletes and maximize their performance potential.

Simplified, their recommendations boil down to this:

  1. Play more than one sport
  2. Limit training hours and get enough rest
  3. Take time off every year
  4. Participate in an injury prevention exercise program

What Do Wayne Gretsky, Jerry Rice and Kristine Lilly Have in Common?

Some of the greatest athletes of all time agree with doctors’ guidelines advising youngsters to play more than one sport in their childhood, and specialize later.  

Learn more about what they say and the recommendations from youth sports organizations.

Ankle Sprain Prevention: What Works?

Ankle sprains routinely top the list of most common sports injuries. Preventing them would be a boon to humankind.

Taping, bracing and certain exercises all help. What does the research say about these prevention strategies and which athletes benefit the most?

Preventing ACL Injuries in Female Athletes

Females have a two- to six-times greater risk of suffering an ACL tear than males playing comparable sports.

Can training programs reduce their risk? If so, how big is the benefit, and which exercises help most?

How to Know if an Injury Prevention Program Works

Proving the effectiveness of injury prevention programs can be challenging.

Researchers list four essential steps. We explain what it takes to know whether a training regimen can deter anterior cruciate ligament injuries.

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General Injury Prevention 

FIFA 11+ Kids. A video-guided set of 7 warmup exercises designed to be fun, prevent injuries and teach young players effective movement patterns for playing soccer. Exercises are progressively more complex based on athletes’ age and ability.

Female Athlete Issues for the Team Physician: A Consensus Statement-2017 Update. A paper reflecting the recommendations of doctors from the American College of Sports Medicine and other major medical societies on medical issues especially pertinent to female athletes, including ACL tears, patellofemoral (knee) pain, bone stress injuries and more.

Overuse Injuries and Early Specialization

Overuse Injury. This two-page handout from STOP Sports Injuries explains how overuse injuries occur, risk factors for developing them, and how they can be treated and prevented. (American Orthopaedic Society for Sports Medicine)

The American Academy of Pediatrics provides information for parents on sports specialization and overuse injuries in young athletes, including:

Youth basketball guidelines. These guidelines from the NBA and USA Basketball advise young athletes to postpone specialization in basketball until age 16 or later. They also provide recommendations on time to spend in organized practices and games each week, optimal hours of sleep per night, time off during the year and more.

Benefits of playing multiple sports. USA Baseball encourages players to participate in other sports, noting the additional opportunities to develop as an athlete and the risk of burnout and injury from early specialization.

Project Play parents’ checklists in English and Spanish for children ages 0-5 and 6-12. The checklist poses 10 questions parents should ask about sports programs for their children, and includes a scoring matrix for judging a program. (Aspen Institute)

Estimated probability of competing in college athletics. This table shows how many athletes compete in each sport played at the high school and NCAA levels, along with an estimate of the percentage of high school athletes going on to compete in the NCAA. (NCAA)

Ankle Sprains

Ankle Sprains in Youth. This one-page patient summary from JAMA Pediatrics provides a general overview explaining what an ankle sprain is, how to treat and rehabilitate one, and uncommon but serious situations when imaging may be helpful.

Ankle Sprain. This web page from the American Orthopaedic Foot & Ankle Society provides a high level of detail about the anatomy of the ankle, factors that increase the risk of an ankle sprain, and the diagnosis and graded rehabilitation of an ankle injury.

ACL Injury Prevention 

FIFA 11+. A highly detailed 76-page booklet from the international soccer association FIFA describing the 15 exercises that comprise the FIFA 11+ program for prevention of injuries to the anterior cruciate ligament.

LaxPrep is a warm-up and exercise program for boys and girls that is designed to decrease an athlete’s risk of an ACL injury. The program emphasizes core strength, balance and proper landing techniques, including a dynamic warm-up for each of its three phases. (US Lacrosse)

PEP. A brief document summarizing PEP (Prevent injury and Enhance Performance), a five-part ACL injury prevention program designed for teams to use three times per week. (Santa Monica Sports Medicine Research Foundation)

The Female Athlete Triad: What It Is and Why It Matters

Left unrecognized or untreated, the female athlete triad will eventually claim your attention. It has the potential to spell the end of an athlete’s career.

Its health consequences include debilitating stress fractures that may not be reversible, infertility, and disorders affecting an athlete’s weight and performance, heart, kidneys, digestive and nervous systems, and more. Learn what the female athlete triad is, why it matters and personal factors that increase the chance of a stress fracture.

The Female Athlete Triad: Fueling for Health and Performance

Any active girl or woman can develop the condition known as the female athlete triad, but some are at higher risk than others. Decades of research point to the culprit behind it.

In a word, it’s calories—calories too few to stock the energy stores a female athlete needs to run, jump, dive or dance. What can people do to fuel an athlete for health and performance—and prevent the triad?

Can Birth Control Pills Prevent Knee Injuries?

Recent studies suggest that women taking birth control pills are less likely to have surgery for a torn anterior cruciate ligament than women not taking the pills.

But two independent reviews say the studies suffer from critical shortcomings, and don’t prove that it’s the pills that are providing the protection.

Does Birth Control Raise Blood Clot Risk After a Marathon?

Research shows that flying cross-country and running a marathon both increase the small risk of developing a dangerous blood clot.

Does taking birth control pills add to that risk? If so, does wearing compression socks make flying safer?

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Exercise and Pregnancy

Exercise during Pregnancy and the Postpartum Period. The 2018 Physical Activity Guidelines for Americans contains a section on exercise recommendations during and after pregnancy. These include: doing 2 hour and 30 minutes of moderate-intensity aerobic activity each week, preferably spread throughout the week; and for women who regularly engaged in vigorous activity before pregnancy, continuing these activities during pregnancy and the postpartum period. (U.S. Department of Health & Human Services)

Blood Clot Risks and Prevention

Air Travel–Related Deep Vein Thrombosis and Pulmonary Embolism. One-page patient handout on factors that can increase the risk of blood clots during extended air travel, including sitting with bent knees for long periods without much activity. (Journal of the American Medical Association)

Ten Things People Should Know about Blood Clots. One-page handout on blood clots, including their symptoms, factors that increase the risk of having one, and blood thinners that can prevent and treat them. (American College of Sports Medicine)

Female Athlete Triad

Female Athlete Triad Coalition

  • The Education Center for athletes provides resources to learn more about the amount of energy (food or calories) required to fuel your body’s needs, how the calories you consume affect your period and bone health, and tips for a healthy body.
  • A two-page pamphlet for parents and coaches summarizes the female athlete triad, including how to recognize it and recommendations on treatment and prevention.
  • Making Up an Energy Deficit: Food and Meal Ideas. Tips from a dietitian that focuses on eating throughout the day.

Food with Benefits. Two dietitian nutritionists explain how to gain a competitive edge with a “food-first” approach to fueling. (ACSM’s Health and Fitness Journal)

Fueling for Fitness. Food and fluid recommendations for before, during, and after exercise. (ACSM’s Health and Fitness Journal)

Female Athlete Issues for the Team Physician: A Consensus Statement—2017 Update. Written for team doctors, this summarizes the medical issues facing female athletes, including anterior cruciate ligament injuries, concussions, menstrual dysfunction, bone stress injuries, the female athlete triad and exercise before and during pregnancy.

2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad. Written for researchers and healthcare providers, this exhaustive document covers the research on the female athlete triad, including diagnosis and recommendations on treatment and return to play. (British Journal of Sports Medicine)

When Back Pain Stops a Young Athlete, Think Spondylolysis

Spondylolysis is a stress fracture of a bone in the spine that is a common cause of back pain in young athletes.

The good news: If doctors find this injury early, it has an excellent chance of healing without surgery, and the athlete can return to sports free of significant pain and limitations. The not-so-good news: Treatment often requires extended rest, typically two or three months. Learn more about the problem and the chance it will improve with treatment.

Weighing the Treatment Options for Spondylolysis in Young Athletes

Treatment for the spinal stress fracture spondylolysis requires an extended period of rest in many young athletes, but not all.

Advanced imaging tests can help determine the severity of a stress fracture and whether an athlete will benefit from a lot of rest or little to none. But imaging tests have important downsides. Understand their pros and cons, and how the treatment options vary with and without advanced imaging.

Got Back Pain? Don’t Blame the Backpack

Active kids often develop back pain whose cause is difficult to pinpoint. And backpacks have long been blamed.

Indeed, pediatricians and other healthcare professionals have declared them dangerous, and developed guidelines recommending safe carrying strategies and weight limits. But more than two decades of research suggest the multipurpose satchels may be innocent.

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Do schoolbags cause back pain in children and adolescents? A scientific review of 69 studies involving more than 72,000 kids concluded that no feature of backpacks or the way school-age children use them was connected to back pain. (British Journal of Sports Medicine)

Spondylolysis. This webpage for parents explains in simple terms a common cause of back pain in kids—the spinal stress fracture spondylolysis—including who gets it, and how it is diagnosed and treated. (Nemours Foundation)

Preventing Overuse Injuries in Young AthletesThis summary explains the four stages of overuse injuries in young athletes, who is at risk and how to prevent them. (American Academy of Pediatrics)

Low back pain in adolescents. In this post for an audience of sports medicine professionals, Stan Herring, M.D., cofounder of The Sports Institute at UW Medicine, describes the causes and symptoms of spondylolysis and the important role advanced imaging plays in decisions about how to treat the painful spine condition. (British Journal of Sports Medicine) 

Image Gently: What can I do as a parent? This webpage is packed with information for parents who want to understand more about the imaging tests recommended for their children, including computed tomography (CT) scansnuclear medicine studies and more. (Image Gently)

My Child’s Imaging Record. Keep track of your child’s imaging history with a handy wallet-size or 8.5 x 11 register for recording the date, type of exam and place where the exam was performed. (Image Gently)