For young athletes, concussion risks of playing sports are still unclear, experts say

Soccer players try to head the ball
Two soccer players compete to head the ball. Pediatric experts say they still don’t know how risky concussions can be for young athletes.
(Christine Cotter)

New guidance on concussions shows there isn’t enough solid evidence to answer some of parents’ most burning questions about contact sports. That includes what age is safest to start playing them.

Pediatric experts in sports medicine, neurology and related fields evaluated and rated three decades of research on concussions, sports and children. They say recent evidence filled in some blanks, such as:

◆ Teen girls face higher concussion risks than boys when playing the same sport by the same rules.

◆ Body-checking bans in hockey reduce concussions in players under 13.


◆ Limiting contact in youth tackle football results in fewer head impacts.

“Parents worry, ‘Is one concussion to my child going to result in him having dementia at age 50?’” said Dr. Frederick Rivara, lead author of the consensus statement published Monday in JAMA Pediatrics. “And the data are pretty clear that the answer is no.”

But it remains uncertain how many concussions are too many, when to call it quits, and what the long-term consequences of multiple concussions in youth sports might be. Still, parents shouldn’t let the unknowns and undue fears keep kids from playing sports, he said.

“The last thing we want to tell kids is not to be active,” said Rivara, a pediatrician and injury prevention researcher at the University of Washington’s medical school.


Among the experts’ other conclusions:

◆ Kids should be taught collision techniques before beginning play in contact sports.

◆ There is not conclusive evidence that younger children face higher risks for getting sports-related concussions.


◆ Evidence is inconclusive on whether multiple childhood concussions are linked with long-term neurological changes.

◆ Technology that measures head-impact exposure, as well as advanced brain-imaging techniques, are both experimental and not ready for use.

◆ Helmets should be worn in high-impact sports even though there’s little or no evidence that headgear prevents concussion in rugby and soccer.

Concussions, also called mild traumatic brain injury, are caused by a bump or jolt to the head. The impact causes the brain to bounce or twist, potentially damaging brain cells. Repeated concussions have been linked with a debilitating brain disease found in autopsies of some retired football players.


More awareness of the potential dangers of concussions has led to more reporting of the injuries, but there’s no evidence that there has been a true increase in their incidence, said Dr. Cynthia LaBella, a panel member from Chicago’s Lurie Children’s Hospital.

LaBella emphasized that concussions can happen in all recreational activities and said the physical, mental and social benefits of playing organized sports outweigh the risks of any injury, including concussions.