More Kids Who Play Basketball Suffering Head Injuries

Children's basketball may be getting rougher or the kids may be bigger, but either way the number of head injuries is soaring, researchers report. "Although the total number of injuries decreased during the study period, the number of traumatic brain injuries increased by 70 percent," said study author Lara McKenzie, of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. "These injuries are exceedingly high in this popular sport," she added. "This is cause for alarm." McKenzie thinks the increased size of players is one factor in the increase in concussions. Another is that the game has become more competitive, she said. Why total injuries have gone down by 20 percent over the 11 years covered by the study is not clear, McKenzie added.

"We don't want to discourage kids from physical activity. We don't want to discourage kids from playing basketball, either," she said. "But we need to recognize that there are some inherent risks in any activity." McKenzie added that the problem of traumatic brain injury needs to be addressed. "Maybe we need to do more education of coaches, athletes and parents to recognize the signs of concussion and help to prevent them," she said. The findings are published in the Sept. 13 online edition of the journal Pediatrics. For the study, McKenzie's team used data from 1997 to 2007 from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System to estimate the number of children injured while playing basketball.

Over the study period, the researchers found an estimated 4,128,852 children were treated in emergency rooms for injuries sustained while playing the sport. That's 375,350 every year. While the total number of injuries went down over the study period, traumatic brain injuries increased 70 percent, the researchers found. The most common other injuries were sprains in the legs 30.3 percent, particularly of the ankle. Boys were more likely to suffer cuts, fractures and dislocations, while girls were more likely to suffer concussions and knee injuries. Children 15 to 19 years of age were three times more likely to injure their knees and ankles, while younger children, aged 5 to 10, were more likely to suffer concussions, fractures and dislocations, the study found.

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Clearing Kids for Sports Participation Sparks Conflicts

Most teenagers think they're invincible, and that goes double for talented teenage athletes. They're young, immortal, at the top of their game, the envy of their friends. So when news hits that an apparently healthy, high school or college athlete has dropped dead in the midst of playing his or her favorite sport, millions of parents get understandably anxious. The uppermost question becomes: Should my child be screened before participating in sports? What tests are needed? And how can we be sure that he or she is truly healthy enough to compete? Everyone agrees that a medical checkup before participating in sports is crucial. But the agreement seems to stop there. At the core of the conflict over further testing is how extensively young athletes' hearts should be tested before they're cleared for athletic participation.

"I think everyone should have a doctor who evaluates them, and the doctor should know the child is going to be participating in athletics," said Dr. Paul Thompson, the director of preventive cardiology at Hartford Hospital in Connecticut, who helped write a joint position statement in 2007 from the American College of Sports Medicine and the American Heart Association. That statement recommends cardiovascular screening for high school and college athletes before they start participating in athletics and at two- to four-year intervals. The screening should include a family history, a personal history and an exam "focused on detecting conditions associated with exercise-related events," according to the groups' recommendation.

But, there's more: "The AHA does not recommend routine, additional noninvasive testing such as a routine EKG." The American Academy of Pediatrics seems to agree. "Every athlete should have a thorough history [taken] from the athlete as well as the athlete's family," explained Dr. Reginald Washington, a pediatric cardiologist and chief medical officer at Rocky Mountain Hospital for Children in Denver and past chairman of the academy's committee on sports medicine and fitness.The doctor should ask about any chest pain and dizziness, and whether the athlete has ever passed out or experienced a racing or unusual heartbeat, Washington said. The physician should also ask if the athlete's parents have had early heart disease, before age 55 for a man and 65 for a woman. And the physical exam, he said, should be thorough and include listening to the heart, taking blood pressure and feeling the pulse.

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