Minnesota study: Concussions most likely in football, hockey players

Minnesota high school football and hockey players are more likely to suffer concussions than those in other sports, according to a new report.

And girls have higher concussion rates than boys who play the same high school sport.

Using data collected from 36 Twin Cities-area schools this past school year, the Minnesota Department of Health report offers a look at concussions in high school sports. Parents should continue to let their children play sports but should understand the seriousness of the injuries, Minnesota Health Commissioner Ed Ehlinger said.

"When I was in high school playing competitive sports, we just shook it off and got back to the field as soon as we could," said Ehlinger, who as a medical student suffered a concussion while playing touch football. But it’s important to take seriously the problems these brain injuries can pose, he adds.

Getting hit in the head can not only get a player knocked out of a football game, it can interfere with how well he does in school. A concussion can cause educational as well as health issues, and in a minority of cases can cause long-term problems.

Five years ago, Kayla Meyer suffered her first concussion while playing on the New Prague High School hockey team as a 13-year-old eighth-grader. The second concussion came 10 months later, also in hockey practice.

Although she went to a hospital the following day, "the doctors didn’t know and we didn’t know" that the brain injury would cause long-term complications, she said.

In school, the constant headaches made it harder to concentrate, and her grades dropped before she figured out she had to study harder than she had before.

Meyer found the Minnesota Brain Injury Alliance, which suggested resources to help her condition and put her on its speakers bureau. She then founded Connections4Concussions, a support and resource group for students and their parents. Now 18 and a freshman at Minnesota State Mankato, she plans to study communications so she can continue to speak about the issue.

CONCUSSION RATES

According to the data gathered from school athletic trainers, the concussion rate -- roughly six players per 100 athletes -- is about the same for girls hockey, boys hockey and football. Football players, though, suffered the bulk of concussions, 42 percent, but football teams are much larger than those of other sports.

The problem goes beyond sports so physical they require pads and helmets; concussions were also reported from students involved in soccer, basketball, wrestling, volleyball, dance team, lacrosse, baseball, cross country and gymnastics.

The Minnesota Health Department and the Institute of Athletic Medicine wanted to base the analysis, which appeared in the September issue of Minnesota Medicine, on athletic trainers’ reports, rather than hospital records, since most of the injured aren’t treated at a hospital.

In the 36 metro-area schools, 730 concussions were reported last year, occurring in about one out of every 100 student athletes. Based on that number, the experts estimate that statewide, athletes suffered about 3,000 concussions, or an average of 22 per high school, during the 2013-2014 school year.

The number is likely conservative, as athletic trainers were not at every event.

Officials declined to list the schools that participated in the study. The schools were chosen on the basis of athletic trainers being present for games and scrimmages, which is the case for most suburban and some urban schools, they said.

The numbers, which will continue to be collected this year, are important for recommending changes in how schools, health care staff, parents and students handle concussions.

A Minnesota "return to play" law already requires coaches to take students younger than age 18 out of the game if they have concussion symptoms and to get an OK to return from a health care provider. But, said health department epidemiologist supervisor Jon Roesler, "we still have a lot to learn about the ’return-to-learn’ piece."

MEASURED RETURN

Mounds View football coach Jim Galvin said the school has a team doctor and trainer on the staff. If a player is diagnosed with a concussion-like symptoms, he is monitored for 24 hours, he said.

When the player is symptom free for 24 hours, they start their protocol:

• Day 1: Walking. If the player is symptom free after walking, he advances to Day 2. If not, he returns to this stage.
• Day 2: Light jogging. If symptoms persist, he goes back to Day 1. If he feels good and shows no symptoms, he advances to Day 3.
• Day 3: Football-type activities with no pads. If symptom free, advances to Day 4. If not, he must repeat this step.
• Day 4: Returning to contact. Stays at this level until symptom free. When they are symptom free, they are eligible to play again.

People need to be more aware of the warning signs of brain injuries, Ehlinger said, and to realize that injured students may need additional resources, especially if symptoms go on for more than two weeks. That is the case in about 5 percent of the students in the new study.
And students need to recognize how important it is to be truthful about how they’re feeling following a hit on the head, said Lori Glover, rehabilitation director at Fairview Health Services.

Signs of a concussion are headache, passing out, confusion, amnesia, dizziness, ringing in the ears, nausea, vomiting, slurred speech, delayed response to questions and fatigue.

Concussions have been a big issue recently in professional football, as the NFL this summer reached a tentative settlement in a class-action lawsuit of concussion-related claims.

Former Minnesota Vikings quarterback Brett Favre’s last play in his 20-season career came in 2010 when he was sacked, hit his head on the ground and suffered a concussion.

The state plans to expand its data collection statewide this year and tackle questions such as why girls suffer concussions at higher rates and does it matter whether the school is in the metro compared to rural communities?

Ultimately, the state hopes to use concussion data to target specific on-field or training changes that will prevent concussions, said Jon Roesler, an epidemiologist supervisor at the health department. One year of data from 36 schools isn’t enough to find a silver bullet, but it’s a start, Ehlinger said.

ON THE WEB

For information on a support and research group founded by a young woman who suffered two concussions playing ice hockey, go online to connections4concussions.org

For information about sports concussion training through the Minnesota Brain Injury Alliance, go to braininjurymn.org and click on the link about concussion training.