Middle school concussions an often overlooked statistic

NWI Times

June 28, 2021 From Little League and Pop Warner to high school to college and to the pros, the sports medicine studies abound.

We worry over torn ACLs, concussed brains, and overused elbows — among other maladies. We know the injury rates and have a decent idea on how to prevent and treat. However, one group is missing from along this line of progression in sports.

Years ago in this space, I repeated what then-Red Sox team doctor Arthur Pappas said at a sports medicine conference: “Children are not miniature adults.”

More precisely, though, the members of the missing group — middle schoolers — are neither miniature high schoolers nor oversized Little Leaguers.

This year’s National Athletic Trainers’ Association’s annual meeting was held virtually last week and finally featured multiple studies on the too often forgotten kids in the middle.

One of those investigations was performed at George Mason University as part of its Advancing Healthcare Initiatives for Underserved Students project. Specifically, the researchers looked at concussion rates in 12 sports (baseball, boys and girls basketball, cheerleading, football, boys and girls soccer, softball, boys and girls track, volleyball, and wrestling) at five Virginia middle schools between 2015 and 2020.

Similar to what has been previously reported among high school and college athletes, football had the highest rate of concussions with 1.36 concussions per athlete exposures — an exposure being one practice or one game. Girls soccer was a close second at 1.26/AE and wrestling was right behind at 1.12/AE.

Also along the same lines of high school and college studies, among sports played by both boys and girls, the concussion rate for girls was twice that for boys.

Among the interesting findings was that more than a quarter of the 339 recorded concussions occurred outside of a school-sponsored sport. That discovery perhaps underlines how crucial it is for all middle school personnel — administrators, counselors, nurses, and teachers — to be familiar with concussion, its signs and symptoms and how the condition is best managed.

However, the most striking statistic was that the overall concussion rate of 0.60/AE was higher than the rate typically found among athletes at the high school and college levels.

Consequently, the study’s authors concluded, “Our findings reinforce the value and importance of onsite athletic training services within middle school sport settings.”

The same researchers also made separate presentations on overall middle school injury rates in baseball and wrestling. Again, perhaps surprisingly, the rate of all sports-related injuries in both sports was higher than what has been previously reported in other studies at the high school and college levels.

The Korey Stringer Institute at the University of Connecticut and the NATA have been tracking and reporting on the level of athletic training coverage at the high school level since 2017. Their third annual report, for the 2019-20 school year, found that 64% of high schools across the country had some form of athletic training coverage. Indiana was better than average at 83%, but Illinois lagged at 58%.

While KSI and the NATA also started surveying last year for middle school coverage, they have not yet reported specific numbers. Still, even absent the evidence from a reputable survey, it is safe to say athletic trainer services at the middle school level are minimal compared to those one level higher.

Given the data in these studies from the ACHIEVES project, we need to do better.

Still stuck in the middle of COVID

We are well past the beginning of the COVID-19 pandemic. Yet, as evidenced by what happened to the North Carolina State baseball team at the College Baseball World Series – forced to withdraw due to too many players being in the NCAA’s COVID-19 protocol, we have not reached its end either.

A major reason? The continued reluctance of young people to get the vaccine and unfortunately professional athletes are leading the way — only 23 MLB teams, for example, have reached the 85% vaccinated threshold required to relax COVID-19-related regulations and restrictions.

Yes, there is a risk of cardiac inflammation among young men from the vaccine, 12.6 cases per million vaccination doses delivered or 0.00126%. Meanwhile a study in JAMA Cardiology, reported on in this space in March of this year, found that 5 of 789 professional athletes diagnosed with COVID-19 were also afflicted with myocarditis or pericarditis. That is 0.6%. The numbers from a similar large-scale study of college athletes were nearly identical. In short, one is 475 times more likely to experience cardiac inflammation from the disease than from the shot.

Aside from the cardiac dangers associated with infection, there are others such as lung damage and long-term energy/cognitive issues.

When comparing the virus to the vaccinations, there is no comparison. Unless your physician (96% of them are vaccinated according to the AMA) tells you not to get the vaccine, then you should get it. The sooner that advice is taken, the sooner we will be able to get this crisis entirely behind us.

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