ABSTRACT
A pediatrician is asked by her local school board to help them decide whether to discontinue their high school football program. She reviews the available evidence on the risks of football and finds it hopelessly contradictory. Some scholars claim that football is clearly more dangerous than other sports. Others suggest that the risks of football are comparable to other sports, such as lacrosse, ice hockey, or soccer. She finds very little data on the long-term sequelae of concussions. She sees claims that good coaching and a school culture that prioritizes the health of athletes over winning can reduce morbidity from sports injuries. In this paper, 3 experts also review the evidence about sports risks and discuss what is known and not known about the science and the ethics of high school football.
Subject(s)
Athletic Injuries/epidemiology , Athletic Injuries/prevention & control , Attitude of Health Personnel , Brain Concussion/epidemiology , Brain Concussion/prevention & control , Chronic Traumatic Encephalopathy/epidemiology , Chronic Traumatic Encephalopathy/prevention & control , Dangerous Behavior , Football/injuries , Pediatricians , School Health Services , Adolescent , Cross-Sectional Studies , Humans , Male , Primary Health Care , Risk , Safety , United StatesABSTRACT
Based primarily on consensus and some research evidence, young athletes with musculoskeletal and cervical spine injuries should not return to play until they have full range of motion, resolution of pain, normal strength, psychological readiness, and the ability to demonstrate adequate sport-specific skills. Based primarily on consensus, young athletes with suspected concussion should not return to sport until they have returned to their baseline physical and cognitive activities and successfully completed a return-to-play protocol. Based on consensus and some research evidence, any young athlete with a significant eye injury, visual changes, or abnormal findings on ophthalmologic examination results should not return to play until evaluated by an ophthalmologist. A significant number of eye injuries can be prevented by the use of approved protective eyewear.
Subject(s)
Athletic Injuries/diagnosis , Athletic Injuries/therapy , Clinical Decision-Making , Musculoskeletal System/injuries , Return to Sport , Adolescent , Ankle Injuries/diagnosis , Brain Concussion/diagnosis , Evidence-Based Medicine , Female , Humans , Male , Neck Injuries/diagnosis , Risk Factors , Trauma Severity IndicesABSTRACT
Acute care visits for sports-related concussion (SRC) are increasing dramatically in adolescents. This review summarizes current concepts in the evaluation and management of pediatric SRC by health care providers in the acute care setting.
