Preventing Head Injuries and Concussions in High School Sports

Traumatic brain injury (TBI) symptoms can range from mild to life-threatening or lifelong effects. Once you've had a concussion — the most common type of TBI — you are up to three times more likely to have another.

Athletes typically incur head injuries due to a blow to the head or neck area, being shaken violently, or on impact with another object such as a wall, the ground, or pavement. Signs of a concussion are not always apparent but should always be evaluated by a professional. TBIs are of particular concern for youth whose brains are still developing.

Preventing brain injuries such as concussions is a high priority for any sports organization and should be a top priority in high school sports programs. More is becoming known about concussions, their harmful short- and long-term effects, their prevalence in sports, and how to prevent them.

At Oddjob Hats, we understand the importance of protecting big heads and keeping young adults and their heads safe and adequately protected. To prevent or minimize the damaging consequences of concussions, we prepared this guide for coaches, officials, schools, parents, and high schoolers to stay current on protection and prevention strategies for almost any sport. 

Traumatic Brain Injuries in Youth Sports

One in four U.S. teens has suffered at least one concussion. The number one worry for parents of athletes participating in youth sports is concussions. Many parents avoid letting their teenagers participate in sports for this reason. 

With proper safety protocols, properly fitting sports equipment, and knowledge of the signs and symptoms of concussions, high school athletes can minimize the risk of TBIs. Sports leaders can be aware of concussions to get them treated before they turn into more severe issues.

Which Youth Sports Have the Most Concussions?

It is no secret that some sports are more physical than others, and evidence shows that girls have a higher rate of concussions than boys in gender comparable sports (soccer, baseball/softball, lacrosse). Due to their nature, contact sports have a higher risk of trauma. Knowing which youth sports have the most concussions is the first step in appreciating and assessing the danger of concussions.

Youth sports with the highest concussion rates include:

1. Football;
2. Girls’ soccer;
3. Boys’ ice hockey.

Other sports, in no particular order, with notable concussion rates include: 

1. Rugby;
2. Lacrosse;
3. Bicycling;
4. Wrestling;
5. Basketball;
6. Softball and Field Hockey;
7. Baseball;
8. Horseback Riding;
9. Cheerleading.

It should be noted that a large number of concussions are not reported, as players may be embarrassed. Or they may want or feel pressured to keep playing, and parents and coaches may not notice the symptoms. Coaches and parents might not see the signs of a concussion because the immediate signs are often subtle, and high school athletes might not want to be sidelined.

Brain Injury Safety Tips and Prevention

Any young adult athlete or coach will want to have the best chance of staying healthy. Concussions are a tragic reality of sports, but there has been an increase in awareness about them and the long- and short-term harms they can cause. While TBI safety is evolving, there are several things coaches and parents can do today to help minimize the risk of a concussion for their teenagers and players.

Know the Signs of a Concussion

Teach your high school athletes to recognize the signs of a concussion, in addition to becoming familiar with them yourself. Concussions can have physical and mental effects on athletes, and coaches must know the common signs of a concussion, including:

• Dizziness;
• Headache;
• Nausea;
• Trouble concentrating.

After a head injury, and if a concussion goes untreated, a teen may experience:

• Changes in behavior such as irritability, restlessness, and agitation;
• Changes in personality;
• Slurred speech;
• Loss of consciousness;
• Convulsions/seizures;
• Drowsiness;
• Memory problems and confusion;
• Difficulty paying attention;
• Sensitivity to light and noises;
• Blurred vision and one pupil larger than the other;
• Vomiting.

Long-term effects of an untreated TBI could include brain damage, rage, dementia, and death in extreme cases.

Post-Concussion Baseline Testing

If you (or the athlete themselves) believe that a teen has suffered a concussion, you should immediately take them to a professional. Before a teenager begins participating in sports, you may want to get a baseline test done. A baseline test is a simple and often free neuropsychological test from a healthcare professional. This test is conducted so the teen can have an individualized comparison of their brain function — their cognitive baseline — before suffering a concussion.

Any teen that may suffer a concussion in the future can be compared to their former baseline test. This test will assess balance, memory skills, and problem-solving abilities. This can establish brain function and better determine if a teen has had any changes after an injury if you fear they have suffered a concussion.

Follow Sports Safety Guidelines

Although some contact sports involve inherently physical aspects — tackling, heading, and hitting — there are protocols to increase safety in most sports. Any coach should adhere to these standards and instruct their players on properly participating in the activity. Parents will be required to furnish their high schoolers with the appropriate equipment for playing their chosen sport safely. Teen athletes themselves will be responsible for properly applying their safety and protective equipment, playing safely, and communicating any injuries or health concerns to their coaches and guardians. 

These high school athletes will also need to:

• Know the rules of the game;
• Wear protective gear (helmets, cups, padding, and mouth guards);
• Warm-up and cool down;
• Know their physical limits;
• Look out for the safety of others;
• Hydrate;
• Take breaks.

Some of the inherently physical aspects of particular sports such as American football and soccer continue to be adjusted and regulated. For instance, players will receive a penalty and may be ejected from the game for helmet-to-helmet tackling. Additionally, some are calling for heading in soccer to be banned, and heading the ball is already forbidden until the age of 10.

If coaches are aware of the current safety guidelines and teach their players how to play the game safely, this can significantly minimize the risk of concussions and head injuries.

Wearing all the necessary equipment and making sure it fits will help high school athletes reduce the risk of injury, and specifically TBIs, as well. Parents and coaches will need to supply their teenagers with this equipment, make sure it is appropriately fitting, and ensure their players are wearing equipment safely to participate in any sport.

Considerations for Buying Helmets

The number one way to avoid concussions is to wear a helmet. Not wearing a helmet drastically increases the chance of severe head injuries, so much so that you are required to wear a helmet for specific sports.

Helmets are required to compete in common sports and activities such as:

• Biking;
• Skating/skateboarding/rollerblading;
• Skiing/snowboarding;
• Horseback riding;
• Football;
• Climbing;
• Baseball/softball;
• Lacrosse.

Parents and coaches are responsible for supplying their teens with helmets that fit correctly and making sure they wear them as instructed to ensure safety. However, an athlete simply putting a helmet on is not enough.

Helmet Safety Tips

Helmets can fall off before impact, or not be effective because they are not the proper size. It is essential for young athletes to understand how to correctly choose a helmet. Teens will also want to make sure it's the right fit. A helmet should be snug and slightly resistant when you’re putting it on. A head-size chart can help them determine what size of helmet your athlete needs. 

Teenagers with smaller heads will need a smaller helmet for retention and proper cushioning. Additionally, helmets for athletes with larger heads may be uncomfortable, and proper cushioning may be a concern. One indicator of your teen's head size is their hat size. Have they ever had to purchase especially small or large hats? If they’ve ever had to buy an oversized athletic cap or large camp hat, you can apply this sizing toward a helmet. 

If your teen's head is in between sizes, they should start with the smaller size and then adjust as necessary when buying a new one. Here are some more tips to consider when you’re selecting a helmet:

• Retention: Athletes can check the retention system to make sure it's doing its job. There should be no movement when they try to grab the helmet at any point and remove it, whether at the chin, up near the forehead, or on top of the head. Teens can adjust the chin straps of a helmet if needed to ensure retention.
• Cushioning: Make sure the helmet has enough cushioning to absorb shock. Check for a sticker that shows it passed a required safety test. If you want to be confident, specialized shops perform tests on helmets and can give you specific information about how much they reduce force through proper cushioning.
• Certification: Helmets also come with credentials such as CPSC and NOCSAE. These certifications rate helmets based on their ability to reduce concussive forces, among other data. NOCSAE is the National Operating Committee on Standards for Athletic Equipment. This organization sets standards for the performance and safety of equipment used in organized sports. They mandate all equipment must pass tests to be certified before being sold.
• Maintenance: All headwear requires regular cleaning and maintenance, but helmets may take some additional care. A cracked helmet will not be effective in protecting an athlete because its structural integrity has been compromised. Make sure you teach your young athlete how to inspect the helmet regularly for cracks or other defects to cushioning or chinstraps. Helmets also come with expiration dates and should be retired after that time. Finally, helmets are continuously being refined to reduce the risk of head injuries. You may choose to buy a new helmet every year for the latest safety technology.

Resources for Further Reading on Youth Sports Safety

There are constant updates in safety procedures and cutting-edge technology or equipment for high school athletes. To stay current on any sport, continual reading and research will be a priority for coaches, parents, and the athletes themselves. Begin by regularly visiting the following resources.

All Sports

• Current Sports Medicine Reports: Current Sports Medicine Reports is an online resource that publishes monthly on sports medicine and exercise-related topics. The journal provides practitioners with the most current evidence-based information they need to make better decisions for their athletes' health and performance.
• National Council of Youth Sports: The National Council of Youth Sports (NCYS) is a non-profit organization that provides resources for youth sports leagues, including safety information.
• Youth Sports Safety Alliance: Youth Sports Safety Alliance is a non-profit coalition of groups dedicated to creating safer sports for all teenagers. The alliance's website contains education, guidelines, and best practices for preventing injuries in young athletes.
• STOP Sports Injuries: STOP Sports Injuries is an online resource for information about sports injuries and safety, including concussions.
• MomsTeam: MomsTeam is a parent-directed sports safety organization that provides information, resources, and tools to help parents make their teen's sports experience safer.

Baseball and Softball

• SAFE Baseball: The SAFE Baseball program helps to improve safety in youth baseball around the world. You can find information about concussion awareness and prevention, adult training, coaching manuals, and much more through its website.
• PONY: The Protect Our Nation's Youth organization (PONY) focuses on youth baseball and safety. PONY provides resources for coaches, umpires, players, and parents to help make youth baseball and softball safer.

Basketball

• USA Basketball: USA Basketball is dedicated to teaching athletes about basketball and how it can be played more safely. Their youth safety page provides information about hydration, warm-ups, proper equipment, and more.
• KidsHealth.org: KidsHealth.org provides information for kids, parents, and teachers about various health topics, including the effect of sports on young bodies. Their basketball page addresses the proper growth and development of youth athletes and common sports-related injuries.

Football

• USA Football: USA Football is the official youth development program of the NFL. Its website offers advice on creating a safe football environment that inspires success both on and off the field.
• CDC: The Centers for Disease Control and Prevention (CDC) website provides information for parents about youth football, including common injuries.
• NFL.com: The NFL.com website provides individuals with information about how to play it safe, including information about concussions and proper equipment fitting.

Soccer

• US Youth Soccer: Youth soccer players, parents, coaches, and referees can visit the US Youth Soccer website for concussion awareness information.
• SoccerToday: SoccerToday provides information about youth soccer safety, including common injuries and ways to prevent them.
• American Youth Soccer Organization: The American Youth Soccer Organization's website provides information about concussion awareness, heat training, and much more.

Bicycling

• USA Cycling: The USA Cycling website provides a variety of resources, including safety information. They also offer a course that helps people learn how to be better cyclists.
• CyclingSavvy: CyclingSavvy's mission is to promote bicycle safety and awareness as a means of improving the quality of life in communities throughout America.