In recent years, significant attention has been given to the problem of sport-related traumatic brain injury (TBI), including concussion. Led by its Center for Sport Science, US Lacrosse has assisted in helping the lacrosse community gain a better understanding of TBI and concussions through research, education, and awareness efforts. 

The latest information comes from the new consensus statement on sport-related concussion in youth sports, published last month in JAMA Pediatrics, a monthly peer-reviewed medical journal by the American Medical Association. 

Partly funded by US Lacrosse, this project was designed to gain a better understanding of the scientific evidence regarding the risk of injury. A panel of experts developed seven specific questions and then conducted an extensive review of the current literature to identify evidence-based research studies related to each question.

The group finished with 26 recommendations for the prevention, assessment, and management of sports-related concussions among young athletes, defined as individuals under the age of 19. 

“This process took two years to complete and included the review of 1,400 articles,” said Dr. Andrew Lincoln, director of the MedStar Sports Medicine Research Center and a member of the US Lacrosse Sports Science & Safety Committee. “The panel really did a lot of the hard work for the rest of us to better understand what the scientific evidence tells us about the risk of injury.”

One of the conclusions from the panel was that males, regardless of age, have a higher rate of reported sport-related concussions than females in youth sports overall. The panel recommended that parents, youth sports participants, coaches, and other stakeholders should be educated that contact and collision sports are associated with an increased risk of concussions compared to non-contact sports in both male and female youth.

It is strongly encouraged that parents should consult with qualified healthcare professionals as the primary source of concussion information, rather than media reports or other secondary sources.

The panel also noted that the data on the association of age and risk for sport-related concussions is inconclusive, and thus, the group did not recommend an age or developmental stage at which contact or collision are most safely introduced for practice or competition. It did, however, recommend that youth players be taught sport-specific contact techniques before contact or collision is introduced.

“This group that came together for the consensus statement did an excellent job,” said Dr. Ruben Echemendia, a clinical neuropsychologist who also serves on US Lacrosse’s Sports Science & Safety Committee. “They reviewed the literature in a very rigid manner, scrutinized what was there, and identified what were the key points that needed to be brought out.” 

●​ Video: More Reaction to the Consensus Statement from Dr. Ruben Echemendia

The panel concluded that there was no data to suggest that using equipment perceived as being more protective increases the risk of sport-related concussion in youth by creating a false sense of security leading to more dangerous behavior. It recommended that helmets should be worn in sports with a high risk of contact to the head, including boys’ lacrosse.

Among some of the other recommendations:

● Further research is needed to evaluate methods of teaching sports-specific contact and collision techniques.

● The technologies to measure head impact exposure are research tools that require further development and validation prior to clinical use.

● Research evaluating the effect of protective equipment fit, type, and condition on risk of concussion is needed.

● In the absence of medical contraindication, youth should not be restricted in their choice of sport.

The findings were developed by a panel of experts across multiple disciplines, including pediatrics, pediatric neurology, pediatric neurosurgery, physical medicine and rehabilitation, and others. All individuals on the panel have expertise in youth sports and concussion. 

“I think key to the recommendations that this panel made was, number one, that education is critically important across the board,” Echemendia said. “Also, what came out as being very important is the cost-benefit ratio of sports, and that sports are incredibly important for the development of many kids. Yes, some sports have risks of injury, but clearly, the benefits of sports outweigh the risks.”
 

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