Play at Your Own Risk: Sport and the Injury Epidemic

Abstract

Each year, more than 30 million children and adolescents participate in organized sports in the United States (US), and more than 4.3 million nonfatal sports-and recreation-related injuries are treated in US hospital emergency departments. Two types of activity-related injuries, in particular, that we study in the Bone and Joint Injury Prevention and Rehabilitation Center at the University of Michigan are anterior cruciate ligament (ACL) injuries and head injury and concussion. Knee ACL injuries are occurring in epidemic-like proportions. In the US alone there are approximately 200,000 new ACL injuries at a total cost of over $1 billion per year. ACL-injured patients are at a significant risk of developing early onset osteoarthritis. Exacerbating the concern is the increase in ACL injury rates in youth and adolescents; particularly girls can experience ACL injury rates from two to five times greater than boys in the same sport. In addition, 3.8 million sports-and recreation-related concussions occur in the US each year. Significantly more research is needed, but intriguing findings are surfacing. For example, high school athletes' recovery times for a concussion are longer than college athletes' recovery times. Moreover, high school athletes who sustain a concussion are 3 times more likely to sustain a second concussion. Preliminary studies state suggest women have a higher risk for head injury and post concussion syndrome due to potentially weaker neck muscles, different muscle activation patterns, and hormone variations. Three key questions must be answered to understand these and other sports-related injuries: 1) What is the magnitude of the epidemic? 2) What are the causes of injury? and 3) What can we do to prevent injuries? Without a greater awareness of the injury risk and a better understanding of the injury mechanisms, the risk of sport-related injuries may escalate in the coming years.

Substance Use and Related Harms Among Adolescents With and Without Traumatic Brain Injury

“…A binary variable was created by summing up the responses from the 10-items and using the WHO's the recommended cut score of 8 or more of a maximum 40 (binary coded as 1 and 0 otherwise) to classify those displaying a hazardous/harmful drinking pattern. [41][42] The second measure was drug use problems experienced by adolescents during the past year and used the 6 yes/no items of the CRAFFT screener ( [1] use drugs to relax, feel better about self; [2] used drugs while alone; [3] forgot things you did while using drugs; [4] gotten into trouble while using drugs; [5] family/friends told you to cut down; [6] used drugs when driving). 43 A total count of two or more problems, binary coded as 1, classifies adolescents as having a drug use problem and may be in need of treatment.…”

“…1,5,6 Most TBIs among youth occur during sports. 2,3,4,14 The Centre for Disease Control and Prevention (CDCP) in the US reports that between 2001 and 2009 the number of head injuries during sports among youth has risen by 57%. 15 In recent years, CDCP has termed TBI among youth a -silent epidemic‖, as most incidences of sports related TBI among teens, go unreported.…”

Prosodic processing post traumatic brain injury - a systematic review

“…The main mechanism of TBI among infants age 0–4, are falls, among adolescents age 10 to 20 are sport related injuries, and among adults are traffic collisions, falls, and assaults [2–4, 7, 11, 12]. Fall-related head injuries are approximately four times greater among older adults (over 65) compared to adults less than 65 years old [2–4].…”

“…Based on hospitalized and non-hospitalized records, estimates indicate that more males than females sustain TBIs [1–4, 11]. TBIs have large societal and economic toll [8, 13] and also affect the individual as TBI affects quality of life, including challenges to the individual’s ability to return to work or school and sustain relationships with family, friends, and community [2–4, 7]. …”

“…Symptoms associated with TBI involve sensitivity to sounds (increased irritability with loud and/or high pitched sounds) along with various physiological, cognitive, and emotional symptoms including dizziness, headaches, sensitivity to light, mood changes, irritability, diminished focused attention, and slow reaction time [2, 4, 5, 7, 8, 11, 14]. Post-TBI symptoms are difficult to diagnose and prognosis as to whether the symptoms will persist or lead to adverse conditions is difficult [8, 11, 14].…”