University of North Carolina’s Dr. Kevin Guskiewicz, PhD continued his evangelical-like support of children playing full-contact tackle football during a 2014 concussion discussion presented at Texas A&M. Dr. Guskiewicz was one of nine presenters at the 2014 Huffines “concussion discussion” which included well known Boston University CTE researcher Dr. Ann Mckee, MD. As one of the most engaging, outspoken supporters of full-contact youth football, Guskiewicz continued to be unwilling to cite any age too young for football collisions.
McKee’s colleague at BU, neurosurgeon Dr. Robert Cantu, MD has often stated that he feels that children under the age of 14 are too physically undeveloped to safely sustain the head impacts that occur in full-contact youth football.
“Teaching kids technique at ages 10-13 is critical to avoiding catastrophic injuries later.”
The director of Texas A&M’s Huffines Institute for Sports Medicine and Human Performance, Dr. Timothy Lightfoot, PhD, introduced Guskiewicz as “the only sports medicine individual to ever win a MacArthur Fellowship.”
“It’s one of those awards that they walk in your office, you don’t know they’re coming and they give you this really, really big check . . . no one knows quite how anyone is nominated for this.”
Indeed, the nomination and award process for the $500,000 Charles D. MacArthur “genius grants” is very secretive. What is known though, is that the no-strings attached disbursements are $100,000 per year annually for 5 years. Practically though, like any guaranteed payments, the cash disbursements act more as a reward for past success, than an incentive for future work.
Dr. Guskiewicz’s 22 minute presentation is currently available in its entirety on Youtube.
Some of his talking points from the conference are detailed below:
We need more research to connect CTE to football.
• There is nothing there in respect to prospective studies on the cause and effect of these neurodegenerative changes such as CTE.
• There are associations that have been identified, but we have to do a better job with longitudinal prospective studies.
There are no more concussions occurring today than there were 15-20 years ago.
• The reason there are more concussions showing up in the ER is because of increased awareness.
Dr. Guskiewicz is grateful for the media attention, but then criticizes it.
• The media has done a pretty good job of helping to educate.
• Although there are many positive things happening in regard to concussions, it is very common to see negative headlines about concussions because “negative headlines sell newspapers.”
So what does “all the paranoia” that’s been created around this topic mean for these young kids?
• All 3 of Guskiewicz’s sons have played youth football and hockey.
• The rate of childhood obesity is climbing in the United States.
Full contact sports activity is important to developing character.
• Actually, Guskiewicz does not specify full-contact sports, but he offers no alternatives from tackle football or ice hockey as a suitable substitute for practice, teamwork and exercise.
Concussions are not just a football injury.
• We see concussions in just about every sport.
• I tell people about the cross country runner I had my second year at Carolina who was hit by a deer on the cross-country course and sustained a concussion. The local Elks Club gave me an honorary membership.
• Skill practice, on-field exposure, and teaching kids at the right age how to do this.
For ages 10 -13, skill development is more important than exposure.
• It’s really at the ages of 11 to 13 if you get into the motor learning literature where skill development is a critical window – about 10 to 13 years old.
• My fear is, if the first time we put a kid in pads, be it football, hockey, lacrosse pads, at that age, I fear we’re going to see more catastrophic injuries because kids are not going to know how to protect themselves.
• We need to place more emphasis on cervical neck strengthening.
• We believe this (neck strength) is one of the reasons that women are more susceptible to concussions than men.
On equipment technology:
• Putting accelerometers in the helmets of hockey and football players to measure.
• And we’re beginning to teach how to tackle.
Sub-concussive impacts have little to do with mild cognitive impairment.
• We don’t know if playing contact sports for any number of years makes someone more susceptible to CTE.
• Guskiewicz cites his own 2014-15 study to say that functional imaging shows that mild cognitive impairment is related to a history of 3 or more documented concussions, and “little to do” with additional years of exposure or sub-concussive impacts.
• Is it just concussions that cause CTE? I’m not convinced that 1000 impacts in a year compounded over some period of time is going to be worse than 5 diagnosed concussions.
• We don’t know at which age kids are safe to begin playing contact sports.
The pendulum has swung perhaps too far in the direction of concussion phobia.
• “Great study” (by Dr. Ann-Christine Duhaime) published a few years ago. about whether the pendulum has swung to far.
• Historically most kids with concussions do fine. Our species wouldn’t survive if we didn’t.
• So, the topic has been sensationalized in many ways.
• The pendulum has swung perhaps too far in the direction of concussion phobia.
NFL rule changes have reduced concussions.
• We changed the kickoff rule in the NFL and the NCAA to minimize the number of impacts by moving the kickoff line 5 yards. We reduced concussions by about 50 . . . 40 to 50% with just 1 rule change.
Dr. Guskiewicz closes his presentation with a joke to Dr. Lightfoot
“If we knew all of the answers, I’d be out of a job.” ~ Dr. Kevin Guskiewicz, PhD
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