Youth Sports Injuries, What the Stats Show
Written by Chris Dalrymple, DC   
Friday, August 22, 2014 05:32 PM

While the Texas Sunset Commission has recommended to the Texas Legislature that Doctors of Chiropractic be removed from the list of healing arts providers who are permitted to authorize a student athlete to participate in University Interscholastic League (UIL) school athletics, perhaps the legislators involved should consider the statistics from the following reports.

In their hearing, where the public was not permitted to provide input, the Sunset Commission heard that there are more than 700,000 student athletes in Texas.  All of these 700,000+ student athletes must be certified by a listed health care provider prior to participating in sports sanctioned by the University Interscholastic League.  The stated concern of the MD-legislators was the prevalence of sudden cardiac arrest, and their "concern" was that only those under the direct control of a medical physician should be authorized to permit a student athlete to play.

However, the American Academy of Pediatrics, in their Journal Pediatrics, in 2012, reported  in this article that "In the United States, there is no centralized or mandatory registry for pediatric sudden cardiac arrest.

... The Centers for Disease Control and Prevention has estimated that every year in the United States, approximately 2000 patients younger than 25 years will die of SCA. Other older reports estimate the frequency of SCA in children and adolescents to be between 0.8 and 6.2 per 100 000 per year.  Two ... studies from Maron et al estimate fewer than 100 cases of SCA in young US competitive athletes each year. An Italian study reported a baseline incidence of SCA in young competitive athletes at 1:25 000 before implementing a national screening program."  In this one statement alone the incidence of SCA in student athletes younger than 25 for the 700,000 plus student athletes in Texas is anywhere from two (if you average 100 per year nationally by the fifty states) to 5.6 to 43 (for the older studies) to 28 (if you use the Italian study).  

The legislators of the Sunset Commision, without public input, have decided that for between, on the one hand, 2 to 6 cardiac arrests in children under the age of 25, and on the other hand, as many as 28 to 43 sudden cardiac arrests from all causes, per year in Texas, the Texas legislature will now consider removing one of the most prominent musculoskeletal and "alternative medical" therapies as a provider of pre-participation examinations.  

Once pre-participation examinations are removed from the purview of these state-licensed-doctors and federally-recognized physician-level providers, what about the other 699,998+ to 699,957+ student athletes who won't be allowed to utilize their musculoskeletal-focused federally-recognized physician-level doctor of chiropractic for their pre-participation exams.  Talk about throwing the baby out with the bathwater.  And at what point will it be determined that DCs are not qualified to return a student athlete to play?  Once one steps onto the slippery slope momentum continues downhill.  And what about the significant numbers of Doctors of Chiropractic who have been certified by the Federal Government to serve as Federal Medical Examiners?  Does their specialized training in conditions that concern the medical legislators count for nothing?

The Sunset legislators – the three medical doctors in the Texas Senate, Sen. Jane Nelson (who received nearly 16% of her campaign funds from the "health industry"), Rep. Four Price (who received over 6% of his campaign funds from the "health industry"), Senator Brian Birdwell (who received nearly 4% of his campaign funds from the "health industry"), and public member Tom Luce (listed as President and CEO of the Meadows Mental Health Policy Institute working to promote "mental health initiatives" in Texas) – also cited concern over concussion and stroke issues, yet according to this report  "there were 120 sports-related deaths of young athletes in 2008-2009; 49 in 2010; and 39 in 2011."   This averages out to 0.78 to 1.2 deaths per state for "sports related deaths" from all causes.  What about the other 699,998+ to 699,999+ student athletes?

Further, this report identifies that there are 400,000 concussions in 2008-09, averaging to about 8000 per state. The report also identifies that there approximately 19 traumatic cervical spinal injuries per state, per year.  What about the other 699,981+ student athletes?  What pre-participation evaluation will identify potential concussion or cervical spinal injury victims? 

Now we read here that "With the start of a new school year comes a new season of youth sports, and with it growing concerns about player safety.  A new survey by the non-profit advocacy group Safe Kids Worldwide finds 'an alarming gap' in what is known about sports safety and what is being done to reduce the risk of injury to young athletes, whether playing scholastic, intramural, recreational, select or club team sports."  

Their findings indicate that 42% of players (that would be 294,000+ student athletes in Texas) report that they have a hidden or downplayed injury during a game so that they could keep playing, and 62% (434,000+) say they know someone else who has done so.  54% (378,000+) say they have played injured and 70% (490,000) of those kids say they told a coach or parent that they were hurt.  

"Having kids participate in sports is one important way to address the nation's youth overweight and obesity epidemic and offers valuable lessons in leadership and teamwork, 'but because of the reports of injuries, I think more and more parents are very cautious of having their children participate,' says former U.S. surgeon general David Satcher, co-chair of the National Council on Youth Sports Safety.  The new report is the latest to point out a culture "that gives rise to more injuries," says Satcher. "That culture is you keep playing when you get injured. You stay in the game. You sometimes even have practice routines that contribute to injuries."

"Also of particular concern are injuries resulting from overuse. In an effort to improve their game and 'get to the next level,' many young athletes start specializing in a sport at 'an earlier and earlier age.'  That increases the risk of physical injuries.  The same concerns apply to doing too many sports at one time ... 'The body needs time for rest and recovery.'  California's new law, signed in July, that limits the amount of time allowed for full-contact football practices at the high school and middle school level, recognizes, among other things, that 'fatigue also contributes to injuries in children playing sports,' says Satcher."

"According to the new report, most parents (94%) think that their child's coach is very or fairly knowledgeable about preventing injures, but they might be surprised to learn that fewer than half of all coaches surveyed say they have received certification on how to prevent and recognize sport injuries. Among high school coaches, for example, only 47% said they have received any certification to prevent and recognize concussions; 46% have received training on broken or fractured bones; 38% have received training on an overuse injury."  

Doctors of Chiropractic have already been trained, earned a doctorate degree, passed numerous national and state licensure tests, earned state licensure and are annually required to continue to receive continuing education hours to maintain their educational expertise.  Perhaps the legislators of the Sunset Commission would be better served to regulate coaches.