Where sports are concerned, our inner need to protect our kids can sometimes be at odds with our desire to allow our kids to spread their wings. While most sports are safe with proper equipment and coaching, there are always risks involved, especially with contact sports. The question is, how safe is some of the specialized equipment our kids are asked to use, such as chest protectors?
Doctors and researchers have been particularly concerned about sports safety and have spent countless hours and research dollars try to develop new safety equipment for our young athletes. One are of particularly high interest has been in developing reliable chest protector to protect against one of the most dangerous and sometimes fatal heart injuries seen on the field today, commotio cordis. Commotio cordis occurs as a result to a blow to the chest, most notably the sternum, during which time a sudden disruption in the way the heart beats results in sudden cardiac arrest in an otherwise normal young athlete. Wearing chest protectors as well as automatic external defibrillators (AEDs) on the sidelines are all efforts intended to battle back against the rare moments commotio cordis occurs.
You've likely seen one of the currently available chest protectors if your child plays a contact sport such as hockey, baseball, or lacrosse. These chest protectors do provide some protection aginst blows to the chest, and most kids do survive their blow to the chest. However, a recent commentary in Pediatrics revealed that these protectors still only adequately protect 2/3 of athletes struck in the chest and that 40% of blows to the chest are still resulting in fatalities. So, while we can be reassured that more kids are surviving a blow to the chest, it's disappointing that the years of research time and millions of research dollars hasn't yielded a more favorable outcome.
In fact, if you tease through the results given in that commentary closely, there hasn't been anything new to the market in a few years. Seems to me we need a new research and R&D approach in the chest protector development industry on all levels. The answer could be a new design or a new material. We won't know until someone looks at the situation with eyes wide open and a willingness to consider new ideas and options. So far, the same old, same old doesn't seem to be helping our kids the way we hope.
Until that day arrives and someone develops a more reliable chest protector, we need to protect our athletes on the field in other ways. First, we need to be sure that the rules are followed appropriately. Illegal checks and roughhousing only increase a child’s chance of suffering a blow to the chest. Second, we need to make sure proper pads are worn at all times for all activities that put the chest at risk. The current chest protectors are better than nothing at the moment! Third, AEDs and CPR training is a must on the sideline. Many leagues now have EMTs and certified trainers on the sidelines. If your team doesn't, be sure someone has 911 programmed into a cell phone. When seconds count, you don't want to take any more time than the press of 1 button. Also, be sure that cell phone is charged!!
Keep in mind that your child's pre-participation evaluation or sports screening examination just captures a moment in time and doesn't truly take into account the stress your child's body is under while competing. Any new symptoms that develop after that evaluation need to be investigated by your pediatrician, especially ones that occur during exertion, such as getting winded or dizzy or feeling faint or queasy or having chest pain or developing a head ache. Better to have a symptom checked out and have it be nothing than to find that a major medical problem was brewing.
Finally, our sports screening exam itself needs to get a check up each year. I'd like to see an annual evaluation of our sports screening practices against those in other countries just to be sure we are still doing what is in the best interests of the health and safety of our kids. With new sports screening data constantly coming in from around the world, we have to always be willing to say there is another way or a better way to keep our kids safe while they compete in the sports they love and push their bodies to amazing extremes. Other countries rely on US data all the time to guide their medical practices. It would be arrogant of us to not do the same.
Keep in mind that medicine is an evolving science. What works for us today in keeping kids healthy on the sports field may not work tomorrow. But, we won’t ever know if we aren’t brave enough to ask some tough questions and take another look at sports health screening and chest protectors from as many angles and perspectives as we can. Our kids deserve at least that much from the research dollars being used in the name of their health and safety, don’t you think?