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Preventing Concussions in Sports

Because the most-commonly used return-to-play guidelines recommend that an athlete who has suffered multiple concussions be held out of sports for increasingly longer periods of time, up to and including the rest of the season, preventing another concussion may be the difference in the athlete being able to continue playing that season or having to shut his season down.

While athletes sustaining a concussion are at a 3-fold increased risk for future concussions, a risk that increases with each subsequent injury, unlike musculoskelatal injuries, few strength and conditioning methods will help prevent further concussions. This does not mean, however, that no preventative methods can be taken to minimize recurrence of concussions and other head injuries.

In an article by three certified athletic trainers in the July-September 2001 special issue of the Journal of Athletic Training devoted to concussions in athletes, the authors suggest that reviewing game or practice films may "help reveal poor techniques, such as leading with the head to tackle or block or heading a soccer ball incorrectly," and that "reviewing the tape with the athlete and the coach may be useful in improving the athlete's technique or changing the coach's teaching methods."

The following sports-specific measures should be taken to prevent concussions and reduce the number of fatalities and catastrophic injuries in school sports:

Football

  • Continued enforcement of the ban on initial contact with the head in blocking and tackling, along with coaching in the proper skills of blocking and tackling.

Soccer

  • Anchoring soccer goals and warning players to avoid climbing on them, and using proper moving, maintenance, and storage techniques

Ice Hockey

  • Enforcement of current rules and consider new rules against pushing or checking from behind

  • Developing conditioning programs to help players strengthen their neck muscles

  • Teaching players about the risk of neck injury

Swimming

  • Enforcing rules on racing dives in the shallow end of pools that require swimmers to start in the water if there is less than 3 1/2 feet of water, allow starts from platforms no higher than 18 inches for water 3 1/2 to 4 feet deep, and starts from platforms up to 30 inches above the water where it is 4 feet or more deep

Diving

  • Stretching and strengthening to prevent shoulder injuries for competitive divers; and

  • Teaching proper diving technique when attempting new and unusual dives.

Baseball

  • Either banning head first slides or, if allowed, requiring that coaches teach players the safest ways to execute this maneuver

  • Requiring batting practice pitchers to wear helmets

Track and Field

  • Require compliance with rules on the size of pole vault landing pits, stabilizing the pole vault standards, padding the standards, removing all hazards from the pit area, and controlling traffic along the approach

  • Require vaulters to wear helmets, as mandated by several states and state high school athletic federations in the wake of the 2002 deaths of Penn State pole vaulter Kevin Dare and two other young vaulters. A pole vaulting helmet standard was issued by ASTM (formerly the American Society for Testing and Materials) in May 2006.

  • Enforcing safety precautions during discus, shot put and javelin practice and competition, including the fencing off of the back and sides of the discus circle

Cheerleading, Spirit & Cheer

  • Limiting stunts; e.g. pyramids should be limited to two levels and performed on mats

  • Requiring that coaches supervise all practices and be safety certified

  • Requiring that cheerleaders take a preparticipation exam, be trained in gymnastics, spotting and conditioning, and participate only in stunts that they have mastered

  • Permitting cheerleaders who have signs of head trauma to return to cheering only with permission from a physician.