Classifying time-loss and non-time-loss injuries in youth football

¶ … Loss and Non-time-Loss Youth Football Injuries

Sports participation among American youth has been a part of American culture and society for generations. With millions of young players involved in contact sports such as football every year, athletic injuries are inevitable. While the majority of those injuries are not severe, some of them are serious enough to require time lost from sports.

The Journal of Athletic Training article (2007) reviewed here details the importance of the inclusion of certified athletic trainers and of providing fist-aid training to adults involved in youth sports. The Clinical Medicine and Research article (2004) reviewed here examines the issue of concussions sustained by young athletes and relates its findings to the fundamental element of classifying injuries as time-loss vs. non-time-loss injuries.

Defining Time-Loss and Non-Time-Loss Injuries

The Journal of Athletic Training article (2007) defines time-loss injuries as those injuries sustained during athletic competition that require removal from the athletic contest and/or suspension from participation in subsequent contests, or subsequent medical diagnoses or interventions. One weakness of this study was that it did not include injuries sustained in practice and training sessions, but only those actually sustained during official contests. This was a serious flaw, particularly with respect to contact sports like American football because practice drills present many of the same risks as competition and because training exercises are a frequent source of overuse injuries in youth sports. Another serious flaw in that study is that it did not address the specific significance of head injuries that do not typically result in removal of the player from competition or from participation in subsequent contests but which may be associated with concussions.

The Clinical Medicine and Research article (2004) focuses on this particular issue and establishes the importance of recognizing the significance of head trauma injuries in young athletes. More specifically, a volume of empirical research suggests that the relative absence of acute symptoms associated with head trauma incurred in youth sports often results in dangerous practices. In many cases, players who sustain head trauma sufficient to cause a brain concussion injury are allowed to continue in the same competition in which they are injured after a brief removal from play. In other cases, players sustaining such trauma during competition are (appropriately) removed from play but then allowed to practice and compete too soon thereafter than considered medically appropriate in light of existing knowledge about the long-term consequences of brain concussions.

Findings of the Clinical Medicine and Research Article

The Clinical Medicine and Research article (2004) presented the evidence establishing (1) the tremendous medical significance of brain concussion injuries; (2) the cumulative effects of repeated concussion injuries; (3) the much greater susceptibility of young athletes to the detrimental effects of concussion injuries; and (4) the crucial importance of instituting strict rules requiring immediate assessment of any potential concussion injury, particularly in young athletes and of preventing players suffering possible concussive brain injuries from returning to contact sports until after their full recuperation.

Implications

Perhaps the most troubling aspect of the two articles considered together is that the Journal of Athletic Training study was conducted in 2007, three years after the Clinical Medicine and Research article (2004) that specifically detailed the tremendous importance of recognizing potentially serious concussion injuries that typically do not necessarily reveal themselves as requiring immediate suspension from contact sports participation when they occur.

All too often, youth football players sustain head trauma that meet the formal criteria for concussion without being removed from further competition. The significance, according to the Clinical Medicine and Research findings, is that young people are even more at risk of long-term consequences associated with brain concussions, precisely because those types of injuries are typically overlooked and classified as non-time-loss injuries instead of being classified and treated as the potentially serious injuries they are.