What “Concussions and our Kids” says about a crucial issue facing sports
Concussions have become part and parcel of the discussion of professional and college football these days, but one of the most interesting elements of the new “Concussions And Our Kids” book from Dr. Robert Cantu and sports journalist Mark Hyman is how it reflects that this isn’t merely a high-level sports debate, a football debate or a debate solely about adults.
Throughout the book, there’s story after story about how concussions have affected the lives of everyone from professional soccer player Taylor Twellman to university lacrosse player Kristen Chapman to high school softball player Kayla DiBiasie to high school volleyball player Rose-Marie Fuchs, and these are crucial illustrations of how concussions aren’t merely an NFL talking point, but something that can affect athletes of any age in any sport.
This isn’t just jumping from data point to data point; each athlete’s case is carefully used to reinforce one of Cantu’s points, and the end result is a coherent, comprehensive look at what we currently know about concussions in kids and adults, and how Cantu thinks we should proceed with this information. Not everyone will completely agree with what’s presented here, particularly with some of the more drastic recommendations, but this book’s a valuable overview for parents, kids, athletes, coaches or sports fans in general curious about what’s known about head trauma. Its revelations of just how widespread of an issue concussions are will likely surprise many, too, and it comes at this from an unusual angle that should significantly add to the discussion.
Cantu’s own background is what makes the existence of this book so interesting, and it’s well worth going into. He’s the chief of neurosurgery and chairman of the department of surgery at Emerson Hospital in Concord, Massachusetts, but sports fans will likely be more aware of his work as a co-director of the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University. The CSTE has been at the center of much of the research on concussions, including autopsies that have confirmed the presence of chronic traumatic encephalopathy in autopsies of former players from Tom McHale to Dave Duerson to Doug MacIver. They do a lot of research beyond merely post-mortem brain analysis, including investigations into how concussions suffered in explosions (such as war zones) affect those impacted and long-term studies of athletes at high and low risks of CTE, but it’s the work on former football players’ brains that’s made them a key presence in the sports world.
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Cantu’s now a senior advisor to the NFL’s head, neck and spine committee, and some would say that would bias him in favor of the league, but he certainly hasn’t stopped being critical of many elements of football (unlike some previous NFL-linked doctors, some of whom were forced out in 2009 after downplaying the connection between football concussions and long-term health problems for years). He’s one of the most notable voices on concussions out there, and that’s why it’s well worth reading what he has to say.
The book’s helpfully laid out in 10 clearly-delineated sections, from explaining the mechanics of concussions to discussing their incidence in both contact and non-contact sports to chapters on post-concussion syndrome and CTE, thoughts on the parents’ roles and suggestions on how to reduce concussions in a wide range of sports. Most of these sections aren’t intended to be comprehensive, but rather an overview, and along those lines, they work very well. There’s information here that will likely be new and important to even long-time observers of the concussion scene, including thoughts on the incidence of concussions in everything from volleyball to cheerleading, a lot of crucial detail on baseline testing (the common ImPACT test, its strengths and weaknesses, alternatives) and details on post-concussion syndrome and second-impact syndrome and just how terrifying they can be.
The decision to include brief stories of athletes in just about every chapter is a solid one, and it keeps the book from becoming too dry and academic. You get a real sense for just how much these injuries can impact the lives of people like Matt Glass, who battled post-concussion syndrome, depression and more health problems for over a year after a concussion sustained during high school football. Cantu’s discussion of CTE isn’t as comprehensive as it would be in some works, but the important information on it is presented, and it’s not the crucial focus here. In fact, that’s part of the unusual approach that makes this book interesting. Most of the material in other sources dealing with concussions focuses on high-profile cases like that of Duerson, a former NFL star who committed suicide after dealing with mental issues and had CTE found in his brain afterwards.
Cantu has enough information on those cases to get the essential points across for those unfamiliar with them, but this book’s largely about athletes who never get much coverage; those who suffer concussions in high school and community leagues. It’s much more than a football story, too, detailing how concussions (and, crucially, sub-concussive impacts as well) affect everything from field hockey to basketball, and the sections on how concussions happen, what parents should watch out for and how concussion treatment works will be useful to those involved in any sport.
Where the book perhaps overreaches its target a bit is with the final chapter, composed of Cantu’s suggestions on how to reduce concussions in sports. Those include keeping as much contact to the head out of sports before kids turn 14, from taking tackling out of football to banning bodychecking in hockey and prohibiting heading in soccer as well. Those ideas can be debated, certainly, and there’s definitely some support for Cantu’s positions; younger kids don’t necessarily have the physique or training to be able to take head contact (whether with a player in football or hockey or with a ball in soccer) the way older kids can.
However, wide-reaching bans may not necessarily be the answer, particularly if they’re applied in a mismatched way across jurisdictions; that could lead to everything from people moving to let their kid play contact sports to some kids being at significant disadvantages at older ages thanks to later introductions of contact. Cantu’s book as a whole also advocates for more subtle changes that may produce greater effects, including changing the amount of contact in football and hockey practices and the way kids are taught to head a soccer ball, and he rightly talks about the importance of kids understanding the risks they’re taking and being willing to do so. From this corner, those may be more useful starting points for discussion than hard-and-fast across-the-board age bans.
That doesn’t really detract from what’s an excellent book overall, though, and one that looks at an underexamined aspect of concussions. Yes, if you follow football at all, you’ve heard a lot about them and how what we’re learning about concussions is changing the game. Yet that can build up the sense that concussions are only a high-level issue, and it can overshadow the concussions suffered in less-physical sports at lower levels. In a lot of ways, as Cantu points out, some of those concussions can be worse; there may not be as many trained medical staffers on hand for say, high school volleyball, and coaches and parents may not be looking for concussions or have the experience to recognize them when they occur.
There’s plenty of information elsewhere on concussions from a top-down perspective, starting with the most high-profile players and going from there; this book instead looks at them from the bottom-up, and what it finds is frightening information that will make you think about the prominence of concussions everywhere.
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