GOALS

How parents can help their kids balance the risk of injury with the reward of playing sports

We don’t get to pick what sports our kids want to pursue. If I could, I would pick ice hockey. It’s fast, and fun, and can be played on freezing cold winter evenings under a blanket of stars. Some of my happiest memories from high school and college were late-night games, early morning road trips, and learning what it meant to be part of a team.

But am I being reckless in wanting this for my daughters?

Hockey is a rough sport. According to research from the Canadian Journal of Surgery, women sustain 14% more concussions playing ice hockey than men. (But because there is no checking in women’s hockey, only 41% of the concussions suffered by female players during games resulted from player contact, versus 72% for the men.)

Bennet Omalu, the chief medical examiner of San Joaquin County, California, recently wrote an opinion piece in the New York Times calling for a ban on football for children. It was Omalu who, in 2002, first diagnosed Chronic Traumatic Encephalopathy, or CTE, a degenerative brain disease caused by repeated blows to the head. He argues that just as with smoking, we now have too much information not to do anything.

I’m not much worried about my kids pursuing football; I don’t have boys. If I did, I would probably heed Omalu’s advice and encourage them to pursue alternatives. But my girls do play soccer, which according to the National High School Sports-Related Injury Surveillance System (pdf), set up during the 2005-2006 school year to monitor injuries among US high school athletes, is the most dangerous sport for girls. (Note: An athlete exposure is defined as an athlete’s participation in a practice or competition where exposed to the possibility of injury. Also note: The statistics do not include data on ice hockey.)

Across all the sports tracked here, blows to the head or face are the most common injury for girls, representing nearly a quarter of all reported injuries. Ankles strains or sprains were next, at 21.9%, followed by knee strains or sprains at 10.4%. The face/concussion injury rate is nearly identical for boys, followed by hip,thigh, or upper leg strain or sprain (14.9%) and ankle sprain or strain (14.3%).

Knowing all that I know about the risks of concussions, torn ligaments, and sprained ankles, I still want my daughters to take up ice hockey. Sadly, they probably won’t get much of a chance to play it. We live in the UK, a country where the sport is barely existent for men much less women. But I have found a soccer team for them, and when my oldest daughter recently told me she was learning rugby in school, I was thrilled.

Risks everywhere

There are risks everywhere: driving, flying, going to cafes in Paris, or sitting on buses in London. There are risks we know about and those we don’t.

I broke my back figure skating, tore my ACL skiing, and got a concussion biking. My daughter broke her arm because I thought she said “swing my legs” when she was hanging from an eight-foot pull-up bar, when she actually said “hold my legs.”

I’d still make the case that the benefits of taking sensible risks far outweigh the cost of the potentially negative consequences.

Wear shin guards or a helmet, build strength, and learn how to play properly. Those are the responsibilities I would task my children with were they to follow in my extracurricular footsteps.

My responsibility as a parent would be to educate myself, to make sure they have well-trained, thoughtful coaches, and to push for sensible regulations around the sports they play.

Tough vs. stupid

One risk many parents probably don’t think much about when their kids take up a new sport is repetitive stress injury. But it’s a big deal—big enough that USA Hockey, as part of a package of reforms to address statistics showing that almost half of kids playing hockey quit by the age of nine, reduced the number of games played per season and encouraged players to participate in other sports.

In terms of stemming the attrition rate, this may not have been as effective as the federation’s decision to reduce travel and ban body checking for younger players. But it allowed kids to play other sports and discouraged them from specializing in one activity at too young an age, limiting their chance of higher injury risk from repetitive use.

Of course, the risk on most parents’ minds these days when thinking about sports is the risk of concussion, and for good reason.

Concussions are a big deal. They can cause symptoms including memory problems, headache, irritability, or sleeping more than usual. They are also quite prevalent, across a wide range of sports:

According to a study by the Harborview Injury Prevention and Research Center at the University of Washington in Seattle, which tracked high school male football players and female soccer players during the 2012 season, 10% of the football players and 11% of the soccer players sustained concussions just in the course of that season, based on symptoms they reported.

But players don’t always report their injuries. As Reuters noted in an article last year about the Harborview study, the researchers found that more than half of high school athletes with concussions play despite their symptoms, often without their coaches having been made aware of the injury. Playing with a concussion can make it harder to recover, and puts the athlete at risk of repeated injury.

Parents and coaches have to set the tone for injuries. It’s one thing to be tough, and another to be stupid. We can teach our kids the difference and advocate for coaches who do the same—coaches who have no problem taking kids off the field, and keeping them off, when they are hurt.

If this sounds obvious, consider the case of Benjamin Robinson, the 14-year-old Scottish boy whose death in 2011 eventually prompted an overhaul of concussion protocols. Robinson died after being hit in the head multiple times during a rugby match in which he should have been pulled from the field. Guidelines in Scotland now call for players to be removed from the game as soon as there is even suspicion of an injury.

Even non-contact sports are reforming. As the New York Times reported in November, the United States Soccer Federation said it would bar players 10 and younger from heading the ball, limit practice headers for players age 11 to 13, and recommend that other soccer associations implement similar restrictions. The measures helped resolve a proposed class-action lawsuit filed by players and parents seeking rule changes.

More can be done. Recent data in England showed the rate of concussions increased 59 percent last year, prompting the Rugby Football Union to pioneer a study into the long-term effects of playing the sport. In Britain, a team of specialists set up the International Concussion and Head Injury Research Foundation to recruit retired athletes and study the long-term effects of head injuries.

And yet, rugby isn’t the most dangerous sport in England for concussions. On average, there are 10.5 concussions per 1,000 playing hours compared to 17 per 1,000 in boxing and 25 per 1,000 hours in jump horse racing.

Time to lace up, girls

High rewards frequently come from taking on a lot of risk. Sports are high risk: My back will never be fixed, and I’ve had my ACL reconstructed twice. But even since my injuries I have reveled in racing down mountains, and in running 26.2 miles through New York’s five boroughs.

I have won against better hockey teams, lost against lesser ones, skated perfect programs, and made mistakes that still haunt me today. I learned that relentless practice makes you better, but sometimes even that’s not enough. C’est la vie.

Pursuing a solitary sport like competitive figure skating taught me fierce discipline, focus, and eventually, how to forgive myself. After my back injury forced me to quit, I moved on to ice hockey, where being on a team taught me it’s a lot more fun to win, and lose, with others. There’s a unique camaraderie built around working with different people toward a unified goal, sweating and cheering and crying together every Tuesday and Saturday.

Being part of a team did things for me school or skating could not. It helped me to hit pause on all the weird social dynamics of being a teenager and just be in the game. I learned to lose myself in something, and rely mightily on others.

Those skills continue to pay dividends decades later. When I think about my daughters gaining the same kind of skills from their own athletic pursuits, I acknowledge there are risks. But you won’t find that stopping me from encouraging them wholeheartedly to go on and lace up.

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