Ask the Doctors

Dear Doctor: Our older sons both played football in high school, but that was before all the publicity about concussions. Our youngest son is now old enough to try out for the team. Is it really that dangerous?

Dear Reader: Sports offer kids a lot of benefits. There's the physical exercise, the social aspect of being part of a group with a common goal, the lessons about teamwork, leadership and work ethic, and how to win -- and lose -- with grace. The tradeoff, of course, is the risk of injury.

In a competitive atmosphere, you're going full tilt, throwing yourself into the moment with everything you have. Even in a game as seemingly genteel as badminton, you can sprain an ankle, strain a muscle, break a bone or, if you run into another player or object, even sustain a concussion.

That said, football is in a category of its own. Collisions aren't accidental; they're an integral part of the game. Specialized equipment like helmets and braces and pads do offer a measure of protection. But, as you realize, there are variables at play that can have grave and lasting consequences.

We checked with the Centers for Disease Control and Prevention, and it turns out that 2.6 million children and young people under the age of 20 seek treatment in the ER each year for sports injuries. In football, knees and ankles are the most frequent sites of the injuries. A common sports-related injury we see in our practices is a tear to the ACL, the anterior cruciate ligament. That's one of two ligaments that help to stabilize the knee joint. This happens when the lower leg is firmly planted and momentum of some kind sends the body moving in an opposing direction.

Additional injuries sustained by football players include bruises, sprains and strains, broken bones, bruised or damaged internal organs, back injuries, spinal cord injuries and, of course, concussion.

Concussion may not be the most common football injury, but it can be among the most serious. That's because instead of just a bump on the head, a concussion is actually a mild form of traumatic brain injury. In a concussion, the blow to the head is severe enough to cause the brain to literally move back and forth within the skull. This results in physical and chemical changes to the brain tissue that can leave lasting damage.

Some school football programs have successfully limited the amount of head impact among their players by instituting specific safety rules for both practice and play. Advances in protective helmets have also proved helpful. However, as we all know, in an actual game situation, young athletes don't hold back. Football is a contact sport. No matter the precautions taken, the risk of injury -- including concussion -- still exists.

We recommend that you check with the school and the coach and learn what protections are in place. Bring your family doctor into the discussion. The truth is, football offers both risk and reward. With adequate information, you'll know which decision is right for your family.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

More like Ask the Doctors