Protecting Children in Sports
Lifestyle We sat down with sports medicine physician Brian M. Babka of Northwestern Medicine Orthopaedics to talk about the health issues young athletes face.
What inspired you to start your own clinic?
I have always been a science and biology nerd. I went to college as a combined science major and a Division I athlete. During that time, I sustained an injury requiring surgery. I was exposed to sports medicine and found my passion. I immediately developed respect for the athletic trainers, physicians and physical therapists who helped me through that journey, and I realized there was a way to combine my two passions. I have the unique filter of relating to all three sides of an injury. I have had the perspective of the athlete, and now the perspective of the parent and treating clinician. We as clinicians are not immune to injuries, nor are our families. I have sat on an exam table many times and understand the struggle of the athlete to recover, both physically and psychologically. I also understand the challenge a parent faces when his or her child is injured. Northwestern Medicine has created an environment for us to care for athletes, weekend warriors and active individuals and families by supporting development of multispecialty programs like our sports medicine, concussion, running medicine and sports performance programs.
What’s the most common issue you get from children?
The most common things we are evaluating now are overuse injuries. We are always going to see the bruises, falls and sprains that will be from daily life; recreational activities like bike riding, free play and formal sports. The largest increase, however, has been from overuse and early specialization. It is concerning to see our young, developing athletes playing one sport year-round. There is ample evidence to prove it is neither healthy nor advantageous for young athletes. There is a greater risk of injury and burn out. We always educate the athlete and the parents. We reassure a young athlete that an injury is usually not his or her fault. Taking the time to educate athletes and parents on the injury process and the treatment plan, including them in that decision-making, empowers them to take some control. When they realize we are modifying activity and recovery and not restricting, there is better compliance. Unfortunately in sports medicine and concussion care, there is rarely a magic medicine. The athlete has to take some ownership of the treatment plan. There is a very calming and confidence-building effect to that. In concussion care, active rehab is also important. We know cocooning does not work, especially for high-levels athlete and adolescents. A return to daily activity and school can be helpful both physically and psychologically. We do not want an athlete deconditioning or becoming depressed, anxious, and anti-social. Initiating “return to learn” protocols to safely return students to daily activity and school can be beneficial.
What’s the most difficult thing running your own clinic?
We are extremely fortunate to not solely manage our clinics. At Northwestern Medicine, we develop multidisciplinary clinic teams and programs. Not one specialty can own sports medicine, especially sports-related concussion. We integrate our community outreach to educate athletes, parents, coaches, and administrators. We extensively utilize athletic trainers, both on the field and in the office. We have a multispecialty physician team including sports medicine physicians, adult and pediatric neurologists, adult and pediatric physiatrists, neuropsychologists, counselors, orthopaedic surgeons, neurosurgeons, chiropractic medicine, neuro-ophthalmologists, and neurotology. Finally, a sports medicine program and sports concussion program cannot succeed without its multispecialty therapy programs, including physical and manual, vestibular, occupational, speech, and cognitive therapies.
What’s the greatest advice you can give a parent who has a child with a concussion or TBI after they leave your clinic?
Parents are quickly relieved when they understand the injury and the treatment options. Acute concussions are serious injuries, but are not something to be afraid of. Our knowledge of the injury and treatment has vastly improved and evolved over the last 15 to 20 years. Public awareness of concussion and sport-related head injury is obviously very high. But clinicians, parents, and athletes need to be aware that media and public perception may not always be consistent with actual science and data. We need to convince people that one or two concussions are one thing, but playing through symptoms or sustaining repetitive sub-concussive hits can be a different thing. Research shows an acute concussion, especially when treated properly, will not ultimately lead to chronic traumatic encephalopathy (CTE). Educating the athlete and the parents is the most reassuring aspect of treatment. Parents are probably the most vital advocates we have. They are going to recognize symptoms in their children no one else will, and they are the ones helping encourage treatment. It is our role to help them understand each concussion and treatment plan is unique and individualized. We also have to recognize that sports are not the enemy. As in life, there is an inherent risk in sport. There is a benefit to sport that cannot be forgotten. We are responsible for determining and acknowledging risk, and doing what is possible to decrease that risk. Awareness, education, recognition, rules/regulations, and proper coaching are the hallmarks of potential prevention. Sport-related head injuries are common and still too often under-recognized. It is recommended there be no same-day return to play. Athletes need rest, both physical and cognitive, and then gradually advance activity while remaining asymptomatic per a monitored and structured return-to-play protocol. More prolonged cases need a multispecialty approach, which is what we offer at the Northwestern Medicine Sports Concussion Clinic.