Blunt trauma and sudden death in young
Dr. David Geier
June 25, 2011
I have written recently about deaths in youth sports related to cardiovascular
events and commotio cordis. But there is another large cause of sudden death in
sports that is important to discuss, and that is sports-related death due to
In the July 2011 issue of Pediatrics, Matthew Thomas et al. analyzed 30 years of
data from the US National Registry of Sudden Deaths in Young Athletes. They
compiled statistics from athletes 21 years old and younger who participated in
competitive or team sports (not intramurals) who died from blunt-force trauma in
that sport. These deaths resulted from blows or sudden forces to the head,
spine, or other body organs.
In some ways, the study offers good news. The number of blunt trauma deaths in
U.S. sports is relatively low. The average number of deaths from these causes
has averaged 9 per year for the last 30 years, and that number doesn’t seem to
be increasing. And these deaths were about four times less likely than deaths
from cardiovascular causes.
The authors did provide some findings that coaches and parents should
understand. These deaths occurred in 22 different sports, so few athletes are
immune from this possibility. Football had the highest number of blunt trauma
deaths, followed by track and field, baseball, boxing, and soccer. But even
horseback riding, skiing, gymnastics, and cheerleading had multiple
Most concerning was the high percentage of athletes with deaths due to “second
impact syndrome.” These were events where an athlete had experienced a
concussion within the previous four weeks and had persistent neurologic
symptoms, such as headaches, dizziness, blurry vision, and disorientation. 12%
of the football deaths in this study resulted from the repeat head injuries.
So what recommendations would I offer to young athletes, parents, and coaches
from this study? First, while trauma-related deaths in sports are rare, they are
devastating. Proper preparation and medical supervision with athletic trainers
and physicians are essential. Emphasizing appropriate protective equipment as
well as proper sport techniques and safety measures (safe tackling in football,
use of spotters in cheerleading, etc.) are vital too.
And most importantly, I think that education about the dangers of second impact
syndrome is critical. A tremendous amount of media attention has focused on the
dangers of concussions. And many states have passed laws requiring athletes who
have suffered concussions to be cleared by a physician before returning to play.
I’ll tell you, though, that I’m skeptical that athletes really understand the
dangers. In this week alone I have had two high-level athletes in different
sports ask me if they can play after recent concussions despite the fact that
they are both still having symptoms. In this study, 17 of the deaths were
athletes in these exact situations.
Fortunately, sports neuroscience programs like ours (MUSC Sports Neurosciences)
and others across the country are being created to properly evaluate and treat
these head injuries. Sports medicine physicians might not be able to prevent all
deaths related to trauma in sports, but these second-impact deaths are largely
preventable. Educating athletes, parents, and coaches can help to make the
sports landscape a safer one.
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