Head and spine injuries in the young athlete

Recent studies have shown a decrease in the mortality rates from head and neck injuries, especially in American football. This has resulted because of rule changes and their enforcement, equipment modifications, improved coaching and training techniques, and educational programs for coaches, trainers, and team physicians on the early recognition of head and neck injuries. However, morbidity data is not as complete, particularly as it applies to concussion, the most frequent type of head injury in contact sports. Questions on this condition that still need to be answered before a sound medical disposition can be made are the possible cumulative damage from repeated concussions, and whether one concussion renders a player more susceptible to a second. Presently, decisions on when to allow a football player to return to a game or participate in future contests are arbitrary and based primarily on the experience of the team physician. Data on the incidence, mechanisms, and prognosis of transient spinal cord signs and symptoms, such as spinal cord concussion and the central core symptoms, is also incomplete. What is the long-term prognosis for players who suffer frequent "burners"? Certainly, further studies are essential before these questions can be answered. Thus, the pioneer work of Richard Schneider needs to be continued.