Course:KIN366/ConceptLibrary/ContactSports

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Movement Experiences for Children
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KIN 366
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Instructor: Dr. Shannon S.D. Bredin
Email: shannon.bredin@ubc.ca
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Contact sports are sports that involve a certain degree of physical contact between players (Dictionary.com, 2015). Examples include, American football, rugby, wrestling, boxing, and ice hockey (Rice & the Council on Sports Medicine and Fitness, 2008). These sports require that contact be involved in the play, thus they are known as full contact (Rice & the Council on Sports Medicine and Fitness, 2008).

Multiple methods are used depending on the sport as a means to enforce contact. Certain sports such as martial arts, or boxing are scored based on the types and forces of contact one places on their opponent (K., 2012). Rugby and American football, however, involve the tackling of other players (RulesofSport.com, 2012). Equipment can also be involved in the physical contact used in sports, such as hockey and lacrosse, where the sticks can be used to hit an opposing athlete (ex. cross-check) (RulesofSport.com, 2012).

Important to note is that despite other sports (ex. field hockey, soccer, etc.) being considered not full-contact, physical contact can still take place between athletes (Rice & the Council on Sports Medicine and Fitness, 2008). Particularly when looking at soccer, basketball, and field hockey, these sports often involve unavoidable contact due to the close nature of their games. However, inappropriate contact in these sports is penalized no matter the circumstances (RulesofSport.com, 2012. The remaining sports such as swimming, track and field, cycling, and gymnastics involve physical contact that is either prohibited or unlikely (Rice & the Council on Sports Medicine and Fitness, 2008).

Children, in particular, are of a special population when it comes to contact sport, as they are skeletally immature and at increased risk of injury as a result (Caine, Purcell, & Maffulli, 2014).

Grades

Sports can be categorized into different levels of risk depending on the grades of contact; this can be particularly useful when parents are determining whether or not their child should participate (Rice & the Council on Sports Medicine and Fitness, 2008).

Contact

Contact sports, as stated above, involve sports where physical contact must occur between players (Rice & the Council on Sports Medicine and Fitness, 2008). This category can be further broken down into:

  • Collision sports: players will purposely collide with other players, and these sports involve a greater risk of injury than do contact sports (Rice & the Council on Sports Medicine and Fitness, 2008). Examples include: American football, rugby, ice hockey, and lacrosse (Rice & the Council on Sports Medicine and Fitness, 2008).
  • Contact sports: players will routinely come into physical contact with other players; however, less force is involved between athletes than it is in collision sport (Rice & the Council on Sports Medicine and Fitness, 2008). Examples include: field hockey, soccer, and basketball (Rice & the Council on Sports Medicine and Fitness, 2008).

Limited-contact

Limited-contact sports involve infrequent contact between athletes (Rice & the Council on Sports Medicine and Fitness, 2008). Examples include softball and squash (Rice & the Council on Sports Medicine and Fitness, 2008).

Noncontact

Noncontact sports involve no contact whatsoever, although it can occur on rare occasions (Rice & the Council on Sports Medicine and Fitness, 2008). Examples include, power lifting, swimming, and shot put (Rice & the Council on Sports Medicine and Fitness, 2008).

Equipment

Depending on the sport, different equipment can be used for protection (RulesofSport.com, 2012). Some sports such as football require shoulder padding, whereas others such as rugby, require only a mouth guard and, in some cases, a scrumcap (RulesofSport.com, 2012).

Mouth Guards

A mouth guard is a resilient piece of plastic that fits over your teeth, and acts as a cushion to displace any impact forces more evenly across the teeth (Minister of Health, 2007). In contact sport, the risk of dental damage due to physical impact to the mouth is common (Minister of Health, 2007). These types of injuries can be painful and expensive to treat, and as a result, are typically required in all contact sports (Minister of Health, 2007). With younger children, they can be especially important when it comes to protecting any dental wear, such as braces, during play (Minister of Health, 2007). Not only are they protecting the mechanics of the actual braces themselves, but they also protect other children from any potential contact with the braces of another player (Minster of Health, 2007).

Helmets and Protective Headgear

The primary function of helmets and protective headgear is to protect the head from potential traumatic brain injury (TBI) (Daneshvar et al., 2011). A single blow to the head results in a brain-skull collision either on the side of the impact, coup, or opposite the impact, contrecoup (Daneshvar et al., 2011). This type of injury can result in diffuse axonal injury within the brain, followed by the appearance of potential neurological symptoms (Daneshvar et al., 2011). In young children, helmets are especially important because they are that much more sensitive to the effects of a concussion (Hockey Canada, 2014). Within the helmets and headgear is a shock-absorbing material that helps to distribute the impact forces caused by the collision and extends the duration of the total impact (Daneshvar et al., 2011). Depending on the sport, different variations of these headgear designs are used (Daneshvar et al., 2011).

Trends

It has been well known that repetitive trauma to the brain during boxing can result in severe neurological deficits (McKee et al., 2010). More recently it has been shown that repeated TBI, particularly caused by collisions in sports such as, American football, boxing, and hockey, can result in a condition known as chronic traumatic encephalopathy (CTE) (McKee et al., 2010). In recent years, research has accumulated demonstrating the devastating effects of CTE. Christopher Nowinski (2006), the author of Head Games: Football’s Concussion Crisis from the NFL to Youth Leagues, highlights one of the earliest deaths of NFL Hall of Fame center Mike Webster. He suffered a heart attack at the age of 50 after playing for the Pittsburgh Steelers for sixteen years (Nowinski, 2006). His autopsy later showed that he suffered from CTE, which at that time was typically reserved for boxers (Nowinski, 2006). Research has also shown that a player’s risk of suffering from these types of neurological illnesses is proportionate to how many concussions they’ve had in their past (Nowinski, 2006). These recent trends have resulted in parents being especially careful when placing their child in a full-contact sport (Farrey, 2014).

Youth Ice Hockey

In recent years, there has been much debate regarding the age at which bodychecking in youth hockey should begin (Marchie & Cusimano, 2003). In 2002, despite lack of research used to justify the policy, Hockey Canada permitted players as young as 9 years old to bodycheck during games (Marchie & Cusimano, 2003). Following a heated debate among parents, coaches, and others across the country, Hockey Canada decided to raise this age to 11 years old (Marchie & Cusimano, 2003). However, children as young as 9 years old are currently still allowed to bodycheck in an “experimental” fashion (Marchie & Cusimano, 2003). Research demonstrates that bodychecking is the “most common cause of trauma in hockey” (Marchie & Cusimano, 2003). Bodychecking accounts for almost 86% of all hockey injuries among youth aged 9-15 (Marchie & Cusimano, 2003). Despite the enormous controversy surrounding this topic, there are still individuals who believe that bodychecking is a required component of the game, and that youth who are only exposed starting at a later age, will be poorly equipped to avoid future injury (Marchie & Cusimano, 2003). Some parents may even be contributing to this mind-set, by pushing their kids to “win at all costs” (Marchie & Cusimano, 2003).

Vulnerability to Injury in Youth Athletes

Growth Plate Vulnerabilities

The bone structure of a skeletally immature athlete is different from that of a mature adult (Caine et al., 2014). These physical differences can result in several potential vulnerabilities when it comes to injuries in sport (Caine et al., 2014). Examples include:

  • Growth Plate Fractures: susceptible to fracture (at the epiphyseal-metaphyseal junction) because they are the last portion of bone to ossify (Houghton, 2014).
  • Apophysitis and Apophyseal Avulsion Fractures: vulnerable to “traction forces and strong muscle contractions” (Caine et al., 2014).
  • Green-stick Fractures: the immature metaphysis of long bones is softer, and has increased elasticity and resiliency making it more vulnerable to incomplete fractures (Caine et al., 2014).

Differences between Biological and Chronological Age

Sports nowadays are categorized by chronological age; this creates the potential problem of having boys, in particular, who are biologically smaller, playing boys of the same age who have matured earlier (Caine et al., 2014). Unbalanced competition can be particularly concerning in contact sports such as football and hockey where physical contact can lead to serious injuries between youth players (Caine et al., 2014).

Differences in Growth Patterns

The typical growth patterns that occur in children tend to follow an unorganized fashion, with certain body parts growing at one time, and others at another (Caine et al., 2014). Proportionally, a child’s body is considered to be “top-heavy”, where their head and trunk is larger relative to their shorter legs (Caine et al., 2014). Problems can arise including an increased risk of falling in sports, or of overuse injury in activities emphasizing running (Caine et al., 2014). The greater head-to-body ratio in children is especially important with regards to contact sports because it increases their vulnerability to concussion (Caine et al., 2014).

Injuries

Children in their early school-aged years are at increased risk for neurological and psychiatric problems due to TBI (Marchie & Cusimano, 2003), and for this reason, must be considered different from adults (Davis & Purcell, 2013). Importantly, it has been found that in children aged 10-14 years, 53.4% of head injuries were sport-related (Caine et al., 2014). Children have not yet reached full physical development, and thus, their brain is still immature (Davis & Purcell, 2013). A child’s skull is still relatively thin, their head is quite large in proportion to their body, and the cervical musculature to support their head is weak (Davis & Purcell, 2013). As a result of this immaturity, it has been shown that when exposed to the same impact forces, a child’s brain is at risk for greater injury when compared with an adult’s brain (Davis & Purcell, 2013). In addition, the recovery time from a TBI in children is longer than it is for adolescents and even longer than it is for adults (Davis & Purcell, 2013). Unfortunately, the long-term effects of repetitive concussions in children are yet to be discovered (Davis & Purcell, 2013).

Other Common Contact Sport-Related Injuries in Children

  • Anterior Cruciate Ligament (ACL) Injury (Caine et al., 2014)
  • Growth Plate (Physeal) Injuries (Houghton, 2014)
  • Green-Stick Fractures (Caine et al., 2014)
  • Apophysitis and Apophyseal Fracture Injuries (Caine et al., 2014)

Influences on Youth Aggression

Intimidation is a crucial component of any contact sport; however, it can be used in many different ways, some to the extreme (Juhn, 2002). As an athlete, it’s important to be able to make that distinction between a team who is intimidating because of their skillful tactics or a team that intimidates using illegal play (Juhn, 2002). For some, sport can be seen as an outlet for aggression, allowing males in particular, to release any built up anger and negative energy (Isaacs, 2014). In others; however, sport is seen as a facilitator to aggressive behaviours (Isaacs, 2014). Contributing to this idea, are the many external influences that affect whether or not children consider aggression in sport as appropriate or not (Smith, 2000). And unfortunately, violence can be, and often is, reinforced by the media, coaches, teammates, and even the parents of the children themselves (Juhn, 2002).

The Media

In comparison with other televised sports, hockey tends to have a lower audience, therefore encouraging aggression is a marketing tactic used in order to attract more viewers (Smith, 2000). However, this use of aggression can have negative affects on children (Keays & Pless, 2013). For example, youth playing in hockey minor leagues seem to be influenced by watching televised NHL games (Keays & Pless, 2013). One survey completed demonstrated that 90% of youth hockey players reported having learned a behaviour, technique, or skill from a professional hockey player (Keays & Pless, 2013).

Coaches

Coaches not only teach children the skills of the game, but they are also considered significant role models (Smith, 2000). As a result, they must constantly be aware of how they are portraying appropriate and inappropriate behaviour. Particularly in contact sports, where injury is much more likely to occur, it’s important that boundaries are set when it comes to what forms of physical contact are considered legal and which are considered illegal.

Parents

Parents are considered “coaches off the ice”, and thus must act in a similar fashion – promoting the idea of playing a disciplined game (Juhn, 2002). Unfortunately, the “win at all costs” mentality can get the better of some parents resulting in the promotion of illegal violence in their athlete children (Marchie & Cusimano, 2003).

Teammates

Fellow teammates have a large effect on each individual athlete’s moral reasoning (Kavussanu & Spray, 2006). In a study by Kavassanu and Spray, it was shown that if winning was at stake and the coach and other teammates encouraged illegal acts in order to seek advantage, that this would have a strong influence on the player’s intention to engage in these acts (Kavassanu & Spray, 2006).

Recommendations for Children (Athletes), Parents, and Coaches

Return to Play Guidelines

Many sport organizations have their own “Return to Play” guidelines when it comes to head injuries, for example, Hockey Canada (Hockey Canada, 2014). After joining with Parachute Canada, a “charitable organization dedicated to preventing injuries and saving lives”, Hockey Canada has come up with a concussion card used for educating and raising awareness about concussions (Parachute Canada, 2015). In the card, it describes how concussions happen, common signs and symptoms, what your initial response should be to loss of consciousness, prevention tips, and 6 strict return to play guidelines (Hockey Canada, 2014). Children, parents, and coaches should all be aware of the concussion protocol and how to use it in order to prevent and treat concussions in youth.

Managing Youth Return to School

HeadSmart™ is a recovery protocol used by physicians, coaches, parents, and athletes to manage return to sports and school following a concussion (South Shore Hospital, 2015). The program involves a 4-staged colour-coded framework depicting the recovery process that should be undergone after a concussion in children as young as 10 years old (South Shore Hospital, 2015).

Changing the Rules of the Game

In any contact sport, appropriate age restrictions need to be put in place when it comes to physical contact between players. In addition, within each age grouping, there should be different grades of acceptable contact between players. Young children are not physically mature enough to withstand the nature of high impact contact and are at great risk of injury when exposed to this kind of play; therefore, strict rules are required if we are to prevent injuries in our youth (Caine et al., 2014).

Parents and Coaches

Parents and coaches need to understand their responsibility as role models for their children and athletes. It’s important that they demonstrate their knowledge about fair play, as well as teamwork, and conformity to the rules and that the “win at all costs mentality” is not overemphasized.

References

  1. Ashare, A.B., Bishop, P.J., & Hoerner, E.F. (2000). Safety in Ice Hockey: 3rd edition. ASTM International: West Conshohocken, PA.
  2. Caine, D., Purcell, L., & Maffulli, N. (2014) The child and adolescent: a review of three potentially serious injuries. Sports Science, Medicine & Rehabilitation, 6, 22. doi: 10.1186/2052-1847-6-22.
  3. Davis, G.A, & Purcell, L.K. (2013). The evaluation and management of acute concussion differs in young children. British Journal of Sports Medicine, 48(2), 98-101. doi:10.1136/bjsports-2012-092132
  4. Farrey, T. (2014). ESPN Poll: Most Parents Have Concerns About State of Youth Sports. Retrieved from http://espn.go.com/espnw/w-in-action/article/11675649/parents-concern-grows-kids-participation-sports
  5. Hockey Canada (2014). Facts and Prevention: Concussion Prevention Resource Centre. Retrieved from http://www.hockeycanada.ca/en-ca/Hockey-Programs/Safety/Concussions/Facts-and-Prevention.aspx
  6. Houghton, K. (2014). Pediatric Sport Injuries [PowerPoint slides]. Retrieved from https://www.elearning.ubc.ca
  7. Isaacs, D. (2014). Sport and Ethics. Journal of Pediatrics and Sport Health, 50, 749-750. doi: 10.1111/jpc.12717
  8. K., A.A. (2012). Scoring Technology in Martial Arts: Tech-wondo. Retrieved from http://www.economist.com/blogs/gametheory/2012/11/scoring-technology-martial-arts
  9. Kabussanu, M., & Spray, C.M. (2006). Contextual Influences on Moral Functioning of Male Youth Footballers. The Sport Psychologist, 20(1), 1-23.
  10. Keays, G., & Pless, B. (2013). Influence of viewing professional ice hockey on youth hockey injuries. Chronic Diseases and Injuries in Canada, 33(2), 55-60.
  11. Marchie, A., & Cusimano, M.D. (2003). Bodychecking and concussions in ice hockey: Shold our youth pay the price? Canadian Medical Association Journal, 169(2), 124-128.
  12. McKee, A.C., Cantu, R.C., Nowinski, C.J., Hedley-Whyte, E.T., Gavett, B.E, Budson, A.E., … Stern, R.A. (2009). Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury. Journal of Neuropathology and Experimental Neurology, 68(7), 709-735. doi: 10.1097/NEN.0b013e3181a9d503
  13. Minister of Health (2007). Athletic Mouthguards. Retrieved from http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/life-vie/mouth-dents-eng.php
  14. Nowinski, C. (2006). Head Games: Football’s Concussion Crisis from the NFL to Youth Leagues. Plymouth, MA: Drummond Publishing Group.
  15. Rice, S.G., & the Council on Sports Medicine and Fitness (2008). Medical Conditions Affecting Sports Participation. Pediatrics, 121(4), 841-848. doi: 10.1542/peds.2008-0080
  16. Rules of Sport (2012). Rules of Sport. Retrieved from http://www.rulesofsport.com/
  17. South Shore Hospital (2015). Head Smart: A healthy balance to concussion recovery. Retrieved from http://www.southshorehospital.org/workfiles/Medical_Services/Orthopedics/HeadSmart.pdf
  18. Parachute Canada (2015). About Parachute. Retrieved from http://www.parachutecanada.org/corporate/topic/C259
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