Q: [School-Age] My daughter sustained her third concussion during soccer and I want her to stop playing soccer all together because I’m worried about re-injury. Is retiring her from sports a right decision?
A: The decision to discontinue a child from playing contact sports is one of the greatest challenges for parents. There’s also the all too common question, “how many concussions is too many?” and the fact of the matter is that the current state of research just doesn’t know the answer. With that being said, there are numerous factors to consider when making the decision to retire your child from a sport, not simply the number of concussions.
While there are no known guidelines that can definitively ‘disqualify’ an athlete from sports, retirement decisions must be approached on a case-by-case basis and involve a team of medical and healthcare providers with expertise in pediatric concussion and traumatic brain injury. The retirement decision-making process often involves a number of medical and nonmedical considerations that take form in lengthy discussions between the athlete, family, and medical team. Some medical factors to consider include the athlete’s concussion history (e.g., characteristics of each injury, duration of symptoms, recovery patterns, intervals between concussions, injury thresholds, neuroimaging findings, etc.), as well as careful estimation of the overall risk of continued participation. The nature of the medical discussion also differs depending on the athlete’s age, personal and family medical history, level of sport, and skill level.
Understandably, caring and concerned parents are worried about the potential impact ending sports will have on their child’s psychological well-being. Many high school and school age athletes have made extraordinary sacrifices to participate in a sport and their participation has largely shaped their identities and social networks. For some athletes, their athletic talents have been nurtured for many years and they have high hopes of making sports a career-culminating experience. Playing sports also brings with it many health and self-esteem benefits as well. As such, retirement discussions should explore the value of the sport for the athlete and the psychological risks of discontinuing sport.
The choice to retire an athlete from sports should depend on a number of medical and nonmedical considerations, not just the number of concussions. Such decisions should be made jointly between the athlete, family, and multiple healthcare providers that are well versed in concussion research and the psychology of athletes. While we want our children to be active and engaged in sports, safety always comes as a first priority.
Shaleise Collier, PhD is a pediatric neuropsychologist and Director of the Concussion Service at the Center for Learning in Irvine, CA. She provides treatment and evaluation services to youth with neurological and neurodevelopmental conditions.