Food For Thought From One Of The World’s Foremost Concussion Experts

October 10, 2012 | Coaches, Concussions, Parents, Prevention, Science, Sports Science

By Dev K. Mishra, M.D., President, Sideline Sports Doc

In this past Sunday’s New York Times, Dr. Robert Cantu presented some of his views in an article titled ‘Preventing Sports Concussions Among Children‘. Dr. Cantu has spent a good portion of his 40-year professional life as a neurosurgeon championing the cause of concussion prevention, as well as concussion recognition and management. His work is hugely influential and has helped considerably to change the way sports physicians think about concussion.

In the article, Dr. Cantu states ‘We cannot eliminate head trauma from youth sports. What we can change is our mind-set so protecting the head and the brain is always a top consideration. The guiding principle should be that no head trauma is good head trauma. Let’s re-examine youth sports and take steps to keep young athletes safe.’ I would agree fully with those statements.

He then goes on to offer recommendations based upon his experience and research. Among the recommendations are these, with some of my commentary included:


I believe USA Hockey is the most progressive and safety-conscious organization I’ve encountered in youth sports. They?ve taken firm and even courageous stands (the culture of youth hockey runs deep), and as of 2011 have banned body checking before the age of 13. Dr. Cantu suggests this be changed to age 14, but overall my opinion is that USA Hockey gets it right.


He recommends no tackle football until age 14. This recommendation is sure to raise the ire of many but he has literally seen it all over his career and feels strongly enough to place his reputation on the line by stating it publicly. He also states that ‘more worrisome is what we don’t know? meaning that new research could likely lead to a change in how we think about football concussions.


Much debate exists about the proper age to teach heading, and proper technique. Most of the discussion focuses on the effects of cumulative heading of the ball but Dr. Cantu points out that most concussions in soccer occur when two players go up to head the ball at the same time, and concussion occurs from head to head contact between players. He suggests that heading not be allowed until age 14.

Baseball and Softball

The mechanism of head injury in baseball and softball is different than in most other sports, so recommendations here mainly involve strengthening of existing rules. Namely, use chin straps on helmets to make sure they stay on, and eliminate head first slides. These recommendations make complete sense and I would think they are easy to implement since sliding would still be allowed, just not head first.

Field Hockey and Girls? Lacrosse

Here, Dr. Cantu argues for use of full protection helmets in both sports, and enforcement of already existing rules that ban contact to the head. This also seems reasonable given that the rules already exist and enforcement should not result in a significant change to the way the game is played.

So it’s time for us to continue the hard thinking about concussion and our kids. Some of these recommendations will be met with a lot of resistance but I believe in time that the evidence will prove Dr. Cantu right.

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