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Concussion Update

Concussions seem to be a constant in the news every day, with more and more research being reported, we continue to gain new insight (although still limited in solutions for prevention). One story that caught my eye was a report that students in physical education class might be getting more concussions than students participating in contact sports. This might make sense, since more students are involved in PE classes overall compared to the number participating in formal middle and high school sports. Why is this important? While entities like the WIAA have initiated mandatory education for athletes and their parents in organized sports and their coaches, PE teachers have no such mandatory education on concussions.

According to the results of a research study from New Mexico that asked 99 athletic directors in the state to report the number of middle and high school students who were removed from athletic participation due to an acute concussion. The reported rates of concussion sustained in PE class were 60% higher than the rates of concussions in sports during the 2013-14 school year. The calculated injury risk was 3.5 out of every 100 students missed sports participation time due to concussion, while 4.7 out of every 100 PE students missed time due to concussion.

Many physicians and sports medicine experts were surprised by the results, due to the lack of contact sports like ice hockey and football that are not part of typical PE curriculums. Is there a reporting bias that might explain this, due to the incentive of kids participating in mandatory PE classes reporting concussion to get out of mandatory PE activities, versus athletes hoping to avoid losing game time being more likely to hide concussion symptoms? Only further concussion research will tell, but it does remind sports medicine providers to include PE teachers in educational outreach on concussion prevention, recognition, and management.

Vitamin D and Calcium Supplements and Fracture Risk

In another surprising research study published in JAMA, older adults who are instructed by their physicians to begin taking vitamin D and calcium supplements to reduce fracture risk are no less likely to fracture their hips or any other bones. This report comes from a literature review of 33 randomized, controlled trials, involving 51,000 independent, community dwelling people age 50 and older, including both men and women. This research flies in the face of the commonly held belief that because vitamin D assists the body in the absorption of calcium to build bone mass and reduce bone loss, supplementation reduces fracture risk.

So, what should you do to prevent fracture risk instead? Experts recommend weight bearing exercise, eating calcium rich foods, and getting outside and absorbing direct good old-fashioned sunshine! Remember that high doses above the recommended amounts of 1,000 IU of vitamin D can cause serious side effects such as an increased risk of falls, fractures, painful kidney stones, some types of cancer, and death. What to do next? Talk to your doctor about the results of this study, and whether you should continue supplementation of calcium and vitamin D, or if it should be stopped in lieu of other options to improve bone health.