pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Concussion vs Skull Fractures
TED: David Camarillo explains difference

A ton of great information, right? I enjoyed the talk, even if he seemed a bit didactic and condescending in his delivery. None-the-less, the information that he DID give us is eye-opening and should cause us to pause in our analysis of how we’re going about protecting our kids. Completely being naïve to what we are doing doesn’t do anybody any good and may delay or prevent us from doing what really will protect them.

I completely understand the difference between concussion and skull fracture. And I understand completely why everyone’s first attempts at keeping kids safe was to protect against skull fracture. Obviously everyone makes the assumption, as I do, that decreasing skull fracture is a laudable goal because it intuitively must be related to concussion. But it’s interesting to realize that helmets are only designed and developed against fracture. However, we haven’t needed Camarillo to tell us that our former beliefs weren’t completely accurate. Most of us have come to believe that for several years; but, I’m glad that he and his group are trying to put some real dimension to the study and for that he should take credit.

If I find a disappointment with his talk it would be his appearing to want to take the credit for the discoveries of others in the field; and, his carefully worded dancing around the question regarding what we do now? Did you notice that he posed the question himself, then gave a non-answer… several times. He asked “what do I recommend to parents?” then skated to something like: “I don’t need to answer for me because I’ve got a couple years before my daughter actually rides a bike.”

So really, what DO we DO?! The honest answer is that there is nothing we can do, EXCEPT to do what we can—BUT not delude ourselves that what we are doing actually protects us from concussions. We’ve got helmets that don’t protect against concussion only fracture. We use what we can and look for other things we can do. We all have to decide for our own kids whether or not to let them participate in any activity, situation by situation. At the same time, to actually protect our kids we need to DEMAND MORE of our equipment, rule-makers, sports-organizers, government regulators, coaches, other teams, referees and umpires—pretty much everyone who is trying to turn children’s PLAY into trophy’s, pro-level goals and techniques and, yes, money-making schemes.

Those situations are not easily decided because of the complexity we have turned today’s “children’s play” into. It’s NOT just your coach; but how qualified, tolerant the referees are. Do they simply use common sense beneficial to children or are they just “winging it” or some sports wannabe living vicariously. And the other coach. Is he a complete nut who belittles his kids to basically “win at all costs?” And the schedule, does it suck every bit of spare time for other (let’s face it more life-important or family) activities out of not only your kid but the family as well? And the equipment—and on and on. Every decision stands on its own. Just know that today, there is probably 800 times more regimented activity available than is needed by your child to grow, develop and be happy in his life. You don’t NEED to endorse any sport for them to grow to their best potential.