In the book, Dr. Cantu does call for no hitting in football, no heading in soccer, and no body checking in hockey until age 14. All of which are very controversial stands to take in a culture where these sports are such an integral part of childhood and how parents raise their children. I think that one part of the chapter is overlooked in which he does make the concession that this complete ban is probably unrealistic, but better efforts should be made to change the number of hits children sustain in practice. He cites several examples, but the soccer reference stood out the most to me. He describes parent (volunteer) coaches kicking the ball with a great deal of force and then asking the kids to repetitively practice heading those kicked balls. This might go on for about 30-40 times per kid in each practice.
He questions if this is really necessary. During the course of the game, it is more probable that there will only be a few headers with this kind of force that are even possible. He argues that there is no reason kids should be trying to head balls that are given that much velocity in practice at all, much less 30-40 times. The same skill can be taught with less force and be much safer to the kids in practice.
Dr. Cantu also questions the practice of tackling in football and cites St. John's University in Minnesota that has not had a full contact practice since the Eisenhower administration.
"The Johnnies' football coach is John Gagliardi, who sets the records for wins and longevity every time he steps on the field. That happens when you're well into your seventh decade of coaching college football. Coach Gagliardi has notched more victories than any college football coach in history, approaching five hundred. His teams have won national championships four times. He is one of two active coaches in the College Football Hall of Fame."He uses this example of how weeks of avoiding collisions on the practice field can still produce a quality football team that wins championships and does so at a lower risk to their athletes. Dr. Cantu states that in order for this to become more widespread, it requires many more football coaches to take the same leap of faith that Mr. Gagliardi did and try it for themselves. However, changing this belief may be even harder than moving mountains.
Finally, I have read a couple of reviews of this book that took a decidedly harsh stance on Dr. Cantu's reference to the older standards of grading concussions according to their symptoms. Today, this is widely frowned upon since all mild traumatic brain injuries are completely different from each other and grading the injury is not effective in predicting time away from sport. In short, concussions that were once thought of as "mild" occasionally keep a child off the field longer than some concussions that were once thought to be "moderate" or "severe." Therefore, the old system of grading the head trauma is not effective.
I don't think that Dr. Cantu was trying to advocate, however, for the continued use of the grading system that he developed. It is my belief that in this chapter, he was trying to do nothing more than give a history of the progression of how we treated this injury and include his contributions to those efforts. I don't think that it can be understated that he was not trying to advocate for the continued use of the grading system of concussions in this book.
Overall, I would recommend this book to parents of kids in all contact and collision sports so that they can have a greater appreciation for the risks that their child assumes when they take the field. While some sports certainly have a much higher risk and greater rate of injury, (i.e. football and hockey) no sport is safe from the possible effects of TBI.
