Chest Protectors Don't Protect Young Athletes

Catchers, goalies at risk of fatal blow to heart, study says

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By Meryl Hyman Harris
HealthDay Reporter

FRIDAY, April 7, 2006 (HealthDay News) -- Chest protectors don't prevent sudden death when a child is hit in the chest with a ball while playing sports such as baseball or lacrosse, a new study shows.

The injury, called commotio cordis, is a cardiac arrest caused when a blow occurs as the heart is preparing to pump, disrupting the heart's electrical system. It occurs an estimated 10 to 20 times a year in the United States, particularly in children, said study co-author Dr. Mark S. Link, an associate professor of medicine at Tufts New England Medical Center in Boston.

The researchers tested seven commercially available baseball chest protectors with regulation baseballs and five lacrosse protectors with standard lacrosse balls on anesthetized pigs. The balls were traveling about 40 mph. The protectors are typically worn by catchers in baseball and by goalies in lacrosse.

Heart attacks occurred almost as often in pigs not outfitted with the protectors. The researchers concluded that current chest protectors are designed to protect against soft-tissue or bone injury, and may lead to a false sense of security for young athletes, their coaches and parents.

"I would have expected the chest protectors to work, or at least do a better job," said Link, who participated in an earlier study that had similar results for baseball protectors only.

"We have to look for different materials, different chest-wall designs," he said. "And we should consider the possibility of looking into rule changes."

Link would like to see lacrosse goalies forbidden from blocking shots with the chest.

And children should be required to play both games using softer balls, said Dr. Lyle Micheli, director of the Division of Sports Medicine at Boston Children's Hospital.

The new study findings appear in the April issue of Pediatrics.

Both doctors said the most important protection parents can give their children on the playing field is adult supervision, and a plan for medical emergencies -- something too few recreational teams pay attention to.

"You need an emergency-response plan, said Micheli, "an assigned volunteer with medical responsibility" who can contact a response center when something happens. Both doctors also noted that portable defibrillators are inexpensive and can prevent some traumatic cardiac deaths when handled by properly trained individuals.

But nervous parents shouldn't steer their children away from sports, the physicians said. Link's children play baseball and lacrosse, although he tells them not to block the ball with the chest.

"My daughter is a goalie and wears two chest protectors," he said. "But that's probably overkill. There is a certain level of caution that needs to be taken, but you can't ruin the sport."

The injury is rare and the benefit of sports far outweighs the risk, he said.

More information

For more about children and sports safety, visit the American Academy of Orthopaedic Surgeons.

SOURCES: Mark S. Link, M.D., associate professor, medicine, Tufts-New England Medical Center, Boston; Lyle Micheli, M.D., director, Division of Sports Medicine, Boston Children's Hospital; April 2006 Pediatrics

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