To chest guard or not to chest guard against commotio cordis and other questions parents need to ask youth sports coaches

My son's first baseball game is next weekend and he is playing on the 8 and under squad this year. The little kid days of T-ball are drifting away and most of the kids will be pitching and catching on their own for the first time.

So earlier this week when I read this Chicago Tribune article about youth baseball and the risk for commotio cordis, I paid attention. Or maybe a better way to describe my reaction was the more you know, the more you freak out. I am relatively new to the world of youth sports so I was totally unaware of this as it seems most of the press has been devoted to head concussions.

Maybe it's time to add commotio cordis to the youth sports conversation.

Commotio cordis is essentially a heart concussion, a direct blow at a precise time in the cardiac cycle causing sudden cardiac arrest. It's rare but usually deadly when it does happen. According to this MomsTeam article, "It is the second highest cause of death in athletes younger than 14 years, and is unique occurrence among children, usually younger than 16 years." It happens most often in youth baseball although there are incidences in lacrosse, hockey, martial arts and other sports or playground activities. The Tribune article mentions there are "about 10 to 20 cases each year in the United States."

The contents of my son's baseball bag: batting helmet, glove, and now, a chest guard.

The contents of my son's baseball bag: batting helmet, glove, and now, a chest guard.

Up to this point my son's baseball gear has been pretty basic: a bat, cleats, batting helmet, a water bottle, and an athletic supporter. Maybe I need to protect more than his head and well, what's under his underwear.

I can't help but worry about the risk, especially considering commotio cordis tends to happen at higher ball speeds. My son threw 35 mph in a pitching skills competition last summer so I know even with the 8 and under kids the speeds are getting there. And many players are totally exposed, right in the line of fire.

So it seems like the obvious answer is yes, my son needs a chest guard. It's a no brainer. If I can give him something that can prevent him from dropping dead from an ill-timed chest hit, you just do it right?

Well it's not so simple when you consider one of the main points of the Tribune article was that none of the chest guards available on the market are 100% effective in preventing commotio cordis. Some don't even come close. From the Tribune article, "One 2013 study that reviewed 216 U.S. cases of commotio cordis found that, of the 115 incidents related to competitive sports, 37 percent occurred while the victim wore a chest protector." So much for that sense of security we as parents believed chest guards could provide.

To me this seems like a good business challenge, to design an effective chest guard, one that really works. I love the philosophy quoted by Unequal Technologies CEO Rob Vito in the Tribune article, "We figured if we can stop a grenade blast, we could certainly stop a ball, stick or hand adversely hitting the chest."

Vito's company, Unequal Technologies, sells a type of chest guard technology that claims to be up to 95% effective in preventing commotio cordis and this high, unprecedented percentage was the result of this peer study just published in March. Critics of chest protectors have complained about the lack of peer reviewed research when it comes to assessing the efficacy of chest guards.

So I bought my son the HART Pad. By the way, I have to disclose no one from Unequal contacted me or sent me any consideration for this post. That $89.95 plus shipping for the chest guard came straight out of my wallet.

Still, that leaves an exposure of 5%, at best. As a parent, am I willing to live with that? My husband and I wondered what more could we do to help reduce the risk knowing firsthand how fast and furious Little League balls can fly. We're both financial analysts so we know how to identify and assess areas of risk for companies. Why couldn't we do the same for youth sports?

So we came up with this short, but important list of questions to ask the coach but forget about my kid for a minute, I think these are questions all parents of youth athletes should ask their coaches. When I was a banker, KYC was the acronym for Know Your Customer, the questionnaire that was sent to new customers to protect the bank from fraudulent or illegal activities. I thought, why not adapt KYC for youth sports, and call it Know Your Coach in an effort to protect our kids.

Here is my Know Your Coach questionnaire:

How are you training the kids to protect their heads and chests during the game? 

What is your CPR and First Aid training? Where is the nearest First Aid kit?

Do you know how to recognize a potential case of commotio cordis? Is there an established protocol?

Is an ambulance on site?

Where is the nearest Automated External Defibrillator (AED) located? Is it close enough to the game site, ideally within 3 minutes or less?

This last question on AED proximity possibly could be the most important, not just for preventing a potential commotio cordis tragedy, but for any type of sudden cardiac arrest, such as those from hypertrophic cardiomyopathy which according to MomsTeam occurs with greater frequency. Many schools have AEDs inside the building but so many youth sports games are held at facilities which are not affiliated with any school. And the fields are priceless minutes away.

If you are not satisfied with the answers you get, you can try to do something yourself. This list from MomsTeam provides a how-to guide for establishing an AED program in your youth sports community. You can push for an on-site ambulance at youth sports venues. Make sure the coaches are instructing the kids to turn theirs chests away from inside pitches and line drives. For youth baseball players, there are also special reduction in force balls that can be used.

Or you can reevaluate your child's participation until better measures are in place.

Some of these questions may be tough to ask since often youth coaches can be friends, teachers, and mentors. But please, do ask. The life you save may be your child's.

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Tags: MBA Son, parenting

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