Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”

“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”

“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”

“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”

“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”

“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”

The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”

The Specialty of School Sports

July 24, 2018

(This blog first appeared on MHSAA.com on November 18, 2016.)


There is much finger pointing when it comes to sports injuries, and I’d like to point in a direction that is often missed.

Some people blame equipment – it’s either inadequate, or it’s so good that it encourages athletes to use their bodies in unsafe ways.

Some people say the rules are inadequate, or inadequately enforced by contest officials.

Some people say the pool of coaches is inadequate, or they are inadequately trained.

But let’s not miss the fact that risk of injury is inherent in athletic activities, and at least part of the reason injuries occur is because the participants are developmentally deficient. In fact, this may be the fastest growing contributing cause to injuries in youth sports. It’s not the sport; it’s the lack of development, the lack of physical preparation.

When rushed into early and intense specialization in a single sport, youth may not be ready for the rigors of that sport. Lindsay J. DiStefano, PhD, ATC, of the University of Connecticut, has researched the topic among youth basketball and soccer players and linked higher injury rates to lower sports sampling, and vice versa. Exposure to multiple sports during early childhood positively influences neuromuscular control and reduces injuries.

Do we encourage youth to sample several sports and help them learn basic athletic movements and skills? Do we offer opportunities to train and condition and focus special attention on strengthening knees and necks? Do we provide more time and attention on practice than on competition and assure safe technique is taught and learned?

Early and intense specialization, with excessive attention to competition, invites injury. There is a much healthier way for most youth – and that’s balanced, multi-sport participation – the specialty of junior high/middle school and high school sports.