A Q and A with Dr. Frederick Mueller

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Interview by Garry Boulard

Dr. Frederick Mueller believes in the power of statistics.

As the director of the National Center for Catastrophic Sports Injury Research, which is based on the Chapel Hill campus of the University of North Carolina, Mueller is constantly collecting and analyzing sports injury data.

The reason is simple: By going over such data, Mueller and his fellow researchers, including Dr. Robert Cantu, the Center’s medical director, can spot areas of danger in competitive sports, letting schools know where their prevention efforts need to be improved.

Since 1977 the Center has been compiling data on high school sports injuries and, beginning in 1982, putting out an annual report that provides a comprehensive national picture and has helped to spur greater prevention efforts at hundreds of schools.

In 2007, for example, the center reported that high school football players sustained more than half a million injuries during the season ending in early 2006, including nine cervical vertebrae fractures, five brain injuries (one of which was a severe concussion), and four transient paralysis injuries. From its 2007 data collection, the center also noticed a disturbing trend: That year produced “the highest number of catastrophic recovery injuries since the study was initiated in 1977.”

The center also compiles injury numbers in soccer, basketball, lacrosse and cheerleading, noting of the latter that between 1982 and 2007 there were more than one hundred fatal, disabling or serious injuries, with a rise in recent years attributed to the increasingly gymnastic character of cheerleading.

State Legislatures: Your report indicates that injuries in football are on the rise. Why do you think this is happening?

Dr. Frederick Mueller: On the catastrophic side, we’ve been seeing more, it’s true—especially in football. And I don’t know exactly why it’s increasing. In North Carolina we’ve had three deaths just this year, as well as a couple of serious injuries. Much of this is related to concussions. Some of the kids go back into play after an initial concussion. And as a result North Carolina is now looking at who is on the sidelines. Do they have a certified athletic trainer there? In one case that I know of there was what they called an “injury management specialist,” but that is not the same thing.

SL: You have indicated that many things may be contributing to an increase in injuries. Could you explain that?

Mueller: The games are more intense today, and the size of some of the kids is unbelievable. And you see this at the professional level, too. There has also been a change in how injuries are regarded, a change that is working its way down because this is something that everyone sees on a Sunday. The college players follow it and then the high school students see it and hear these guys talk about “Oh, I had a concussion, but it’s not going to keep me out of the game,” and they think that’s the way to go.

Plus sports for these kids are now year-around, there is no denying that. In the summertime they are playing at camps and leagues and practicing off-season. During the school year they go from one sport to another, with little time for rest in between.

SL: You have emphasized that schools should have on staff a certified athletic trainer. Why is that so important?

Mueller: Certified athletic trainers are very important in situations like this not only because they have the training and background to diagnose whether or not someone has a problem on the field, but they have the knowledge to determine, perhaps most important, whether or not an individual should be put back into the game after an injury has taken place. Usually there is no certified athletic trainer or physician on site, not to mention immediate access to an ambulance.

SL: Should schools be thinking about having doctors either on staff or on site?

Mueller: It would be difficult for a school to have a physician on site for practice and games. But it would be nice, especially for the games. During practice it might mean just having a doctor available who maybe could meet the ambulance at the hospital to determine how serious an injury is.

There has been talk of having a physician named by the school who all of the athletic teams would be referred to, someone who knows what they are doing, understands athletics, understands head injuries, neck injuries, those type of things.

SL: Do you think state legislatures should mandate that schools hire certified athletic trainers?

Mueller: It would be a very easy thing for the lawmakers to do. But are they also going to attach funding to those mandates? If they don’t a lot of schools are going to be put in a very difficult position.

Some of the schools also require their trainers to teach. That’s something we have seen going on in several states. But you really have to wonder if that’s putting these trainers to the best use. In some cases it may mean that they end up working all kinds of hours. And if there is only one trainer per school and that school has four or five teams practicing at the same time, it is probably going to be too much for any one individual trainer to handle.

There is not enough time in the day for one trainer to do all of those things, so I would hope if state lawmakers become more involved in this issue, they would be aware of those things.