KK: I love the quote from your article, “With orthopedic injuries, athletes, players, and coaches readily accept a four- to six-week recovery period. It is astonishing that they show so much less respect for the brain.” Do you have some statistics regarding football and concussions that you can share with readers?

PA: Yes. There is beginning to be a bit of a surge of a response. I’ve gotten communications from the National Collegiate Athletic Association (NCAA), from independent writers, and from researchers who are interested in this field, and the consensus is that commentaries like we published will hopefully ignite activity to prevent these injuries. I’ve also received responses from parents citing their distress at what’s going on with children.

There are statistics that I’ve seen from the years 2002 to 2012; there was a 200 percent increase in the number of emergency department visits for concussions among 8- to 13-year-olds and the number of reported concussions of children 14 to 19 years old. In 2012, emergency departments treated 325,000 teens for concussion. That is just the tip of the iceberg because those are the patients that seek care. The Centers for Disease Control and Prevention published statistics on the number of children who take part in some sports in the United States, and we’re talking about tens of millions of adolescents.

KK: The 325,000 number I heard a little bit differently, and this caught my attention. In 2012, those 325,000 who came into the emergency department for concussions equaled about 40 an hour. That put it in context for me.

Do you think there is a specific age group that is more at risk than others?

PA: What I’ve read suggests to me that youth players, meaning children under high school age, are more prone to these injuries than are other players. So this starts in the youth leagues, and it’s cumulative. They start injuring themselves the minute they start banging heads, and given what we know about concussions and what happens down the road, in my opinion, that’s unconscionable.

KK: What is your perspective on the current return-to-play recommendations?

PA: The current return-to-play recommendations are not adequate. Subjective tests, written tests, and the combination of motor skills that are used for evaluation can be manipulated by the players. They very likely underestimate the brain health of the player. The concept that the players should be cleared by a knowledgeable health care provider is certainly a step in the right direction, but it doesn’t go far enough because, in many cases, those health care providers aren’t fully aware of the duration of time it takes to heal from a concussion.