Sports have become increasingly prominent in our society. Television viewership continues to rise, and numerous cable networks broadcast sports around the clock. Sports participation at the youth and high school levels continues to rise as well. Just as the participation and importance of sports have risen, the focus on sports safety of the athletes should increase as well. Here are 15 recommendations I have that could make sports safer for athletes at all levels.

Sports safety change #15: Educate athletes on the risks of painkillers.

As team doctors and athletic trainers, we must explain the risks of some of the drugs often used to treat pain, including narcotic medications and Toradol injections. Playing through pain is bad enough, but taking medications to numb the pain to keep you in the game has long-term risks. With studies showing the rates of narcotic use much higher among retired NFL players than the general population, it’s time to cut back on pain-numbing treatments.

Also read:

Pain and painkillers in the NFL

Use of painkillers for injuries during football and pain after football ends

Sports safety change #14: Take preparticipation physical exams seriously.

Many pro leagues have instituted mandatory electrocardiograms (ECGs) to screen for heart conditions, and lawmakers in several states have tried to mandate them. The financial burden and the numbers of athletes that could get held out of sports unnecessarily make mandatory ECGs challenging at the high school level. On the other hand, athletes and their parents should report any symptoms like shortness of breath and chest pain or a family history of heart problems. Doctors can then initiate a workup and hopefully decrease the risk of sudden cardiac death.

Also read:

Sudden cardiac death among young athletes

Ronald Rouse’s death an important reminder for young athletes

Sports safety change #13: Put medical professionals in the booth to watch for injuries.

Athletic trainers and team doctors cannot possibly watch every player on the football field. Unless a player tells the medical staff he is hurt, no one may notice and evaluate his injury. Schools and teams should put a doctor or athletic trainer in the booth to spot injuries and notify the doctors on the sidelines.

Sports safety change #12: Ignore the lure of college scholarships.

Every young athlete (and their parents) wants to earn a college scholarship. Playing soccer, baseball, lacrosse or any other sport all year long, year after year, isn’t the best way to achieve it. Playing in showcase events on the weekends after full weeks of games and practices isn’t smart either. Sure, college scouts attend these events, but if you’re talented, the scouts will find you. If you suffer a serious injury, the chances of earning a scholarship can evaporate quickly.

Also read:

Don’t push kids to compete in “showcase” events

Sports safety change #11: Encourage pitchers to wear helmets.

We have seen a number of MLB pitchers suffer serious injuries from balls rocketing off the bats in recent years. Pitchers will likely resist the idea of wearing helmets in favor of padded caps, but the caps currently being tested will not protect the eyes and face. Manufacturers should work to design lightweight, unobtrusive helmets or caps with some sort of shield. Ideally, getting them into youth baseball would help get kids used to them as they start pitching.

Also read:

Should baseball pitchers wear helmets?

Sports safety change #10: Hire a sports psychologist.

Professional teams often use sport psychologists to improve athletic performance. They can play an important role in the mental health of college and professional athletes too. As we saw recently with the passing of Ohio State’s Kosta Karageorge, depression and other mental and emotional issues can affect seemingly healthy athletes. Sport psychologists can help teams and schools identify mood changes in the players, offer counseling and more.

Also read:

Suicide and mental health concerns exist after concussions in young athletes

Sports safety change #9: Pay for the medical bills of college athletes.

I don’t know exactly how every school could do it, but colleges and universities should pay the expenses from the injuries their athletes suffer. Schools need to find a way to help their current and former players, because some of these injuries lead to pain and disability. At a minimum, schools should pay the out-of-pocket costs athletes’ families face after insurance covers part of the bill.

Also read:

Who should pay the medical costs for the injuries of college athletes?

Sports safety change #8: Remove contact from one football practice per week.

A recent study showed that high school football players average 774 head impacts over the course of the season, or approximately 50 per week. Simply making one practice each week a noncontact session would help decrease the cumulative toll on young players’ brains.

Also read:

Would noncontact practices make football safer?

Sports safety change #7: Focus efforts to decrease Tommy John injuries at the youth level.

It has been estimated that up to one-third of major league pitchers have undergone Tommy John surgery, but it’s too simplistic to look only at the pros to solve this problem. We need to fix some of the root causes in youth baseball. For starters, we must stop overusing these young arms. It’s time to stop pitching all year and pitching for more than one team per season.

Also read:

What is causing the spike in Tommy John injuries?

Sports safety change #6: Don’t rely on helmet technology.

Without question, improving the design of football helmets might decrease some of the impact delivered to the heads of the players. These helmets, though, cannot prevent every concussion, if they can prevent any at all. Instead of hoping they won’t occur, we need to focus on reporting and treating concussions. Athletes must learn to recognize the signs and symptoms of concussions. Parents need to stress to their children that it is crucial that they admit that they’re having headaches and other concussion symptoms.

Also read:

Should parents buy newer, high-tech football helmets?

Sports safety change #5: Give pro athletes more rest.

We don’t have studies on injury rates in Thursday night NFL games or back-to-back NBA games, but they can clearly take a toll on players’ bodies over a long season. In a study of professional soccer, athletes who play in more than one game per week face injury rates six times higher than players who only play one game per week. Pro leagues should examine ways to give players more rest – maybe mid-season breaks or spreading the same number of games over larger periods of time.

Also read:

Are Thursday NFL games harmful to the players?

Professional soccer injuries increase with more than one match per week

Sports safety change #4: Tell someone you got hurt.

Whether you’re a football or soccer player who gets hit in the head, a baseball player with a sore shoulder, or a gymnast with wrist pain, tell someone about your pain. Don’t hide it and try to play through it out of fear of losing your spot on the team or starting position. Talk to your parents, coach, or athletic trainer, and go see a doctor. Get your injury checked out before it becomes a serious injury that knocks you out of sports for months or needs surgery.

Also read:

It’s time to change players’ attitudes toward injuries

Sports safety change #3: Eliminate “ding” and other nonsense words.

Words like “bell rung,” “ding,” and “concussion-like symptoms” imply that these injuries are minor, but all brain injuries are potentially serious. It’s time that we stop acting like a concussion isn’t a big deal, so let’s stop using these terms.

Sports safety change #2: Stop rushing players back from injury.

Teams at every level want to win, and athletes want to play. The players want to get back on the field or court as quickly as possible (and their teams want them to play). Some injuries can actually get worse or become more likely to recur if players return to play before they are healed. Do everything possible to recover quickly, but do it in a way that protects your long-term health.

Sports safety change #1: Hire athletic trainers.

In 2009, only 42% of US high schools had access athletic trainers. Since athletic trainers are so crucial to evaluating, treating, rehabbing and preventing injuries, all high schools should work to find an athletic trainer that can be present at practices and games. Hire an athletic trainer, or work with a local sports medicine program to obtain access. Ideally, youth and recreational teams should try to work with athletic trainers too.

Also read:

Athletic trainers: Some of sports’ true heroes

Athletic trainers critical to the sports medicine team

Note: A modified version of this post appears as my sports medicine column in the December 31, 2014 issue of The Post and Courier.