Are marching band and color guard as dangerous as football? | Expert Opinion

Although I wasn’t born yesterday, I wasn’t aware of the athleticism required by members of marching band and color guard. But when one of my patients told me she had suffered concussions twice in color guard, I decided it was time for a crash course.

It turns out that these quintessential school extracurricular activities weren’t born yesterday, either. In ancient times, percussion and wind instruments were used on the battlefield. During the 1700s and 1800s, rifles and sabers were used to protect the flag (colors) from attack.

Now, marching bands and color guards perform together on friendlier turf — football fields during halftime — in middle schools, high schools, and colleges. Marching band members parade the field while playing instruments that range from the tiny piccolo to the 30-plus-pound tuba.

» READ MORE: How to protect kids who play football from head injuries | Opinion

Color guard members twirl and toss 6-foot-long weighted flag poles, 2½-pound wooden imitation rifles, and 1½-pound stainless steel sabers (also not functional) while performing complex choreography.

Some of their moves can be dangerous, if not executed precisely and with lots of practice. Consider the basic double spin, a trick that starts from the right shoulder position and involves quickly spinning the equipment clockwise, then counterclockwise. Now imagine this: flipping, tossing, and spinning a flag pole that’s taller than you while performing complex synchronized choreography on a gusty day.

In one study of almost 1,400 college marching band and color guard members on 21 teams, 25% reported sustaining a musculoskeletal injury, usually of the legs. Women and members with higher body mass index were more likely to experience these injuries.

Another study looked at injuries sustained during one week of marching band camp and found that the overall injury rate was 124 injuries per 1,000 practices. The instruments with the highest injury rates were the mellophone, trombone, and percussion.

These performers are also at risk for exertional heat illnesses, including heat syncope, heat exhaustion, and heat stroke. These may occur during practices, performances, and competitions and can be exacerbated by carrying heavy instruments and wearing uniforms that retain heat.

One study that measured core body temperatures in 19 college marching band members found an average maximum temperature for rehearsals of 101.1 degrees Fahrenheit. During games, the musicians’ core body temperature reached an average max of 102.4. Higher temperatures were found among individuals who were taking medications, especially mental health medications. Most were dehydrated.

Then there’s my patient, who sustained two concussions during color guard. A concussion is a type of traumatic brain injury that happens when a blow makes the head move back and forth with a lot of force. This causes chemical changes in the brain and sometimes damages brain cells. An individual who has had a concussion has a higher chance of concussions with subsequent trauma.

Elliot Cleveland wrote in Marching Health: “We’ve all seen it at marching band and winter guard competitions — a rifle or flag flies through the air. The audience takes an alarming gasp as they can tell the weapon isn’t going to land where it was intended to. Even worse than a bad toss — the weapon nails an unsuspecting performer in [the] head.”

Advice for participating in marching band and color guard safely:

Rima Himelstein is an adolescent medicine specialist at Nemours Children’s Hospital, Delaware.