Children and Sports-Related Concussions:
Identification, Treatment & Prevention
...................“When in Doubt, Sit Them Out!"
A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis. Concussions are typically caused by a blow or jolt to the head and are of great concern in children who participate in sports.
Recently, President Obama stated that he “Would have to think long and hard before he would let his child participate in football.” This statement reflects the concerns of many parents regarding the potential for concussions in their children.
Recent news reports state that there may be a link between repeated brain injury due to concussions and mood and behavior changes including violence towards others as well as suicide. The most recent publicity regarding concussions in professional football players have brought this issue to the spotlight.
Concussions, especially multiple concussions, over the course of time, can lead to permanent brain injury and life long impairment. A concussion can happen in any sport but more often occur in such as football, rugby, or ice hockey. Such injuries are common in contact sports that don’t require helmets, such as soccer, basketball, wrestling, and lacrosse. A concussion can also occur from a collision with the ground; a wall; a goalpost; or a ball that has been thrown, hit, or kicked.
What many don’t realize is that many concussions also occur outside organized sports.
For example, a child riding bike or skateboard can fall down and bump his head on the street or an obstacle.
The number of sport-related concussions is highest in high-school aged athletes but the number in younger athletes is significant and on the rise
The following is guidance from the American Academy of Pediatrics regarding concussions in children.
The symptoms of a concussion which can happen right after the injury or not be noticed until hours or days after the injury. One problem is that athletes who have experienced a concussion may report feeling normal before their brain has fully recovered.
It is important to note that with most concussions, the player is not knocked out or unconscious!
Symptoms of a concussion include the following:
All concussions are serious, and all athletes with suspected concussions to play until they see a doctor. A doctor can confirm the diagnosis of concussion; determine the need for any specialized tests, such as CT scan, MRI, or neuropsychological tests; and decide if it is OK for the athlete to return to play. Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion may be more susceptible to another injury than an athlete with no history of concussion.
No one knows how many concussions are too many before permanent damage occurs. Repeated concussions are particularly worrisome, especially if each one takes longer to resolve or if a repeat concussion occurs from a light blow. The doctor needs to know about all prior concussions, including those that occurred outside of a sports setting, in order to make proper recommendations regarding return to play and future sports participation.
#1: Rest is the best ‘treatment’ for a concussion!
This means rest from ALL physical and mental activity.
Children should be monitored often but there is no need for wake-up checks during sleep.....Remember: rest is the most important. Listening to music, computer use and TV should be limited or stopped if the activity increases the symptoms.
School attendance and work may need to be modified. Tests and other projects may need to be postponed.
Students need to be excused from gym class or recess activities. Any worsening of concussion symptoms or changes in behavior such as agitation, grogginess, or disorientation should be immediately reported to your doctor. Even if the child is just “Not acting right” this warrants an urgent medical evaluation.
Returning to physical activity
Recovery time from can vary from one individual to another. Factors in the recovery time include the severity of the concussion, and the history of prior concussions. An athlete may feel better and want to return to play before their brain has completely recovered. Given the uncertain and unpredictable time frame for recovery, all sports activity should be suspended until symptoms have completely resolved at rest. At this point, a stepwise return to physical activity can begin if the athlete’s doctor says it’s OK. The stepwise plan should be progressive and individualized. Having an athletic trainer involved in monitoring this plan can be very helpful. It is important to pay close attention to worsening symptoms (like increasing headache, nausea, or dizziness). Any concussion-related symptoms that return with exertion are a clear indicator that the concussion has not healed. Final clearance to return to full activity should also be at the direction of a physician.
Not all concussions can be prevented, but some may be avoided.
-Helmets should be worn for any riding activities (like horseback, all terrain vehicle [ATV], motorbike, bike, skateboard, or snowboard) or contact sports (like football, hockey, baseball or lacrosse).
-Helmets should fit appropriately and be in good condition. Athletes should be taught safe playing techniques and to follow the rules of the game. Many sports authorities and schools have developed or reinforced proper techniques related to how athletes play in order to prevent, or at least minimize or decrease concussions.
Most importantly, every athlete needs to know how crucial it is to let their coach, athletic trainer, or parent know if they have hit their head or have symptoms of a head injury—even if it means stopping play. Never ignore a head injury, no matter how minor.
“When in Doubt, Sit Them Out!"
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