Fall sports safety: Kids and concussions
8/23/2021 by Luke Radel, M.D.
As summer break comes to a close, many kids are looking forward to the upcoming fall sports season. Unfortunately, these sports are sometimes associated with injuries to the student athletes. Whether it's cheerleading, volleyball, cross-country, soccer, tennis, swimming or football, no fall sport is immune to unexpected injuries.
One injury that many people are concerned about is a concussion. Many people have heard of concussions from the news, social media, friends and many other sources. This information can be overwhelming and lead to lots of questions and concerns.
Here are some key concussion points to clarify any questions or concerns that you may have:
What is a concussion?
A concussion is a traumatic brain injury that causes a temporary disruption in brain function. This injury is caused by a blow to the head or body that results in rapid rotation of the brain inside the skull, resulting in a variety of signs and symptoms.
What are the signs and symptoms of a concussion?
Concussions can't be seen on a traditional CT or MRI, so clinicians rely on recognizing certain signs and symptoms to diagnose a concussion.
These signs and symptoms include:
- Balance difficulties.
- Light or noise sensitivity.
- Difficulty concentrating or remembering.
- Sleep disturbance.
- Feeling foggy.
If you or your child's coach suspect your child has a concussion, your child should be removed from the sport or activity immediately. A medical provider ― either on the sidelines by an athletic trainer or at your child's clinic ― should evaluate your child promptly.
These symptoms should prompt immediate evaluation in the Emergency Department:
- Severe headache, especially if it's worsening.
- Loss of consciousness greater than one minute.
- Severe neck pain.
- Excessive sleepiness or difficulty arousing.
- Vision loss.
- Slurred speech.
- Recurrent vomiting.
- Numbness, tingling or weakness in an arm or leg.
Can a concussion be treated?
Concussion treatments include:
Your child will receive an individualized care plan from his or her medical provider. The initial treatment for a concussion is a period of rest for the first 24 to 72 hours after the injury. Your child should avoid any cognitive or physical activities during this period. In some severe cases, your child may need to take a break from school for a day or two to rest at home. While resting, try to avoid things that worsen the symptoms, such as excessive screen time, bright lights or noise. Tylenol or ibuprofen may be taken as needed for symptom relief during recovery, but should be used sparingly.
After the initial rest period, your provider will recommend that your child gradually gets back to doing more activity, such as school or other everyday activities. In general, school attendance is encouraged as soon as possible, even if it means taking several breaks or attending half days. When returning to school, your child may require some initial academic accommodations, such as frequent breaks; extended time on assignments and homework; testing in a quiet environment; postponing high-stakes tests; and avoiding loud noises, such as band, choir or shop class.
- Physical activity
Physical activity has been shown to be safe and effective in concussion recovery. After the initial few days of rest, your child should begin some low-impact aerobic activity, such as brisk walking or riding a stationary bike. These activities are safe to do, even if your child has mild symptoms as long symptoms do not worsen. Once your child is symptom-free, he or she can start a return-to-play protocol that focuses on gradually increasing physical activity. This gradual method helps ensure your child is able to safely return to activities. Your child shouldn't fully return to his or her sport until cleared by a medical provider.
- Avoiding high-risk activities
While recovering from a concussion, it's important to avoid activities that place your child at risk for sustaining a repeat concussion. Driving should be discontinued during concussion recovery.
- Taking care of your body
Throughout your child's recovery, it's important to get adequate restorative nighttime sleep, stay well-hydrated and eat healthy foods that fuel and heal the body. Some providers may recommend supplements, such as melatonin, fish oil, magnesium, riboflavin or turmeric.
Can concussions be prevented?
Concussions can't be completely prevented, especially in contact sports, but strategies for lowering concussion risk include:
- Focusing on core and neck strengthening.
- Using proper technique and following the rules of the sport.
- Educating coaches and parents to recognize the signs and symptoms of concussions.
- Although helmets don't prevent concussions, they are important to help protect the head from skull fractures and other severe head trauma.
- Sitting kids out when in doubt.
Some youth organizations may implement injury prevention strategies, such as rule changes that limit unnecessary or excessive contact. It's important that coaches and officials appropriately enforce these rules.
Do concussions have long-term consequences?
A lot of unknowns exist in the relationship between concussions and long-term brain health, and this is an active area of research. No current evidence says a concussion will lead to long-term neurologic disease or impairment. Many people fear concussions will lead to chronic traumatic encephalopathy, or CTE, which is a rare progressive degenerative disease diagnosed only by an autopsy.
Chronic traumatic encephalopathy is a result of previous head traumas, but it's not known to what extent other risk factors may have contributed to developing this disease, such as genetics, lifestyle choices and other health problems. Not all people who experienced concussions in their lifetime go on to develop chronic traumatic encephalopathy, and no evidence supports how many concussions is too many.
The best advice to follow is to reduce the amount of unnecessary head trauma your child experiences. If your child has a head injury, it's important that a medical provider recognizes and treats it appropriately.
Luke Radel, M.D., practices in Primary Care in Rochester and Kasson's Division of Community Pediatric and Adolescent Medicine. He is board-certified in pediatrics and sports medicine. Dr. Radel is the volunteer team physician for the John Marshall High School football team, and he also has worked with the Rochester Grizzlies and Austin Bruins hockey teams. He has experience treating youth, collegiate and professional athletes.