Fall sports safety: Kids and concussions
8/7/2023 by Luke Radel, M.D.
The end of summer break is rapidly approaching, which means many kids are preparing to start the fall sports season. Unfortunately, some kids will experience injuries throughout the season. 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. Here are some key points about concussions to clarify any questions or concerns that you may have:
What is a concussion?
A concussion is a traumatic brain injury caused by a direct blow to the head, neck or body that causes the brain to shake inside the skull and results in temporary disruption in brain function. This injury results in a variety of different signs and symptoms that may present immediately or evolve over minutes to hours.
What are the signs and symptoms of a concussion?
With concussions, there are no abnormalities seen in standard head imaging studies such as a CT or MRI, so clinicians rely on recognizing certain signs and symptoms to diagnose a concussion.
These signs and symptoms include:
- Neck pain.
- Light or noise sensitivity.
- "Don't feel right."
- Difficulty concentrating or remembering.
- Nausea or vomiting.
- Trouble falling asleep.
If you or your child's coach suspect your child has a concussion, he or she 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.
The following symptoms should prompt a more immediate evaluation in the Emergency Department:
- Severe head or neck pain, especially if it's worsening.
- Loss of consciousness greater than one minute.
- 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?
Thankfully with proper attention and treatment, most concussions resolve within days, but some may be prolonged. Concussion treatments include:
- Rest: The initial treatment for a concussion is a period of rest for the first one to two days after the injury. Your child should avoid any major cognitive or physical activities during this period. While resting, try to avoid things that worsen the symptoms, such as excessive screen time, bright lights or noise. Don't take medications such as aspirin or other anti-inflammatories, opioids or sedatives until cleared to do so by a medical provider.
- School: In general, school attendance is safe and encouraged as soon as possible, even if it means taking several breaks or attending half days. In some severe cases, your child may need to take a day or two off of school to rest at home. When returning to school, your child may require some academic accommodations, such as frequent breaks; extended time on assignments and homework; test taking in a quiet environment; 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 as 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. 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. Your child should not drive a motor vehicle until cleared to do so.
- 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 and collision 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 players, coaches and parents to recognize the signs and symptoms of concussions.
- Wearing appropriate equipment when required, such as mouthguards and helmets. Although the equipment doesn't necessarily prevent concussions, it's important to help protect the head and face from fractures and other severe head trauma.
- Removing an athlete from the sport when a concussion is suspected. "When in DOUBT, sit them OUT."
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. Many people fear concussions will lead to chronic traumatic encephalopathy, or CTE, which is a rare progressive degenerative brain disease diagnosed only by an autopsy. No current evidence says a concussion will definitively lead to long-term neurologic disease or impairment, and there is no evidence that describes how many concussions are 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 Rochester John Marshall High School. He has experience treating youth, collegiate and professional athletes.