With the new school year underway, many families will be signing their kids up for various extracurricular activities. Children and youth are fortunate to have a wide array of sports to choose from in North Texas: football, soccer, basketball, baseball, hockey, cheerleading, drill team, wrestling, lacrosse, track and field and more.
Sports are a great way for young people to be active and healthy as they grow. They get beneficial exercise that promotes cardiovascular health and combats childhood diabetes and obesity. They get to run off extra energy. And they learn about teamwork and responsibility, all while having fun at the same time. There is a lot to be said for young people to be involved in organized sports as they grow up.
Naturally, all parents want to make sure their kids are safe when playing in any sports. Injuries do happen sometimes, but taking proper precautions helps to minimize risk. Bumps, bruises and the occasional sprain sometimes result from an athletic activity but usually it’s nothing too serious, thankfully.
Over the last several years, more attention has been paid to the risks of concussions in sports. Much of this focus has stemmed from news about former professional football players who suffered concussions during their playing careers and are dealing with the effects of those injuries later in life. However, while football tends to get a lot of attention in the discussion about concussions, children can suffer a concussion playing any sport or simply by falling while playing, walking, running or riding a bike.
“Increased awareness about concussions is a good thing, as parents are asking more questions and wanting to learn more about what they can do to protect their children,” says Dr. Shelley Weiss, a pediatrician. “It’s understandable that parents may wonder if it is safe for their child to play certain sports that are associated with head injury risk. Your pediatrician is a great resource to talk through the pros and cons and get advice and information.”
Traumatic Brain Injury
A concussion is a type of traumatic brain injury (TBI). The U.S. Centers for Disease Control and Prevention (CDC) defines TBI as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.” Anyone can sustain a TBI, but children and the elderly are most at risk. Falls and motor vehicle crashes are the first and second leading causes of TBI-related hospitalizations, respectively.
TBI is a significant cause of death and disability in the United States; in 2014, TBI contributed to the deaths of more than 56,000 Americans. A TBI is a serious injury and requires immediate medical attention. The effects of a severe TBI can last for a long time and may affect vision, memory, concentration, sleep patterns and mood.
A concussion is considered a mild TBI, but “mild” should not be confused with “insignificant.”
“Just because a concussion is called a mild TBI, that doesn’t mean it’s not serious,” explains Dr. Joy Touchstone, a pediatrician. “Concussions can be very serious at any age and when it comes to a youth concussion, it needs to be taken very seriously by parents, coaches, teachers and any other adults who are around.”
A concussion occurs when there is a jolt or blow to the head that causes the head and brain to move rapidly back and forth. This sudden, fast movement can actually cause the brain, which is composed of matter with the consistency of gelatin, to bounce or move around within the skull. In the event of a concussion, the brain can literally be bruised and suffer chemical or physical changes.
Signs of a Concussion
We have all watched a sporting event and seen a player take a bad fall or a hit to the head that makes us cringe and worry for the player’s health. This is, in fact, the first indicator of a possible concussion: observing someone take a blow to the head or falling and hitting their head. If you observe a young player sustain this type of hit or fall, remove them from the field of play immediately for a proper medical evaluation.
After the fall or blow to the head, there are several signs that may point to a possible concussion. A child may experience:
- Headache or pressure in the head
- Nausea or vomiting
- Loss of balance
- Blurred vision
- Sensitivity to light or noise
- Feeling down or “not right”
In addition to the symptoms experienced by the child, a parent or coach may observe the following signs of a possible concussion:
- Appearing dazed
- Moving in a clumsy manner
- One pupil in the eye is larger than the other
- Speaking more slowly than normal
- Any loss of consciousness, no matter how brief
- Forgetfulness, confusion
- A loss of memory regarding events immediately before or after the injury
If a child experiences any of these symptoms or signs following a hit or fall, adults need to act immediately:
- Remove the child from the game or field of play
- Take the child to a medical provider to be evaluated. Do not attempt to evaluate the severity of the injury yourself; leave it to a trained medical professional to conduct an exam.
- Do not allow the child to return to sports or other physical activity until cleared to do so by a medical professional.
There may be no immediate symptoms following a concussion; it is not uncommon for someone to experience a concussion and not realize it. That’s why in the event of a hit or fall that jolts the head, it is important to closely watch for signs of a concussion in the hours and days following the injury.
If signs of a concussion are present, seek emergency medical care right away. In the event of any head injury, even if there are no signs of a concussion, it is best to get to the doctor within one or two days to be checked out. The American Academy of Pediatrics recommends calling your child’s doctor for any head injury that is more than a light bump.
Physicians have several ways to evaluate a patient for a concussion. They may conduct a neurological examination, which would entail testing vision, hearing, balance, coordination and reflexes. A cognitive evaluation may be done to evaluate memory and concentration. And imaging tests, such as a CT scan or MRI, may be conducted to see if there have been any physical changes in the brain. Finally, keeping a patient under observation overnight may be in order to make sure there have been no serious impacts from the injury.
Recovering from a Concussion
Rest is the most important treatment for a concussion. “After a concussion, it’s important to rest physically, but also mentally. That means avoiding TV, video games, texting and using phones and computers,” says Dr. Lynda Tang, a pediatrician. “It may mean sitting out of school for a few days or limiting hours at school, as well as homework. Just as the body needs to rest, the brain will need to rest, as well.”
As the brain recovers from a concussion, your child’s doctor will likely advise you to ease him or her back into a normal routine by gradually increasing activity. It’s important to get a good night’s sleep every night and focus on relaxing activities during recuperation. Follow the doctor’s instructions closely for returning to normal activity – increasing activity too soon increases the risk for a repeat concussion. Repeat concussions increase risk for lasting damage to the brain.
When it comes to returning to play, the CDC outlines a six-step process that parents should implement under the supervision of their child’s doctor. The goal of this approach is to gradually increase physical activity while minimizing the risk of reinjury or trying to do too much too fast. These six steps may be implemented over a period of days, weeks or even months. Your doctor will prescribe the appropriate plan and timeline:
- Return to regular activities, such as attending school.
- Light aerobic activity,such as 5-10 minutes of light jogging or pedaling a stationary bike.
- Moderate activity,such as increasing aerobic exercise time.
- Heavy, non-contact activity:this could include sprinting or running, provided there is no contact with other players.
- Practice & full contact: practice as normal for the sport.
- Competition: return to competition and all activity.
There are several things parents can do to help reduce the risk of a concussion for their child, both on and off the field.
Helmets are required in many sports, such as football, baseball, hockey, wrestling and lacrosse. In addition, all children (and adults) should wear helmets when bike-riding, skating (including roller skating, rollerblading and ice skating), skateboarding, horseback riding, skiing and snowboarding.
Helmets cannot prevent 100% of concussions, but they can dramatically reduce risk. To ensure maximum protection, helmets much be specifically designed and certified for the sport or activity, must be worn consistently and in the correct manner and must be in good condition.
Off the field, parents can reduce risk of concussion for young children by installing safety gates at the top of staircases (to prevent accidental falls) and properly restrain children in a car seat when in a vehicle.
Resources for Parents & Coaches
The CDC program “Heads Up” provides great resources on concussion prevention and head safety for parents, coaches, school nurses and others. At the Heads Up website, you can download useful documents, find out how to get concussion protocol training and stay abreast of best practices for minimizing injury.
“By helping your child understand that precautions such as helmets are a main part of responsibly playing a sport, you can significantly reduce your child’s risk of a head injury,” says Dr. Chris Straughn, a pediatrician. “And by knowing how to identify possible signs of a concussion, you will be as prepared as possible if it happens and be able to get your child the care he or she needs immediately.”
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