A Parent’s Guide to Concussion in Sports
What is a concussion?
A concussion is a brain injury which results in a temporary
disruption of normal brain function. A concussion occurs when the brain is
violently rocked back and forth or twisted inside the skull as a result of a
blow to the head or body. An athlete does not have to lose consciousness
(“knocked-out”) to suffer a concussion.
Concussion Facts
- It is
estimated that over 140,000 high school athletes across the United States
suffer a concussion each year. (Data from NFHS Injury Surveillance System)
- Concussions
occur most frequently in football, but girl’s lacrosse, girl’s soccer,
boy’s lacrosse, wrestling and girl’s basketball follow closely behind. All
student-athletes are at risk.
- A
concussion is a traumatic injury to the brain.
- Concussion
symptoms may last from a few days to several months.
- Concussions
can cause symptoms which interfere with school, work, and social life.
- A
student-athlete should not return to sports while still having symptoms
from a concussion as they are at risk for prolonging symptoms and further
injury.
- A
concussion may cause multiple symptoms. Many symptoms appear immediately
after the injury, while others may develop over the next several days or
weeks. The symptoms may be subtle and are often difficult to fully
recognize.
What should I do if I
think my child has had a concussion?
If a student-athlete is suspected of having a concussion, he
or she must be immediately removed from play, be it a game or practice.
Continuing to participate in physical activity after a concussion can lead to
worsening concussion symptoms, increased risk for further injury, and even
death. Parents and coaches are not expected to be able to “diagnose” a
concussion, as that is the job of a medical professional. However, you must be
aware of the signs and symptoms of a concussion and if you are suspicious, then
your child must stop playing:
When in doubt, sit
them out!
All student-athletes who sustain a concussion need to be evaluated
by a health care professional who is familiar with sports concussions. You
should call your child’s physician and explain what has happened and follow
your physician’s instructions. If your child is vomiting, has a severe
headache, is having difficulty staying awake or answering simple questions he
or she should be taken to the emergency department immediately.
When can a
student-athlete return to play following a concussion?
After suffering a concussion, no athlete should return to
play or practice on that same day. Previously, athletes were allowed to return
to play if their symptoms resolved within 15 minutes of the injury. Studies
have shown us that the young brain does not recover quickly enough for an
athlete to return to activity in such a short time.
Once an athlete no longer has symptoms of a concussion and
is cleared to return to play by health care professional knowledgeable in the
care of sports concussions he or she should proceed with activity in a
step-wise fashion to allow the brain to re-adjust to exertion. On average the
athlete will complete a new step each day. The return to play schedule should
proceed as below following medical clearance:
Step 1: Light exercise, including walking or riding an
exercise bike. No weight-lifting.
Step 2: Running in the gym or on the field. No helmet or
other equipment.
Step 3: Non-contact training drills in full equipment.
Weight-training can begin.
Step 4: Full contact practice or training.
Step 5: Game play.
If symptoms occur at any step, the student-athlete should
cease activity and be re-evaluated by their health care provider.
How can a concussion
affect schoolwork?
Following a concussion, many student-athletes will have
difficulty in school. These problems may last from days to months and often
involve difficulties with short and long-term memory, concentration, and
organization.
In many cases it is best to lessen the student-athlete’s
class load early on after the injury.
This may include staying home from school for a few days, followed by a
lightened schedule for a few days, or perhaps a longer period of time, if
needed. Decreasing the stress on the
brain early on after a concussion may lessen symptoms and shorten the recovery
time.
What can I do?
- Both
you and your child should learn to recognize the “Signs and Symptoms” of
concussion as listed above.
- Teach
your child to tell the coaching staff if he or she experiences such
symptoms.
- Emphasize
to administrators, coaches, teachers, and other parents your concerns and
expectations about concussion and safe play.
- Teach
your child to tell the coaching staff if he or she suspects that a
teammate has a concussion.
- Monitor
sports equipment for safety, fit, and maintenance.
- Ask
teachers to monitor any decrease in grades or changes in behavior that
could indicate concussion.
- Report
concussions that occurred during the school year to appropriate school
staff. This will help in monitoring injured student-athletes as they move
to the next season’s sports.
Other Frequently
Asked Questions
Why is it so important that a student-athlete not return to
play until they have completely recovered from a concussion?
Athletes who are not fully recovered from an initial
concussion are significantly vulnerable for recurrent, cumulative, and even
catastrophic consequences of a second concussive injury. Such difficulties are
prevented if the athlete is allowed time to recover from the concussion and
return to play decisions are carefully made. No athlete should return-to-sport or
other at-risk participation when symptoms of concussion are present and
recovery is ongoing.
Is a “CAT scan” or
MRI needed to diagnose a concussion?
Diagnostic testing, which includes CT (“CAT”) and MRI scans,
are rarely needed following a concussion. While these are helpful in
identifying life-threatening brain injuries (e.g. skull fracture, bleeding,
swelling), they are not normally utilized, even by student-athletes who have
sustained severe concussions. A concussion is diagnosed based upon the student-athlete’s
story of the injury and the health care provider’s physical examination.
What is the best
treatment to help my child recover more quickly from a concussion?
The best treatment for a concussion is rest. There are no
medications that can speed the recovery from a concussion. Exposure to loud
noises, bright lights, computers, video games, television and phones (including
text messaging) all may worsen the symptoms of a concussion. You should allow
your child to rest as much as possible in the days following a concussion. As
the symptoms lessen, you can allow increased use of computers, phone, video
games, etc., but the access must be lessened if symptoms worsen.
How long do the
symptoms of a concussion usually last?
The symptoms of a concussion will usually go away within one
week of the initial injury. You should anticipate that your child will likely
be out of sports for about two weeks following a concussion. However, in some
cases symptoms may last for several weeks, or even months. Symptoms such as
headache, memory problems, poor concentration, and mood changes can interfere
with school, work, and social interactions. The potential for such long-term
symptoms indicates the need for careful management of all concussions.
How many concussions
can a student-athlete have before he or she should stop playing sports?
There is no “magic number” of concussions that determine
when a student-athlete should give up playing contact or collision sports. The
circumstances surrounding each individual injury, such as how the injury
happened and length of symptoms following the concussion, are very important
and must be considered when assessing a student-athlete’s risk for further and
potentially more serious concussions.
The decision to “retire” from sports is a decision best reached
following a complete evaluation by your child’s primary care provider and
consultation with a physician or neuropsychologist who specializes in treating
sports concussion.
I’ve read recently
that concussions may cause long-term brain damage in professional football
players. Is this a risk for high school athletes who have had a concussion?
The issue of “chronic encephalopathy” in several former NFL
players has received a great deal of media attention lately. Very little is
known about what may be causing dramatic abnormalities in the brains of these
unfortunate retired football players. At this time we have very little
knowledge of the long-term effects of concussions which happen during high
school athletics.
In the cases of the retired NFL players, it appears that
most had long careers in the NFL after playing in high school and college. In
most cases, they played football for over 20 years and suffered multiple
concussions in addition to hundreds of other blows to their heads. Alcohol and
steroid use may also be contributing factors in some cases. Obviously, the
average high school athlete does not come close to suffering the total number
or shear force of head trauma seen by professional football players. However,
the fact that we know very little about the long-term effects of concussions in
young athletes is further reason to very carefully manage each concussion.
Some of this information has been adapted from the CDC’s
“Heads Up: Concussion in
High School Sports” materials by the NFHS’s Sports Medicine
Advisory Committee.
Please go to www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm for
more information.
What can I do to help
my child?
Please encourage your children to tell coaches, nurses,
school staff, EMT’s, paramedics, athletic trainers and/or other medical
personnel the truth when it comes to a potential injury and symptoms that they
may be experiencing.
Often, these injuries occur in situations that do not
involve a stoppage of play, or even have the student-athlete fall to the
ground. Under these circumstances, a
coach may not notice or follow up with a student-athlete.
If you see any symptoms or changes that your child might be
experiencing, please let us know.
If we work together, we can help ensure that we continue to
maintain the safety of our students and student-athletes.
