Q: It seems that we are hearing more and more stories about the effects of concussions in athletes. What do I need to know about concussions given that my children play sports?
A: There definitely is a lot more discussion about concussions recently, and this is largely due to increased awareness – it’s not that the sports are suddenly more violent than they used to be. In addition to the increased awareness of what a concussion is, we have learned more about potential consequences, especially with recurrent concussions. Along with this knowledge, pediatricians and sports-medicine physicians have altered our approach to head injuries.
The first thing to recognize is that a concussion does not always involve loss of consciousness or amnesia – the presence of these findings may indicate a more severe concussion, however. Symptoms are often less dramatic and can include headaches, drowsiness and difficulty concentrating, among others. As a result, it is important to take these symptoms seriously in your children if you suspect they might have had head trauma from sports or other activities (this can include heading a soccer ball).
The next thing to know is that returning to a normal activity level after a concussion should be gradual and based on the presence or absence of symptoms. Returning to play too quickly can result in delayed recovery and increased risk of recurrence, as well as a condition called second impact syndrome, which is a severe traumatic brain injury that may be fatal. Parents and coaches should know that children and adolescents take longer to recover, on average, from concussions than adult athletes do, often needing as many as 7-10 days to recover. Returning to activity does not only include sports: "brain rest" may include staying home from school (and avoiding television and computers!).
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In 2011, Gov. Bev Perdue signed legislation regarding concussions among high school athletes in North Carolina. This legislation stipulates that athletes cannot return to play on the same day as suffering a suspected concussion; that players, parents, trainers and coaches must receive education about concussions at the start of each season; and that student athletes may not return to play until cleared by a physician. This is known as the Gfeller-Waller Concussion Act.
It is important to consider the developmental stage of adolescent athletes. At this age, it is normal to feel “invincible” or to believe “it won’t happen to me.” As such, the decision to return to play cannot be left solely up to athlete’s report of symptoms; it must also involve parents, coaches, and physicians. It is important to emphasize that the significance of a particular game or match should NOT factor into the decision. Decision-making should be the same for exhibition games as it is for championship games. The most mportant factor should be protecting our young athletes' developing brains.
Please be sure to contact your physician and your child’s coach if you have questions and also make sure to report any suspected concussions. Encourage your child to wear a mouthguard and helmet if appropriate for his or her sport. I hope that your children have fulfilling, enjoyable and safe sports seasons this fall!