Concussions in Young Athletes
What is a concussion?
A concussion is a brain injury causing a temporary disturbance of brain function. Concussions may be caused by a bump, blow, or jolt to the head or body. Anyone with a suspected concussion should be removed from sports and physical activities until assessed by a medical professional such as a physician or athletic trainer.
When should I seek immediate care?
Emergent issues may arise over the first 24-72 hours. Patients should not be left alone for the first 72 hours, and you should go to a hospital at once if the patient has:
- A headache that is worsening
- Increasing drowsiness or difficulty waking up
- Difficulty recognizing people or places
- Repeated vomiting
- Unusual or irritable behavior
- Weakness or numbness in arms or legs
- Slurred speech
After any suspected concussion, always consult a physician. Your treating physician will be able to provide further guidance. It is always better to be safe, rather than sorry, when dealing with head injuries!
What are the symptoms of a concussion?
Concussion should be suspected in the presence of any one or more of the following:
- “Pressure in Head”
- Neck Pain
- Nausea or Vomiting
- Blurred Vision
- Balance Problems
- Sensitivity to Light
How long do concussion symptoms last?
Symptoms frequently last up to three weeks in children and adolescents:
- Sensitivity to Noise
- Feeling Slowed Down
- Feeling Like “In a Fog”
- “Don’t Feel Right”
- Difficulty Concentrating
- Difficulty Remembering
- Fatigue or Low Energy
- Trouble Falling Asleep
- More Emotional
How do you treat concussions?
Unfortunately, there is no medication for concussions. Most concussions will resolve with proper rest from both physical and mental activities. Your physician should be able to offer further guidance on returning to your regular activities. X-rays, MRIs and CT scans all appear normal in patients with concussion and are not always necessary.
What should I avoid?
- Driving a motor vehicle
- Aspirin or anti-inflammatory medication for the first 3-5 days
- Sleeping tablets
What are some tips for brain rest?
Resting the brain involves both physical and mental rest. Symptoms may get worse with:
- Talking on the phone
- Watching television
- Playing video games
- Listening to music
- Physical activity
- School work
Symptoms may worsen when the patient initially returns to school. Testing, classroom and homework assignments may need to be modified temporarily until the patient fully recovers from a concussion. Consider returning to school initially for a half day, and then progressing to a full school day as tolerated. Parents should stay in touch with the student’s teachers to monitor his or her progress.
If I play a sport, when can I play again?
Anyone with a concussion should NEVER return to play the same day of injury. The most important step is to rest both physically and mentally until all symptoms have resolved. Once all symptoms have resolved, you may start the gradual return-to-play protocol below.
What is the return to play protocol?
Rest until astymptomatic (may be 2-3 weeks). Each step below takes at least 24-48 hours:
- Step 1: Light aerobic exercise for 20 minutes (stationary cycling/brisk walking)
- Step 2: Sport-specific exercise for 20 minutes (skating in hockey/running in soccer)
- Step 3: Non-contact drills (shooting, dribbling, etc.); may start weight lifting
- Step 4: Return to full-contact practice AFTER MEDICAL CLEARANCE BY A PHYSICIAN
- Step 5: Return to full competition or game play
If concussion symptoms return during any step, the athlete should rest for 24 hours. After resting, start the protocol again with the previous step. (For example: your concussion symptoms returned while you were on step three. Rest for 24 hours, and start the protocol again at step two.)