The word “concussion” can strike fear in the hearts of parents – especially those with children who participate in youth contact sports. Head injuries are most commonly associated with football, but concussions can (and do) occur in sports ranging from soccer to wrestling to cheerleading.
Nathan Falk, MD, a sports medicine specialist at Florida Hospital, says while contact sports come to mind most often, nearly all sports and physical activity come with some risk for concussion.
“In fact, in women’s college sports, cheerleading has the highest rate of concussions,” Dr. Falk says.
At the same time, the risk for concussions needs to be balanced against the benefits of getting moving.
“While these risks need to be recognized and are not something to take lightly, physical activity is encouraged at all ages,” he says.
A concussion is a mild traumatic brain injury (TBI) that occurs when the brain bounces within the skull. It can happen when two players collide on the field, when a child stumbles and hits his head on the ground, or during a bicycle or car accident, to name a few potential causes.
It’s important to remember concussions are not limited to the football field.
Dr. Falk sees concussions from falls and head impacts on and off the field, including physical education class and recess.
And though concussion changes how the brain functions, it does not necessarily change its structure. This means that a brain can look normal after a concussion.
“During the course of regular life, the brain performs billions of chemical reactions to help us think, feel, and accomplish daily tasks,” he says. “Concussions interrupt the brain’s ability to do these jobs well.”
Beyond concussion, mouth, eye and other facial injuries are also an unhappy possibility in youth contact sports. Protective gear such as goggles, facemasks and mouthguards can go a long way in keeping your child’s face free of injury.
Bike helmets are one of the most important pieces of safety equipment, as they can prevent or lessen the severity of brain injury and scrapes. Because kids grow so fast, this equipment should be checked to make sure it still fits properly.
Finally, don’t forget one of the most basic pieces of safety equipment — your seatbelt.
Though all sports and physical activities come with some risk of injury, that doesn’t mean they should be avoided altogether. With the combined efforts of coaches, parents, players and sports medicine staff, young athletes can enjoy the many physical and emotional benefits of youth sports while minimizing the risk of injury or long-term complications.
Most children should aim for an hour of physical activity per day, whether at school, during sports or at home.
“The health, social, and emotional benefits of being active are tremendous,” Dr. Falk says.
The goal, then, is for children to benefit from the health benefits of activity while being protected from the injury risks.
“Safety in organized sports has become a point of emphasis and continuing to work with local leagues, coaches, and parents to ensure games and practices are conducted in the safest and most fun way possible should be everyone’s goal!”
Signs & Symptoms of Youth Concussion
When a concussion is sustained, a wide range of symptoms may be present. What a supervising adult observes often differs from what the child or teen suffering from a concussion reports. Here are some of the signs to watch for:
Commonly Observed by Parents or Coaches:
- Appearing dazed or stunned
- Confusion about an instruction, assignment, score or opponent
- Clumsy movement
- Delayed response time
- Loss of consciousness (even briefly)
- Mood, behavior or personality changes
- Problems with memory (for example, can’t recall events surrounding the injury)
Reported by Children and Teens:
- Headache or pressure in the head
- Nausea or vomiting
- Ringing sound in ears
- Dizziness or balance problems
- Double or blurred vision
- Sensitivity to light or noise
- Feeling sluggish or groggy
- Sleeping more or less than usual
- Confusion or trouble concentration
- Memory problems
- Feeling “off” or down
From the outside, you may not be able to tell that a concussion has occurred, which is why thorough examination and monitoring are crucial – especially within the first 24 hours. If a concussion is suspected, seek immediate medical attention. Even seemingly minor bumps to the head can lead to complications and long-term damage.
Florida Hospital for Children’s Sports Concussion Program uses state-of-the-art technology, including the ImPACT computerized neurocognitive testing software – a 20-minute test that has greatly improved detection and management of concussions in youth athletes.
Detection of concussion is critical because it’s not enough for a child to return to activity just because they feel good that day.
“How we feel and how our brain is functioning are not necessarily the same,” Dr. Falk says. “In fact, there is very often a lag time of one to two days (may be more for younger kids) between when people feel better and when their brain is performing at a normal level.”
This means that objective tests of brain function, balance and symptoms should be considered together when choosing the right time to safely return to activity. Therapies and medications can also be used in certain circumstances when needed.
After all, going back too early can slow healing and risk worse injury, Dr. Falk says.
Staying Safe On & Off the Field
If your child participates in youth sports, don’t stress – but do stress safety. Here are some precautions that should be taken to avoid concussion and facial injuries:
Wear a Helmet
There is no such thing as a concussion-proof helmet, but head protection can greatly reduce the risk of a skull injury. And not just any helmet will do; make sure the helmet is properly fitted to your child’s head and in good, safe condition. In some sports, such as ice hockey, lacrosse and certain positions in football, a facemask is also required to protect against face injuries.
Before hitting the field, it’s a good idea for youth athletes to undergo baseline testing of their concentration, reaction time and memory. If concussion is suspected during a game, the same test can be given to check for changes or disturbances.
Educate Kids On the Signs of Concussion
When parents, coaches and youth athletes are well-acquainted with the symptoms of a concussion, there is a greater likelihood they will know when something is wrong. The first 24 hours of a concussion are crucial, so make sure everyone is educated on warning signs.
Prevent Facial Injuries with Mouth Guards
Concussions aren’t the only head injury in youth sports. From football to field hockey, many sports run the risk of tooth fractures and injuries to the tongue and lips. A custom-fit mouth guard can offer excellent protection.
Teach Athletes Techniques for Safe Play
Coaches play a vital role in teaching young athletes techniques for protecting their head and face during game play. For instance, football coaches can teach players to avoid hits to the head during tackles, while soccer coaches can prohibit heading for players under 10.
Limit Contact (And Increase Supervision) During Practices
According to the U.S. Centers for Disease Control & Prevention (CDC), as many as 63% of concussions in high school football occur during tackles. In youth cheerleading, most concussions occur during practices. Coaches can help reduce the risk of head injuries by providing close supervision, as well as limiting the number of full-speed drills, head-on blocking and other heavy contact during practice.
Play on Soft Surfaces
For younger children, play time can be a breeding ground for nasty falls, bumps and bruises. Parents can seek out playgrounds with softer grounding, such as mulch or sand, rather than grass or dirt surfaces.
Follow Doctors’ Orders
If a concussion does occur, it’s crucial to do as your child’s doctor says. Kids and teens should also avoid looking at screens or playing video games until the concussion symptoms have subsided. And rest is a crucial part of healing, no matter how eager they are to get back in the game.
“Going back too soon from a concussion can be risky business,” Dr. Falk says. “When a child is not fully recovered from one concussion, they are more likely to get another one from an even softer hit.”
Multiple concussions can delay recovery to the point where missing a few weeks becomes missing an entire season or more. And keep in mind that while kids are going to want to get back on the field, activity needs to be balanced with rest.
“As with any athlete or child, when you give them an inch, they will take a mile,” he says. “Structured programs through physical therapy are available if needed during a prolonged recovery course.”
Concerned about concussion and facial injuries? See how Florida Hospital for Children’s multidisciplinary Sports Concussion Program can help improve the safety practices, diagnostics and treatment of youth concussions. Give us a call at (407) 303-8012 today.