“It’s just a ding,” says Coach. “Bobbie didn’t get knocked out or anything — put him back in.” It’s the championship game after all, and Bobbie is the star player.
In this scenario, the question that should be asked is; Could Bobbie have a concussion? Too often, incomplete understanding of concussions can put a child like this in grave danger.
Dr. Richard Anderson from the Pediatric Neurosurgery Center says, ” Unfortunately there are many misconceptions about concussions. For example, some people think boys get more concussions than girls when boys and girls are equally at risk. One of the biggest is that people think there has to be a loss of consciousness for it to be a concussion.”
When there is a direct blow to the head, or a blow to the neck or body that causes a shock to the head, the brain can be injured. This may or may not be accompanied by a black-out. “It is also important to note,” says Dr. Anderson, “that symptoms can be very mild and close inspection of the child is imperative.”
Symptoms can be subtle like, difficulty concentrating, becoming tearful or irritable, or a feeling of being “in a fog.” More frank symptoms include, headache, confusion, vision changes, sensitivity to light or noise, nausea, drowsiness, or amnesia.
Dr. Anderson says, “Symptoms can also be delayed. After impact, a child should be watched carefully over the next few hours.”
Fortunately, with a concussion, these symptoms are temporary. Unfortunately, there is a misconception that, if the symptoms have lessened or gone away all-together, the child can return to play. Anderson says, “It is important to remember that, though mild, a concussion is still a brain injury and it needs time to heal.”
Children also typically need more time to recover than adults. Where professional athletes usually need three to five days to recover, and college athletes need five to seven days, high school athletes in many cases, should be given greater than 14 days of rest. That time should be increased if there is a history of prior concussions. It may also be necessary to rest from scholastic and other mental stresses.
According to Anderson, “The Risks of returning to the game too soon are several: The player may have slowed reaction times that increase the risk of re-injury; If they do get re-injured they have a higher risk of more severe symptoms the second time around; And, though rare, there is a risk of second impact syndrome.” In other words, if they do receive another concussion it can be much more serious.
Anderson says, “If an athlete has a second head injury while still symptomatic from a prior head injury, loss of auto-regulation in their young brain my occur and possibly lead to global swelling and permanent damage.”
The best medicine, of course, is prevention. Learn the symptoms and the Return to Play Guidelines. “Keep a close eye on kids” says Dr. Anderson, “and make sure they wear their helmets. Helmets are the one thing that can reduce the impact forces to the brain and help prevent skull fractures and catastrophic injury.”
Return To Play (RTP) Guidelines:
1. No RTP until the athlete is symptom free, cognitive rest is important so they recommend limiting scholastic and other cognitive stressors.
2. Limit exertion. No return to play on the same day. This is, in fact, currently the state law in eleven states.
3. Young athletes require longer recovery time than adults.
Learn more about Dr. Anderson on his bio page here.
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