- Leah Fischer, PT, DPT
Combating a Concussion

With so many youth participating in sports, concussions are becoming more and more common and are now a hot topic of conversation. Concussions do not just occur during football. They can occur during any sport where there is the potential for contact such as soccer, hockey, basketball, or baseball. A concussion is a mild traumatic brain injury that results in a complex physiologic process that affects the brain. It can be caused not only by a direct hit to the head, face, or neck region, but also a blow to another area of the body with an impulsive force transmitted to the head. Because the brain of a young person is still developing, it is crucial to recognize a child who has been concussed and take the necessary precautions to protect him/her.
What are the symptoms?
There are a variety of symptoms associated with concussions, and each person may present differently. The most common symptoms include headache, dizziness, depression, anxiety/nervousness, decreased memory, difficulty concentrating, and irritability. Additional signs include a blank stare, easily distracted, delayed verbal and motor responses, and slurred speech. A loss of consciousness and amnesia are additional symptoms of concussion, but they are not always present. They also do not predict time of recovery. Ultimately, you know your child best, if they are acting in an unusual way after a possible event that could cause a concussion, precautions need to be taken.
What can I do to help my child with a concussion?
It is important to monitor the signs and symptoms of your child to determine if symptoms are increasing or decreasing. Especially if symptoms are increasing, it is crucial for your child to see a physician. Allowing your child to rest their brain will aide in their recovery and level of comfort. That said, resting their brain does not mean having your child sleep all day as this does not allow for monitoring of symptoms. Below are a few additional suggestions:

Avoid: medications with ASA or NSAIDs (Advil, Ibuprofen), narcotics, and alcohol
Acetaminophen (Tylenol) can be used for a headache
Apply ice to the head or neck as needed
Avoid strenuous activity and sports
Decrease time in front of a TV or using electronic devices (computer, phone, tablet, etc.)
Low light environments are typically better as bright environments and fluorescent lighting can be irritating and increase headaches
When returning to school, your child may only tolerate a half day initially. Sometimes a child needs to ease back into school.
When can my child return to sport?
The answer to this question is the answer that everyone dislikes...it depends. Every person will respond differently, and every concussion will present differently. Studies have shown that chemical levels in the brain can be altered for up to 7-10 days post-injury. For this reason, it is best to keep kids out of their respective sport for at least 7-10 days after they are symptom free. The brain is at increased vulnerability for secondary injuries during this time. This means that a child is not only symptom free during resting activity, but also symptom free with increases in activity level. Similar to how a child may need to ease back into school, it is important for the child to ease back into sports. On the first few days back, they may only participate in 50% of the practice. The intensity can slowly be increased as long as symptoms do not increase. This means that the child, coach, and parent should also be aware of what to look for to determine if symptoms are increasing. If your child has had multiple concussions, their recovery may differ concussion to concussion. As the child returns to sport, it is important for parents, coaches, and athletes to be aware of the potential risks and complications associated with a concussion.

How can the risk of concussion be decreased?
There are several methods that can be utilized to help decrease the likelihood of a concussion:
Use helmets
Use mouth guards
Utilize equipment that meets ASTM standards
Ensure children are playing by the rules (i.e. avoiding hard hits)
References
Livingston, S. (2009). Sports-related mild traumatic brain injury. Annual Conference & Exposition of the American Physical Therapy Association.
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