The appearance of back-to-school shopping lists and the hint of autumn in the air means the return of some of America’s favorite pastimes…We’re talking about fall sports. Some of the most popular sports (we’re thinking football, soccer, hockey) are the most likely to lead to concussions in players.
A concussion is a mild traumatic brain injury. If that sounds scary, that’s good. A concussion cannot be seen on any medical imaging tests (X-ray, CT, MRI etc.), but can lead to serious complications if not identified and treated properly. Also, the recurrence of concussions after an initial concussion is high, particularly in athletes and active children. If you suspect a head injury capable of causing a concussion, it is important to see your doctor as soon as possible.
The cardinal signs of a concussion are:
- Headache
- Dizziness
- Confusion
- Blurred vision
- Sensitivity to light
- Ringing in ears
- Loss of consciousness
- Fatigue
- Malaise (“not feeling right”)
- Difficulty with coordination/balance
- Changes in mood
After a mild concussion, it is best to rest from physical and mental activity and limit loud TV/video games. The child should not be left alone in order to monitor symptoms, and it is important check them throughout the night as they sleep. Rest is needed, and it is not always necessary to wake the child when you check on them, unless you have concerns about their breathing. Your child should also be excused from gym class and recess activities. A medical professional can tell you when it is appropriate for your child to return to these activities.
If concussion symptoms do not resolve, or begin to worsen, see your primary care provider immediately. These worsening symptoms include:
- Increasing headache
- Vomiting
- Agitation or other strange behavior
- Increased confusion or grogginess
- Increased neck pain,
- Trouble walking/coordinating movement,
- Seizures,
- Not waking up
- Weakness/tingling/burning in arms or legs
Concussion prevention is almost as important as concussion treatment. Wearing proper protective gear (helmets with biking/skateboarding, baseball, football) is one important step in preventing concussions, recurrent concussions, and overall injury.
In order to return to sports/high-contact activities your child must not exhibit any lingering signs of concussion for a minimum of 24 hours and be cleared by their doctor. Gradual return to sports (general light exercise, sport-specific drills without contact, and on-field drills without contact) is important before full-contact return to practice and games, and must be cleared by a physician. Physical therapists are trained to help athletes of all ages return to sports after injury, including concussion, and work closely with doctors in helping kids get back in the game. We work with individual athletes to carefully and progressively increase level of activity while monitoring their concussion symptoms. Physical therapists can address many of the gross motor symptoms that accompany a concussion, such as poor balance, difficulty with coordination, and decreased endurance.
Amanda Munro PT, DPT & Jaime Kemery, DPT
References:
Ontario Neurotrauma Foundation. Guidelines for Diagnosing and Managing Pediatric Concussion. First edition, June 2014, v1.1
American Academy of Pediatrics. Concussions. Healthychildren.org. Accessed online August 2014.
