With the start of summer comes many youth sports programs and activities. While there are numerous benefits to a child athlete participating in sports - such as physical conditioning, goal orientation and learning to work as a team player - team sports are not without risk. In the United States, an estimated 300,000 concussions are thought to occur in sports each year, second only to motor vehicle accidents in cause of brain injury in people 15-24 (Source: Journal of Athletic Training).
Though previously acknowledged with terms such as “bell-ringer” and “ding” and thought to be “part of the game”, concussions are actually anything but minor. ALL concussions need to be taken seriously. To have a concussion, a person does not need to lose consciousness or be “knocked out”. They do not even need to directly hit their head. A concussion occurs when sudden movement or stopping of the brain actually tears/stretches tiny brain cells, causing injury. Symptoms of a concussion can include headache, confusion, dizziness, behavior and/or speech changes, fatigue, sensitivity to light and/or sound, difficulty concentrating or remembering, and difficulty falling or staying asleep. If you have any of the above symptoms you should see your healthcare provider. If the headache is severe or the athlete has a seizure, difficulty moving his or her arms or legs or worsening of any of the above symptoms, care should be sought in the nearest emergency room immediately.
There is no specific test to diagnose a concussion; this can only be done by a trained healthcare provider after thorough evaluation of the athlete. If throughout this evaluation your provider feels there may be further injury, he or she may order more additional testing.
Medical treatment for a concussion is REST, both physical and mental. Physical rest is just that - relax and do not participate in any strenuous activity. Mental rest can be much more difficult for most people. This means absolutely NO electronic use (TV, video games, texting), no reading and no activity that requires a lot of focus. Some concussive symptoms can be treated, such as a headache, with over-the-counter pain medication or a hematoma (bruise/swelling) with ice packs.
The Center for Disease Control and Prevention recommends a 5-Step approach for the safe return-to-play for athletes. Before these steps can begin, the athlete must have had both mental and physical rest, and experienced no concussive symptoms for a minimum of 24 hours. After they are cleared by their provider, the following steps should be taken when returning to activity.
- Step 1: Light Activity. This should be just enough to increase heart rate.
- Step 2: Moderate Activity. An increased intensity from light activity, but not to full exertion.
- Step 3: Heavy (non-contact) activity. This should be close to athlete’s high-intensity training without any physical contact.
- Step 4: Practice and Full-contact.
- Step 5: Competition.
If at any point the athlete has a return of symptoms, they will need to return to complete cognitive and physical rest and follow up with their medical provider.
By DesiRae Dinius, PA-C, Family Practice, CHI St. Alexius Health Dickinson