By Tracy Zaslow, MD
In the Sports Concussion clinic at Children’s Hospital Los Angeles, I met a soccer mom whose 10 year-old son sustained a concussion when a ball blindsided him in the head during practice. She explained her frustrations, common to many parents, as she didn’t know what to do: How do you know when a concussion occurs? When do you seek medical help from a physician? How do I help my child feel better?
This fall, in order to help educate parents and coaches, she invited me to meet with the Santa Monica AYSO youth soccer league board of directors and division commissioner to give a presentation on concussion prevention and head injuries.
I’ve treated many pediatric concussion injuries as a concussion specialist and primary care sports medicine physician for Children’s Hospital Los Angeles where I see concussion patients from all sports, not just football.
As a team physician for the Los Angeles Galaxy professional soccer team and other soccer teams, I see first-hand how common concussions occur in soccer and many other sports.
By educating coaches, referees, league officials, trainers, and parents of young athletes, we develop a whole team of first-responders who can identify concussion symptoms and know when to seek professional medical attention. Here are some common questions I addressed with the AYSO officials.
What Is A Concussion?
A concussion is a mild injury to the brain that disrupts how the brain normally works. Concussions are caused by a hit or jolt to the head that causes the brain to move around inside the skull; this may be a direct hit or just a quick change in motion that causes the head to rotate quickly. Sometimes the actual event may not even be recalled by the athlete or be noticed by witnesses.
How To Know If A Concussion Occurred
Concussions can cause many symptoms. Symptoms are not always obvious so it’s important to know what to look for and when to suspect a concussion may have occurred. Some of these symptoms can appear immediately, but others may not appear for several hours or days. If you suspect a player has received a concussion, do not allow him or her back in the game. Have them sit in a quiet, shaded area and do not leave them unattended.
Here are some of the common symptoms associated with concussions:
• Feeling dazed, dizzy, or confused.
• Forgetting what happened around the time of the injury.
• Sensitivity to light/noise.
• Change in vision/hearing.
• Trouble concentrating, difficulty remembering, slowed thinking.
• Emotional changes: Irritability, sadness, and anxiety.
• Losing consciousness.
How Is A Concussion Treated?
Rest! Rest! Rest! Rest truly is the best medicine when it comes to concussion. After a concussion, being more tired than usual is normal so let your child go to bed early, sleep in, and take naps. Rest includes a break from all exercise and athletic activity as well as cognitive rest. Cognitive rest means giving the brain a break from thinking. That means no texting, computer time, email, phone calls, video games or loud music/television. Additionally, kids may need to even stay home from school and definitely refrain from intense studying or reading.
Concentrating and paying attention can be a challenge after a concussion, so as your child starts to feel better and is ready to begin some schoolwork start slowly with short intervals of studying (30 minutes or less) at a time. Taking breaks is essential to avoid over-working the brain and causing a recurrence or worsening of symptoms. Being observant of resting right after a concussion will enable the speediest recovery and return to sports possible. Your doctor, who is experienced in treating concussions, can help you determine when your child is ready to return to school work and sports.
Do I Need To Wake Up My Young Athlete During The Night After A Concussion?
No, as long as your young athlete has been behaving normally, eating well, and not demonstrating any “severe symptoms” prior to going to sleep then it is best to let your young athlete sleep. Rest is the number one best remedy for concussion so it’s best if we don’t interfere with it.
When Can An Athlete Return To Sports?
Once all the symptoms are gone, a doctor will evaluate your young athlete and determine readiness for return to school and sports. For most athletes with mild concussions, symptoms resolve within seven to 10 days but all athletes and injuries are unique. The doctor will evaluate your child with tests of memory, concentration, balance and more.
What Happens If My Child Goes Back To Sports To Soon After A Concussion?
While most young people recover from a single concussion, everyone’s recovery occurs at their own rate. If an athlete returns to activity before the symptoms have gone away, concussions can result in prolonged headaches, poor school performance, and many other post-concussive syndrome symptoms. Also, another blow to the head while the initial concussion is still healing can occasionally result in fatal brain swelling – a condition known as second impact syndrome.
1. When in doubt, sit out: If you think you’re young athlete may have had a concussion, get it checked out by a doctor before letting your young athlete go back to activity.
2. Use correct technique in sports: Don’t hit “head first” in football. Don’t head the ball with elbows up in soccer. Make sure your young athlete has appropriate neck strength before heading the ball in soccer or making a football tackle.
3. Use safety measures well: Make sure pads are appropriately positioned on goal posts, helmets are well-fitting, and soccer balls are the appropriate size and inflation.
Tracy Zaslow, MD is director of the Sports Concussion Program at Children’s Hospital Los Angeles and medical director of the hospital’s Children’s Orthopaedic Center Sports Medicine Program with satellite offices in Santa Monica. The center treats all sorts of sports injuries, limb deformities, and spinal disroders. For more information, call 310.315.2041 or visit chla.org/ortho.