Concussions on the Playground

 
 

There has been a great deal of attention paid to the topic of concussions. Although they are often thought to only occur with collision and impact sports, concussions can occur in any activity, including outside organized athletics. Parents, teachers, coaches, caregivers and children should all be aware of the signs and symptoms of concussions as well as how to manage them.

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A concussion is defined as any injury to the brain that will disrupt normal function on either a temporary or permanent basis. The mechanism of injury is often secondary to the brain “shaking” rapidly in the skull. This can occur either from a direct or indirect impact.  Concussions occur most frequently in contact sports such as football, ice hockey, soccer, and lacrosse. They can happen with direct head to head contact or from a collision with the ground, a wall, or a ball. The Center for Disease Control estimates that nearly 3.8 million people a year suffer a concussion while playing a sport and that about 10 percent of athletes will have one concussion a season.

The symptoms of a concussion vary and do not always occur immediately after the injury. In fact, some symptoms may develop hours or days later. Some symptoms may resolve quickly, and others may take weeks or months to improve. Headaches, confusion, and memory loss are some of the most common symptoms of a concussion. Contrary to popular belief, most people are not “knocked out” and do not suffer from loss of consciousness as a result of a concussion.  Some other symptoms of a concussion include:

Nausea or vomiting

Dizziness, feeling off balance

Blurry vision

Sensitivity to light or noise

Feeling “foggy” or “out of it”

Difficulty remembering or concentrating

Feeling irritable, sad, or more emotional

Difficulty falling asleep or staying asleep

When someone suffers from a concussion, it is most important to immediately stop play and to not return to any physical activity until cleared by a health care professional. Doctors and other providers can accurately diagnose a concussion and determine if any additional testing such as a CT scan or MRI is warranted. Once the diagnosis has been made, the most important treatment is rest, both physical and cognitive. This includes avoiding watching television, texting, playing video games, completing homework, and in some cases, even attending school.  Once symptoms have resolved at rest, the child should be reevaluated by a physician and can return to physical activity in a step-wise fashion, under appropriate guidance. The return of symptoms at any point when the child is resuming activity indicates that the concussion is not resolved. Returning to activities before they are fully healed will increase the child’s risk of another concussion. In fact, a child with a history of concussions is at higher risk for repeat concussions when compared to someone who has not had a concussion. There is no way to determine how many concussions may lead to permanent brain damage. If a child has had multiple concussions or suffered from symptoms for longer than 3 months, the child should consider “retirement” from contact sports.

While not all concussions can be prevented, there are certain steps that one can take to minimize the risk. Most importantly, children should wear a helmet when the activity requires it. This includes sporting events, but also while riding bikes, skateboards, and ATVs. When playing a sport, all athletes should be taught the safe playing techniques, good sportsmanship, and be reminded to always follow the rules. In addition, children should be encouraged to alert a responsible adult if they have suffered an injury. They should understand the importance of telling someone, even if it will result in them being taken out of the activity. No head injury is too minor.

Featured Blogger

Leslie Greenberg

Leslie Greenberg

Leslie Greenberg, MD, FAAP is a general pediatrician practicing with Princeton Nassau Pediatrics.  She graduated from Brandeis University magna cum laude with a BA in sociology.  She attended medical school at Tufts University School of Medicine and completed her residency training at The Children's Hospital of Montefiore in the Bronx, NY.  She currently lives in the West Windsor, NJ area with her husband and two sons. She has been with PNP since 2009.  Princeton Nassuau Pediatrics is a group of board certified general pediatricians whose mission is providing the highest level of health care to the children of the greater Princeton, West Windsor, Monroe, and Pennington areas. The group provides state of the art care for children from infancy through college based on the most up-to-date medical advances. PNP has four locations, and offers routine well care visits, same day sick visits, weekend/holiday and evening urgent care coverage, as well as full in-office laboratory services. Visit www.princetonnassaupediatrics.com.

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