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Sports Concussion in Children

WHAT YOU NEED TO KNOW:

What is a sports concussion?

A sports concussion is a mild traumatic brain injury that happens during a sports activity. It can happen during almost any sport but is most common with football, hockey, and boxing. Your child's head may come into contact with another player, the player's equipment, or a hard surface. Even what seems like a mild blow can cause a concussion. It is important to follow return to play and return to sports protocols, even if your child does not lose consciousness.

What signs and symptoms of a concussion may happen right away during a sports activity?

  • A loss of consciousness or needing help getting off the field
  • Trouble remembering what to do during the game, or not keeping up with other players
  • Ringing in the ears or feeling foggy
  • Dizziness, loss of balance, or blurry vision
  • Nausea or vomiting
  • Sensitivity to light

What other signs and symptoms may develop?

  • A mild to moderate headache
  • Trouble thinking, remembering things, or concentrating
  • Drowsiness or decreased energy
  • Changes in your child's normal sleeping pattern
  • A change in mood, such as restlessness or irritability

How is a concussion diagnosed?

Your child's healthcare provider will examine your child and ask about his or her symptoms. Your child may need any of the following:

  • A neurologic exam can show healthcare providers how well your child's brain works after an injury. Healthcare providers will check how your child's pupils react to light. They may check his or her memory and how easily your child wakes up. Your child's hand grasp and balance may also be tested.
  • CT or MRI pictures may be used to check your child's skull. These may be used if your child has symptoms of a serious injury. Your child may be given contrast liquid to help any injury show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.

What can I do to help my child manage a concussion?

Concussion symptoms usually go away without treatment within 2 weeks. The following may be recommended to manage your child's symptoms:

  • Stay with your child for the first 72 hours after the injury. Contact your child's healthcare provider if he or she has new or worsening symptoms.
  • Have your child rest to help his or her brain heal. Your child's healthcare provider may recommend complete rest for the first 72 hours. Keep your child home from school or daycare. Do not let him or her ride a bicycle, run, swim, climb, or play sports. Do not let him or her play video games, read, watch television, or use electronic devices. Your child can go back to school and his or her usual daily activities when symptoms are completely gone. He or she will need to stop any activity that triggers symptoms or makes them worse.
  • Help your child create a sleep schedule. A schedule will help prevent your child from getting too much or too little sleep. Your child should go to bed and wake up at the same times each day. Keep your child's room dark and quiet.
  • Pain medicine may help relieve headache pain. Your child's provider will tell you how long to give these to your child. Your child may develop a rebound headache if pain medicine continues too long.
    • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
    • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.

What is a return to play protocol?

This is a system to help officials decide if a player can go back in after a suspected concussion. Healthcare providers who are trained in sports medicine examine players who have a blow to the head. They look for certain symptoms, such as confusion, dizziness, and nausea. These symptoms may mean a concussion happened and it would be dangerous to go back in. Another concussion could cause a condition called second impact syndrome (SIS). This means your child has another concussion before he or she has recovered from the first. SIS can be life-threatening. Your child may also not be able to play in the next several games until he or she heals.

What is a return to sports protocol?

This is a plan to help your child build up to playing at the level from before the concussion. Work with healthcare providers and your child's coach or athletic director to create the plan. It may take months for your child to move through the following steps:

  • Step 1 is for your child to do activities that do not trigger or worsen symptoms. An example is a slow walk. Then his or her healthcare provider will allow a move to the next step.
  • Step 2 is meant to help get your child's heart rate up safely. He or she may be able to do up to 10 minutes of light aerobic activity. Examples include jogging slowly or riding a stationary bike.
  • Step 3 includes activities that need head or body movement, such as a short run. Your child may be able to do some weightlifting in this step. He or she will have to use lighter weights than before. Lifting time also needs to be shorter.
  • Step 4 moves to heavy activity, such as sprinting or weightlifting with heavier weights. All activity at this step still needs to be non-contact. Your child may be able to start doing sports drills if the drills are non-contact. The movements allowed in the drills will have to be limited. Your child's healthcare provider and coach will create a drill plan.
  • Step 5 is for your child to return to practice. If your child plays a contact sport, he or she may be able to return to full contact during practice. This will depend on the instructions your child's healthcare provider gives.
  • Step 6 is a return to competition. Your child's healthcare provider may give limits for how long your child can compete at one time.

How can I help my child prevent another sports concussion?

Each concussion can build on the others and cause more damage. The following can help lower the risk for another concussion:

  • Have your child wear protective sports equipment that fits properly. Check the fit before each season begins. Your child may be heavier or broader than last season, even if he or she is not much taller. If a helmet is used in the sport, make sure your child's fits correctly. A helmet is not a guarantee against a concussion, but it will lower the risk. Make sure the helmet meets all safety guidelines.
  • Help your child understand all the rules of the sport he or she plays. Your child may be less experienced than other players. He or she may change positions on the team between seasons. This can cause confusion and mistakes during the game. This increases the risk for a concussion.
  • Make sure your child has healed from a concussion before returning to sports. Your child may say he or she is not having symptoms to get back to the sport. Symptoms such as balance or vision problems may cause your child to fall or be hit. Explain to your child why it is important for him or her to completely heal before playing again. He or she might miss 1 or 2 games, but another concussion could mean missing the rest of the season.

Call your local emergency number (911 in the US) if:

  • You cannot wake your child.
  • Your child has a seizure, increasing confusion, or a change in personality.
  • Your child's speech becomes slurred.

When should I call my child's pediatrician?

  • Your child has sudden and new vision problems.
  • Your child has a severe headache that does not go away.
  • Your child does not recognize people or places that should be familiar to him or her.
  • Your child has arm or leg weakness, numbness, or new problems with coordination.
  • Your child has blood or clear fluid coming out of his or her ears or nose.
  • Your child has nausea or is vomiting.
  • Your child feels more sleepy than usual.
  • Your child's symptoms get worse.
  • Your child's symptoms last longer than 6 weeks after the injury.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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