May 4, 2020

10 Things Parents Should Know About Children and Concussions

For starters, they’re not just football injuries

child with concussion at emergency room

Concussions can derail the plans of any budding sports star. So a roadmap for athletic success should include a concussion plan.

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“The brain is a complicated structure. It needs TLC like everything else,” explains concussion expert Richard Figler, MD. “Parents and athletes need to be aware of the signs of concussion in children. Then, you can protect your child.”

Whether your child is the next Serena Williams, Tom Brady or Tiger Woods, Dr. Figler explains what you need to know about concussions in kids.

1. It’s OK for kids to play organized sports — if you’re smart about it

It’s all about risk reduction, says Dr. Figler. “Protecting the body and brain at a young, developmental age is extremely important. But don’t avoid sports — developing those skills can reap benefits down the road.”

That means it’s OK — even recommended — for kids to play sports. Research shows that playing sports has benefits like better grades and coordination. But make sure your little athlete-in-training isn’t doing things they aren’t ready for, such as tackling.

Dr. Figler also recommends playing a variety of sports and not specializing in one too early. “It’s important to challenge the body and brain in different ways. Running cross-country uses a different group of muscles than playing basketball does. Plus, switching it up means you’re not subjecting the body to the same force over and over, which means limiting overuse injuries too. If we limit the number of traumatic hits to the head over our lifetime, we’re probably going to be better off.”

2. Concussion symptoms in kids are similar to adult concussion symptoms

When it comes to concussion symptoms, kids and adults experience similar symptoms, including:

  • Loss of consciousness
  • Altered vision
  • Dizziness or issues with balance
  • Headache or head pressure
  • Trouble concentrating or remembering
  • Feeling “out of it”
  • Vomiting or nausea

“But kids may have trouble explaining their symptoms,” notes Dr. Figler. “They can’t articulate how they feel because they may not have the vocabulary. They may just assume their symptoms are normal — until the headache gets worse, or they need to miss school.”

That’s why educating your child about concussion symptoms is so critical. “The effects can be long-lasting and far-reaching for these kids. If they recognize that they have symptoms and leave the field right away, they’ll have a better chance for a faster recovery.”

3. Concussions in kids are increasing, but not for the reason you think

Each year, emergency departments see over three-quarters of a million kids with traumatic brain injuries that include concussion, according to the Centers for Disease Control and Prevention (CDC). But increasing concussion rates are a classic case of the chicken or the egg.

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“There’s probably the same number of concussions or may be even less overall,” says Dr. Figler. “But more awareness, education and state laws have increased how many people report them.”

Some other key concussion rates in youth sports:

  • Girls are 1.5 times more likely to get concussions than boys.
  • A child who has had one concussion is three to five times more likely to get a concussion than one who hasn’t.
  • An 18-year-old’s concussion risk is almost two times higher than a 13-year-old’s.

4. What youth sports have the most concussions?

Concussions in sports are like people and money — some have more than others. The risk for concussion is highest with sports such as:

  • Football.
  • Wrestling.
  • Martial arts.
  • Cheerleading.
  • Ice hockey.
  • Soccer.

But if your child’s sport didn’t make the list, that doesn’t mean you’re off the hook. “We saw two very severe concussions from a volleyball tournament where the ball hit the players in the head during warm-ups,” relates Dr. Figler. “We’ve seen concussions in cross-country skiing — kids hitting their heads on trees — and even in golf and tennis, although those are definitely rare.”

5. You don’t need fancy medical imaging to diagnose concussions in children

“MRIs and CT scans do not diagnose concussions. They diagnose brain bleeds, brain trauma and structural abnormalities. We may use CT scans or MRIs to rule out things that could be worse than a concussion,” says Dr. Figler.

“To diagnose a concussion, we take a comprehensive history and look at the symptoms your child reports. The symptoms after the head injury are what determines if your child has a concussion.”

6. Sleep is important to recovery

Just like inadequate sleep can mean a crankier child (and let’s face it, an angrier you), not enough sleep after brain injury can negatively affect recovery. That’s why Dr. Figler says it’s OK for your child to sleep 20 to 40% more than normal — even during the first 24 hours. (Time to cross that concussion myth off your list!)

“Kids are usually much sleepier after their injury, and they’ll often feel like they want to go to bed earlier. So let them. Don’t ‘poke them with a stick’ and wake them up on a regular basis,” recommends Dr. Figler. “If you need that peace of mind, it’s fine to check on their breathing, but uninterrupted sleep is going to help the brain heal better.”

Naps up to an hour are OK, too (finally, the proof you needed!) — if they don’t interfere with nighttime sleep. But if you’re concerned your child is not sleeping normally, consider visiting the emergency department or a health care provider that specializes in concussion to have them evaluated.

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7. Most concussions heal relatively quickly

“When symptoms are handled properly, about 80 to 90% of concussions get better within about one to two weeks,” Dr. Figler reports. “But there are subsets that can last a little bit – or sometimes, quite a bit – longer.”

8. Say yes to exercise when your child has a concussion

Dr. Figler says light exercise may help the brain during concussion recovery — but have your child take it slow. “We want them to get their heart rate up before they return to normal activities. We think the blood flow helps the brain,” says Dr. Figler.

But a word of caution: If your child develops symptoms while exercising, have them take the intensity down or stop altogether. “We’d rather your child exercise at a lower level for 30 minutes than a higher level for five minutes. We have found – and good studies support – that helps them heal faster.”

9. Return to school should always come before return to play

The term student athlete says it all — school should come first. Once they return to school without symptoms, then they can start a gradual return to sporting activities.

“Standing at practice after their concussion and doing nothing for two to three hours is typically a waste of time. Instead, that time is better spent at home resting, recovering and catching up on schoolwork.”

10. The recipe for concussion recovery

During the first 24 to 48 hours post-concussion, doctors recommend strict brain rest — resting in a relatively quiet environment and minimizing exposure to things that make symptoms worse (so no TV, computer, phones or video games if they negatively affect your child). Dr. Figler says concussion care should also involve:

  • Track symptoms: Watch your child’s symptoms to see if they get worse. “If they have worsening headaches, even with no activity or exposures to light or noise, that’s concerning,” notes Dr. Figler. “We also want to identify those triggers that make symptoms worse, so they can avoid them.” Triggers range from light to walking upstairs or texting.
  • Rest, recover, return: Rest the appropriate amount of time to make symptoms go away, and then return to activity.
  • Slow and steady wins the race: Dr. Figler says school and daily activities are like sprinting: The last sprint is harder than the first, so kids need to take breaks and pace themselves. “That may mean only going to easier classes at first, resting in the nurse’s office or putting their head down on their desk in class.”

Following this advice early can minimize and eliminate symptoms sooner. But every kid is different, so treatment should be, too. “Have them evaluated by a primary care sports medicine specialist or someone well-versed in concussions. A doctor who can craft an individualized treatment plan is a tremendous ally in your child’s recovery.”

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