People often associate concussions in youth sports with football. But the problem goes far beyond America’s most popular sport.
“We know that there are more student athletes participating in sports than ever before,” says Jason Genin, DO, a sports and orthopaedic medicine specialist with Cleveland Clinic Sports Health. “We are also recognizing that with increasing numbers of participants comes increasing numbers of injuries.”
“Better education among parents, coaches and kids is critical,” says Richard So, MD, a pediatrician at Cleveland Clinic Children’s. With that in mind, Dr. So and Dr. Genin seek to bust several common myths and misconceptions about youth sports and concussions.
Football takes the spotlight because it’s the most common sport in which kids experience concussions and the most thoroughly studied.
“Everyone goes to football because it’s America’s No. 1 sport,” Dr. So says. But there are 30 million kids in organized sports programs throughout the country, and other sports face this problem too. Soccer, gymnastics, hockey and lacrosse — all can involve concussions.
“Believe it or not, the next sport that has the highest incidence of concussion is girls’ soccer, then boys’ soccer,” Dr. So says.
Not necessarily. It’s true that concussion incidence rates have increased 16.5 percent annually since 2010, but Dr. So says part of the increase likely comes from increased awareness and education.
“I think that previously, concussions were under-diagnosed because kids weren’t complaining of their symptoms and were facing risk for a more severe injury — and possibly a longer recovery. I think we’re now more aware of what a concussion is,” he says.
Dr. Genin says young athletes often keep playing sports because they assume the headaches they get are a “normal” side effect of contact sports. They also wrongly assume that headaches are the only symptoms of concussion.
“We now better understand that there are several concussion symptom presentations that don’t even necessarily involve headaches, but can be just as debilitating,” Dr. Genin says. Such symptoms include light sensitivity, fatigue, poor school performance, dizziness, sleep disruption and nausea.
This was the perception when old concussion grading scales were in effect. But now, after numerous national and international consensus statements, concussion is better defined. If a child gets hit in the head and presents with symptoms, he or she has a concussion.
Experts no longer use phrases such as getting “dinged” or “getting your bell rung” because those descriptors downplay the injury, Dr. So says.
Not all concussions require emergency care, but watch for red flags: complaints of the worst possible headache, vomiting, unequal pupils or other neurological concerns. These may warrant a trip to the ER, Dr. So advises. Call your primary care physician’s office with concerns.
However, in most cases you can take your child to a primary care doctor — or a concussion specialist if needed. An ER doctor won’t be up to date on your child’s information in the way your primary care doctor is. And often, for example, an ER doctor might order CT scans, which aren’t often necessarily useful for concussion and which may expose your child to unnecessary radiation, Dr. So notes.
Dr. So advises parents: Your child is always a student first, then an athlete. The first priority is to get the child’s symptoms under control so he or she can return to school. “Once they return to school without a recurrence of symptoms, then they can start their gradual return to sports.”
Dr. Genin notes how far our understanding of mild traumatic brain injuries such as concussions — and the consequences if they go untreated — has advanced.
“Physicians, athletic trainers, coaches and athletes are more aware and more apt to treat them with the attention they deserve,” he says.
There’s no one method to treat a concussion. Everyone’s symptoms are a bit different, and they last for varying periods of time.
Concussion requires an individualized treatment plan, Dr. So says. Some patients may need physical therapy to treat neck pain. Yet others might see a speech therapist to deal with cognitive deficits. Likewise, some have problems sleeping after a concussion and need to go to a sleep therapist. That’s why it’s especially important to see a doctor and craft the right plan for recovery.