Get a-head of the game: Understanding concussions in children

Every year, thousands of children are sent to emergency rooms nationwide for head trauma and concussions. The causes for these injuries range from standard playground incidents to more serious automobile accidents. One of the most common ways that kids acquire concussions is from participation in youth recreational and competitive sports. Studies have shown that the majority of sports-related concussions occur in children and adolescents, and of those, female participants sustain the most.

To learn more about concussions, treatment, and prevention, I spoke with Dr. Sergio Buzzini, the chief of Adolescent Medicine at Geisigner Health System, a physician-led healthcare system in northeastern and central Pennsylvania. Dr. Buzzini, a pediatrician and sports medicine physician, has previously examined the impact of concussions in young athletes, having published a study entitled “Sport Related Concussions in the Youth Athlete.”

Shnieka Johnson: Why are kids more susceptible to concussions?

Sergio Buzzini: The brain develops until the age of 25, so it is believed that children’s underdeveloped brains are at a much greater risk and much more susceptible to trauma. Due to the underdeveloped state at younger ages, children have thinner, frailer bones, which provide less protection to the brain.

A child’s brain and head are also disproportionately large for the rest of the body. A child’s weak neck cannot brace for a hit the way an adult’s can and their vulnerabilities to head trauma are far greater.

SJ: What sports have a higher risk of serious injury like concussions? Should parents be cautious about these sports?

SB: The majority of concussions that happen in organized sports in the United States are football, ice hockey, wrestling, girls’ soccer, boys’ soccer, and girls’ basketball. While it should be noted that certain initiatives have been implemented to try to make them safer, for instance, using the head to tackle in football has been banned and stricter rules on body checking in ice hockey, it should always be a family discussion and decision if there are concerns. Particularly if a child has already suffered a concussion playing one of these sports at a young age, as these preventative measures will not completely suppress the risk for concussion.

SJ: How are concussions identified? What are symptoms?

SB: There are three types of symptoms to identify a concussion: physical, cognitive, and emotional. Physical symptoms include headache, nausea, vomiting, balance problems, dizziness, fatigue, sensitivity to light and noise, tingling, and loss of consciousness.

For cognitive symptoms, it’s important to look out for difficulty with concentration and memory, confusion surrounding recent events, answering questions slowly, and feeling dazed or confused. Emotional symptoms can be seen through a nervous or anxious demeanor, feeling tired, and having a lack of energy for daily activities.

SJ: What is the proper care for a child with a concussion? How long is recovery?

SB: While managing and caring for a child with a concussion, the most important factor is rest. The more the brain rests, the more it heals. Parents should make sure the child is going to bed early, avoiding caffeine, eating often and well, and limiting screen time with the TV, computer, and other electronics. Parents shouldn’t be afraid to keep the child home from school to ensure they don’t strain the brain.

If the symptoms continue to get worse, it’s essential to receive further evaluation via a trip to the emergency room to have a brain study and make sure there is no bleeding in the brain.

Each child recovers differently, making each recovery process and length different per individual. In general, 80 percent recover within two weeks, but it could be up to a month after the blow to fully recover. Before returning to the sport, it is necessary that the child be completely symptom free or they are more susceptible to another blow.

SJ: What are some ways to prevent concussions? What if a young athlete receives multiple concussions?

SB: A popular misconception is that helmets will prevent a concussion. While helmets can prevent skin lacerations and inner cranial bleeds, they will not prevent the trauma of a concussion, and we should not rely on them to do so. It is more important to be able to recognize the symptoms of a concussion, and remove the child from play immediately if a concussion is suspected.

Education is the key to protecting children from concussions, and it helps to promote a healthy and safe environment. By knowing how to identify symptoms, coaches, parents, and young athletes are able to recognize a possible concussion more easily and take immediate action. It is also important to educate young athletes on the symptoms and encouraging them to speak up to coaches, trainers, or parents if they feel that they are suffering from any of them.

On the field, some options include delaying full-contact until later in adolescence, ensuring proper techniques and using the right teaching methods to reduce the risk of concussions for young athletes. Make sure to enforce promotional fair play, which encourages the rules of safe play.

If a young athlete has received multiple concussions, it is important to have a baseline understanding of the child’s health before the season starts. This includes a sports physical, notes on the history of past concussions, and other behavioral information, which will make it easier to identify if a child sustains another concussion later in the season. You should always consult your doctor before a child with a history of multiple concussions starts a new season.

SJ: How can parents help young athletes carefully return to sports after a concussion? How do we explain to our kids the seriousness of concussions?

SB: Once a doctor feels comfortable with a child returning to play after suffering a concussion, it is best to make it a process and not a race back to the field. The young athlete should slowly and cautiously work their activity levels back up. Begin with just fast walking, increase to light activity and so on, increasing each day.

It is important to stress the very serious nature of concussions to young children, and the long-term risks of returning to the field too quickly. If kids return to play while still having symptoms and have a second blow, it is possible to suffer from Second Impact Syndrome. This is a devastating case when an athlete is allowed to return to play before having adequate time to recover, and could result in death or coma in children.

Shnieka Johnson is an education consultant and freelance writer. She is based in Manhattan where she resides with her husband and son. Contact her via her website: www.shnie‌kajoh‌nson.com.

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