Understanding concussions in young athletes

When school sports start, I see more and more kids in my office for sports-related injuries, including concussions. As young athletes return to practices and games, it's important for parents, coaches, and players to understand the signs of a concussion and how to respond.

Concussions in youth athletes can be dangerous because the risk to young developing brains is so great, and, unlike a broken arm, we can’t always easily see the impact of a brain injury. So, helping kids heal properly is important. To help keep your young athlete safe this sports season, here are four steps to take.

Sports that involve a high level of contact can increase the risk of concussion. While many people think of football first, concussions can also occur in sports like soccer, volleyball, cheerleading, wrestling, and track and field. I've even treated runners who suffered concussions after slips and falls on trails or sidewalks.

While helmets and protective equipment have improved over the years, no piece of equipment can completely prevent a concussion. That's why it's important for athletes, parents, and coaches to understand the risks and prioritize safe play.

One of the best ways to help reduce the risk of concussion is through proper training and technique. Coaches can play an important role by teaching athletes safe ways to tackle, head a ball, or perform stunts and tumbling skills.

If you think your athlete has had a concussion, take them out of play right away. This applies to parents, coaches, and athletic trainers; anyone responsible for the athlete’s safety. Then, watch their behavior and ask a few questions:

• Do they have a headache?
• Do they seem confused?
• Are they angry or grouchy?
• Do they look listless or absent?
• Is there any memory loss (can they tell you where they are)?
• Are they throwing up or saying they have an upset stomach?

Also, watch the athlete’s eyes. Can they focus on you while you’re talking to them? People with concussions may find it hard to look at lights, too—like in a stadium or gym.

Some of these signs might be hard to notice at first. Headaches, for example, also can come from being stressed or not drinking enough water.

Be sure that the coach or athletic trainer who is evaluating the athlete for a concussion is someone who knows them and their regular mannerisms and personality. That way, they can tell if there are any changes to the child’s personality.

If an athlete begins throwing up after a hard hit or a collision, that’s when we need to see them in the hospital or clinic right away.

The best phrase I like to tell parents and coaches about possible concussion injuries is: “When in doubt, sit them out.” It’s always better to be cautious and save a young athlete’s brain by sitting them out for the rest of the practice or game. Concussions can cause tragic brain injury. Sometimes they lead to something called “second impact syndrome,” which can be deadly. In less extreme cases, young athletes can have lasting ill effects in the classroom, like trouble concentrating or remembering things, that can be avoided just by waiting a little longer. Tennessee is one of many states that has adopted a list of general rules called "Return to Learn" that help treat concussions in students. After a concussion, these steps are important:

• Stay home and rest. For 1-2 days, the child should have little to no TV, lights, texting, or driving.
• School with no work. Students can return to school, but parents and coaches should talk with teachers to make sure they aren’t given homework or in-class work and tests.
• At school with half work. No big tests or long projects, but the child can be given some homework and in-class work.
• At school with full work. Students can be given classwork, but some tests may be changed a little.
• Return to Learn. Students can make up important and missing projects, tests, and classwork.

The return to learn process can take 1-2 weeks. Everyone from parents to teachers, coaches, and your HMG sports medicine physicians should be involved to make sure these steps are followed for a smooth transition.