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Help keep young athletes protected by better understanding the symptoms, treatment and prevention of concussions.


A concussion is a mild traumatic brain injury, that needs to be taken very seriously. It is no longer simply thought of as “getting your bell rung” or a “bump to the head”, it is defined as a “trauma-induced alteration in mental status that may or may not involve loss of consciousness.” This may occur from a tackle, falling and hitting your head, or even a blow to the body that causes the head and brain to move quickly back and forth. Without proper training, a concussion can be difficult to recognize on the field. Most occur without a loss of consciousness or an obvious sign that something is wrong with a player’s brain function. Also, all concussions are not created equally. Each player is different, each injury is different, and your team’s medical staff should evaluate all suspected injuries. The CDC estimates 1.6-3.8 million concussions occur in sports and recreational activities annually. However, these figures vastly underestimate the total, as many individuals do not seek medical advice.


Who is at risk of concussion?

Anyone involved in athletic activities is at risk for a concussion, however there are a few things that could also increase the risk. If there is a history of concussions, that individual is at a higher risk of sustaining another concussion. In addition, athletes who are unfamiliar with the rules and proper technique of their sport may be at a higher risk as well. For parents, it is important to note that youth athletes typically take longer to recover from concussions, since their brains are still developing. In addition, an athlete who has preinjury mood disorders, learning disorders, attention deficit disorders (ADD/ADHD), and migraine headaches complicate diagnosis and management of concussion.


How to recognize a concussion

The signs and symptoms of a concussion vary from person to person, as does the severity of the symptoms. Also, concussion signs and symptoms can appear immediately or not be noticed until days or even weeks after the injury. Symptoms also will increase with physical activity and mental activity such as working on a computer, reading, or watching television. Symptoms can be evident in four different categories: Brain function, emotional changes, physical changes, and changes in sleep.

Changes in brain functions:

  • Unaware of game (opposition colors, score of game, last play)
  • Confusion
  • Amnesia (does not recall events prior to the hit or after the hit)
  • Drastic changes in alertness
  • Does not know time, place or date
  • Slowed responses to questions or conversation
  • Decreased attention and concentration


Mental and emotional changes:

  • Depression
  • Anxiety
  • Anger
  • Irritability
  • Emotionally unstable


Physical changes:

  • Headache
  • Dizziness
  • Nausea
  • Unsteadiness/loss of balance
  • Feeling “dinged” or stunned or “dazed”
  • Seeing stars or flashing lights
  • Ringing in the ears
  • Double vision


Changes in sleep:

  • Too much sleep
    • School-age children (6–13): > 9–11 hours
    • Teenagers (14–17): > 8–10 hours
    • Younger adults (18–25): > 7–9 hours
  • Difficulty falling asleep or staying asleep


How do you treat a concussion?

The first step in treating a concussion is to remove the athlete from all activity so that an assessment can be performed by the athletic trainer or team physician. Once evaluated by a medical professional and assessed to have a concussion, it is important that the athlete rest as much as possible.

It is okay to let the athlete sleep overnight once symptoms have stabilized, no longer does the athlete need to be woken up every couple of hours. The quicker the athlete can begin resting and recovering, the quicker the body can begin healing itself. Never rush a return to play. Return to play should only occur after an athlete has been cleared by a medical professional. If you rush the return, the player is at significantly higher risk for more problems in the future.

Once cleared by a medical professional, it is important that the athlete begin both a return to learn and return to play protocol to allow the brain to adjust back to schooling and activity. Each protocol should last 5-7 days, and if any symptoms re-appear then the athlete should top activity and rest until symptoms resolve. Once resolved, the protocol can re-start again from the beginning. A return to play progression involves a gradual, step-wise increase in physical demands, sports-specific activities, and the risk for contact.

Return to play  after concussion should occur only with medical clearance from a licensed health care provider trained in the evaluation and management of concussion.


How reduce the risk of concussion

The best way to reduce one’s risk of a concussion is by prevention through education. Correct tackling technique and the “see what you hit” initiative have been instrumental in reducing concussions in football. Players, coaches and officials should receive education that unintentional and intentional head-down contact can result in catastrophic injuries. Increase the time that tacklers, ball carriers, and blockers spend practicing correct contact techniques and improve the enforcement and understanding of the existing helmet-contact penalties. Secondary prevention may be possible by appropriate return-to-play management.

Parents, coaches and athletic directors should all know the signs and symptoms of a concussion and encourage youth athletes to speak up if they think they might have a concussion. Fostering a culture of safety is critical.