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By definition, a concussion is a mild traumatic brain injury. You may hear someone say, “Oh, it’s just a concussion,” which might minimize what is actually a significant event.
Concussion occurs when a person’s brain is violently rocked back and forth inside of the skull because of a blow to the head or the neck. When the head is jolted, nerve cells may stretch and cause a brief interruption in brain functions.
Although high school football accounts for the largest share of sports-related concussions, soccer players are not immune. Between two and three percent of all soccer injuries are concussions – slightly below football, but more widespread given the numbers of players. After concussion occurs a player may or may not lose consciousness. In fact, 90 percent of concussed athletes do not lose consciousness.
A 2004 study found that the top five signs of a concussion are:
These early symptoms are usually followed by:
In addition, children, who may not be able to describe exactly how they feel, may report feeling foggy.
It’s important to emphasize that most sports-related concussions don’t involve a loss of consciousness. If any of the symptoms noted above are present, a physician or trained professional should be consulted. Too often, a coach or parent may think a child “just got his bell rung” and put him or her back in the game. In actuality, an athlete should not be allowed to return to play on the day of injury. Given the multitude and variety of possible symptoms, it is important for coaches, trainers and parents to know the expected signs and ask direct, focused questions accordingly. Parents especially need to watch for symptoms because they know their child best.
If a certified athletic trainer is not available, the safest guideline is to take the player out of the game and let him or her play in the next game if symptom free. For mild concussions, time and rest are the best treatments. If a player goes back too soon, the risk of a second injury is much higher.
Before a player returns to play, three criteria should be met. The first is that the player must be consistently symptom free while at rest. The second is he or she must be symptom free even after exertion, either physical or mental. The pressures of a regular school day can make concussion symptoms worsen. The third criterion is the player must exhibit a return to normal cognitive functioning on basic tests.
The idea that children are more resilient and better able to recover from brain injuries than adults is not true. Developing brains are 40 percent more vulnerable to the metabolic changes caused by concussion. This actually slows the recovery in children relative to adults.
The most effective sports concussion management takes an individualized approach because each child will respond differently. Remember to be sure there is a balance between safety and the desire to play, and that returning to play too early puts the player at much greater risk of a more significant injury.
Mark Barisa, PhD, ABPP-CN, is a neuropsychologist on the staff of Baylor Institute for Rehabilitation.
Learn more about neuropsychological services and other evaluations.
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