Think that little head bump your family sports star received while scoring the winning goal is a badge of honor or no big deal? You might want to think again.
Whether it’s the result of a check to the boards, heading a ball, or a collision with another player, concussions, even minor ones, are categorized as Traumatic Brain Injuries (TBI) and are serious injuries that happen far more often than you think.
According to a 2016 article in the Journal of the American Academy of Pediatrics, it’s estimated that children 18 years old and younger account for between 1.1 and 1.9 million Sports and Recreation Related Concussions (SRRC) every year in the United States. They also conclude that because SRRCs are frequently undiagnosed the real number of children’s concussions may be underreported by as much as 50%. [1]
The Centers for Disease Control and Prevention (CDC) estimates the number is closer to 2.5 million per year. [2]
That’s about twice the population of the entire state of New Hampshire.
Which begs the question of why there are so many kids walking around with head injuries.
The answer is a lack of awareness.
Cathy Leer, Director of Family Physical Therapy Services in Bedford, says education is the key to preventing and responding to sports injuries like concussions. “Parents, school administrators, and coaches need to be educated about the use of proper fitting of equipment and how to recognize concussion symptoms including when to seek treatment for the athletes.”
And minimizing the risks of childhood concussions starts with the appropriate protective gear, knowing the signs of concussion, and having standard protocols for handling them.
In fact, it’s the law.
New Hampshire RSA:200-49 Head Injury Policies for Student Sports states “Education is the key to identification and appropriate management of all concussions.” [3]
In addition to a mandate that school districts develop guidelines that inform coaches, student-athletes, and their parents of the risk of head injuries, the law requires local school districts to “distribute a concussion and head injury information sheet to all student-athletes” every year. [4]
Which is where organizations like Safe Sports Network comes in. A subsidiary of the New Hampshire Musculoskeletal Institute, the Safe Sports Network is a 501(c)3 charitable organization dedicated to youth sports safety in the Greater Manchester area.
In addition to training coaches, students, and parents about sports safety, Safe Sports staffs sideline trainers for most of Manchester’s schools as well as providing sports physicals, baseline concussion testing, diagnosis, and treatment referrals for sports-related injuries at no cost to the student.
It’s a fantastic community service, but it only works if you participate and bring your child in for diagnosis.
So when should you worry about a bump on the head?
The short answer is always.
Kids are fearless. It’s normal to see a few bumps and bruises while they run around testing their limits on the field of play, but when it comes to your child’s brain, there is no such thing as a small brain injury.
As a parent or coach, you have to be vigilant about the less obvious symptoms so you can seek treatment when needed. [5]
- Disorientation or confusion immediately after the event
- Impaired balance within 1 day after injury
- Slower reaction time within 2 days after injury
- Impaired verbal learning and memory within 2 days after injury
Safe Sports Network director Amy Hollingsworth says “There is no cookie-cutter diagnosis or treatment” and much of the under-reporting is really under-recognizing the signs and symptoms of concussion.
We see professional athletes take serious blows to the head and think all concussions result in immediate unconsciousness or a period of confusion, but Lauren Fournier, a vestibular and concussion therapist with Family Physical Therapy Services, says that it’s not uncommon for concussion symptoms to present days or weeks after a head injury.
Blurred vision, difficulty concentrating, a nagging headache. The symptoms can be subtle and are often overlooked.
This is where communication between the parents, players, coaches, schools, and health care providers come in.
It’s very easy for a parent to shrug off anxiousness or sleeplessness as being the result of winning or losing a big game, but when a coach notices a student can’t remember a play and a teacher sees the student struggling to focus, the symptoms can add up to a clear sign that the student is exhibiting atypical behavior and should seek medical attention.
The statistics about how many kids suffer head injuries are frightening.
- 15.1 percent of high school students report having at least 1 SRRC and 6% reported having 2 or more [6]
- In a survey of 800 athletes, 69percent reported playing with possible concussion symptoms and 40 percent of those who reported playing with an injury said their coach was unaware of their possible concussion [7]
- Students who suffer one concussion are 4 – 6 times more likely to sustain a second one [8]
What if my child already had a baseline and follow-up concussion testing?
Laura Decoster, executive director at Safe Sports Network points out that baseline concussion testing is not diagnostic. It’s designed to look for injury to the functionality of your brain, not physical damage. It’s a good tool for establishing what is normal for the child, but it’s just a starting point and proper evaluation by a professional is needed to understand the scope of the injury and the required treatment plan.
The good news is that with proper diagnosis and treatment, the student can usually start returning to many regular activities within a few days. And depending on the severity of the concussion, a full recovery from an SRRC can be as little as a few weeks.
The CDC and programs like the Safe Sports Network offer a wide selection of information for sports leagues, schools, coaches, students, and parents including apps, informational flyers, hands-on training, and much more.
And it’s all free.
Remember, you’re the adult. Whether you are the parent or the coach, student athletes rely on your judgement about when it’s safe to get back in the game, and when they should sit out. Work with your school or sports league to make sure everyone has a list of concussion symptoms, and a plan for handling head injuries, no matter how small they may appear.
Visit the CDC website and the Safe Sports Network for more information about children’s sports concussion including prevention, treatment and game guidlelines, and the many symptoms of childhood concussions.
- Sports-and-Recreation-Related Concussions in US Youth, Mersine A. Bryan, Ali Rowhani-Rahbar, R. Dawn Comstock, Frederick Rivara and on behalf of the Seattle Sports Concussion Research Collaborative Pediatrics July 2016, 138 (1) e20154635; DOI: https://doi.org/10.1542/peds.2015-4635
- DePadilla L, Miller GF, Jones SE, Peterson AB, Breiding MJ. Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017. MMWR Morb Mortal Wkly Rep 2018;67:682–685. DOI: http://dx.doi.org/10.15585/mmwr.mm6724a3
- Head Injury Policies for Student Sports RSA:49-200 http://www.gencourt.state.nh.us/rsa/html/XV/200/200-49.htm
- The Law Pertaining to Management of Concussions and Head Injuries in Student Sports http://www.wadleighlaw.com/wp-content/uploads/dlm_uploads/2015/02/Concussions-and-Head-Injuries-in-Student-Sports.pdf
- Nancy Carney, PhD Et al., Concussion Guidelines Step 1: Systematic Review of Prevalent Indicators, Neurosurgery, Volume 75, Issue suppl_1, September 2014, Pages S3–S15, https://doi.org/10.1093/neurosurgery/75.suppl_1.S3
- DePadilla L, Miller GF, Jones SE, Peterson AB, Breiding MJ. Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017. MMWR Morb Mortal Wkly Rep 2018;67:682–685. DOI: http://dx.doi.org/10.15585/mmwr.mm6724a3
- Concussion at Play: Opportunities to Reshapre the Culture Around Concussion, Centers for Disease Control and Prevention
- Brain Injury Research Institute, What is a Concussion?
