Concussions: How to Keep Your Head in the Game

by Tracy Zaslow on 10/04/2012

While the head injuries of high-profile athletes (i.e. Troy Aikman, Sidney Crosby, James Harden) have started to make the news in recent years, it’s a poignant story from Washington State that’s really changed how young athletes are treated.

Zackery Lystedt, a gifted 13-year-old junior high football player, played hard. He was driven to succeed, both on and off the field. So when, towards the end of the first half of a football game, Zach got tackled and hit his helmeted head on the ground, he didn’t want to come out of the game. The spectators, his parents and coaches, all saw his grimace of pain as he grabbed his helmet and staggered to the sidelines. Zack sat out a few plays but then he “shook it off” and returned to the game after halftime. He didn’t want to let his team down.

In Zack’s usual “go big or go home” style, he gave it his all through the second half, until he suddenly collapsed, unconscious, and had to be emergently airlifted to a local hospital. He received all the best treatments, but still had a complicated and tragic course; the damage was done. Returning to football while still symptomatic of a concussion, led to the dangerous “second impact syndrome,” where sudden, severe swelling occurs in the brain because a second hit takes place before the brain has recovered from the first hit. While 50% of young athletes who experience second impact syndrome die, Zack was lucky. He survived, but with significant and permanent disabilities.

Zack’s parents, who didn’t want other families to endure the same tragedy, have been instrumental in getting legislation passed in Washington State, to educate and mandate that young athletes can not return to play after a suspected concussion, until it is cleared by medical personnel experienced in identifying and treating concussions. Variations of this legislation are now in effect in most states to protect our young athletes and prevent such tragedies from affecting other families like the Lystedts.

Do you know how to recognize a concussion in your young athlete? Do you know what to do when you think your young athlete may have a concussion?

What is a Concussion?

A concussion is a mild injury to the brain that disrupts how the brain normally works. Concussions are caused by a hit or jolt to the head that causes the brain to move around inside the skull; this may be a direct hit or just a quick change in motion that causes the head to rotate quickly. Sometimes the actual event may not even be recalled by the athlete or noticed by witnesses.

How do I know if my young athlete sustained a concussion?

Concussions can cause many symptoms. Symptoms are not always obvious so it’s important to know what to look for and when to suspect a concussion may have occurred. Some of these symptoms can appear immediately, but others may not appear for several hours or days. Here are some of the common symptoms associated with concussions:

  • Feeling dazed, dizzy or confused
  • Forgetting what happened around the time of the injury
  • Headache
  • Nausea/vomiting
  • Sensitivity to light/noise
  • Change in vision/hearing
  • Trouble concentrating, difficulty remembering, slowed thinking
  • Emotional changes: Irritability, sadness, anxiety, etc.
  • Losing consciousness

While the list of possible symptoms is long, even the presence of one or two symptoms in the setting of sports participation (practice, games, or casual play) should raise suspicion of a possible concussion. If you have any concern a concussion may have occurred, it’s important to get it checked out by a physician with experience in concussion care.

Some symptoms are clues that there is something even more serious than a concussion going on and will require immediate evaluation by a doctor. If any of the following “severe symptoms” occur, visit a doctor immediately:

  • Increasing confusion
  • Strange behavior
  • Severe, worsening headache
  • Multiple vomiting episodes
  • Difficult to wake up
  • Trouble walking
  • Seizure
  • Weakness of any extremities

How is a concussion treated?

Rest! Rest! Rest!  Rest truly is the best medicine when it comes to concussion. After a concussion, being more tired than usual is normal so let your child go to bed early, sleep in and take naps. Rest includes a break from all exercise and athletic activity, as well as cognitive rest. Cognitive rest means giving the brain a break from thinking. That means no texting, computer time, email, phone calls, video games, or loud music/television. Additionally, kids may need to stay home from school and definitely refrain from intense studying or reading. Concentrating and paying attention can be a challenge after a concussion, so as your child starts to feel better and is ready to begin some schoolwork, start slowly with short intervals of studying (sessions not longer than 30 minutes are best).

Taking breaks is essential to avoid over-working the brain and causing a recurrence or worsening of symptoms. Being observant of resting right after a concussion will enable the speediest recovery and return to sports possible. Your doctor, who is experienced in treating concussions, can help you determine when your child is ready to return to schoolwork and sports.

Do I need to wake up my young athlete during the night after a concussion?

As long as your young athlete has been behaving normally, eating well, and not demonstrating any “severe symptoms” prior to going to sleep, then it is best to let them sleep. Rest is the absolute best remedy for concussion so whenever possible don’t interfere with it.

When can an athlete return to sports?

Once all the symptoms are gone, a doctor will evaluate your young athlete and determine readiness for return to school and sports. For most athletes with mild concussions, symptoms resolve within 7-10 days, but all athletes and injuries are unique. The doctor will evaluate your child with tests of memory, concentration, balance, and more.

What happens if your child goes back to sports too soon after a concussion?

While most young people recover from a single concussion, everyone’s recovery occurs at it’s own rate. If an athlete returns to activity before the symptoms have subsided, concussions can result in prolonged headaches, poor school performance, and many other post-concussive syndrome symptoms. Also, another blow to the head while the initial concussion is still healing can occasionally result in fatal brain swelling – a condition known as second impact syndrome.

{ 2 comments… read them below or add one }

Brian Goldberg October 5, 2012 at 10:01 PM

Very well written and helpful article. We are seeing more cases of serious head trauma to our students.

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Stephen November 17, 2012 at 8:00 PM

Great article. I really hope parents take note of just how serious “getting your bell wrung” is for a young athlete. The urgency and enthusiasm that makes kids want to jump right back into the game—a feeling often shared by their parents—can seriously affect their long-term ability to play a sport they love. It’s just not worth it.

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