Concussion injuries in youth athletes

by Erin Graham on September 23, 2009

hitinheadLast week, Massachusetts lawmakers proposed a new state bill aimed at minimizing concussion injuries in youth athletes that would force coaches, trainers, parent volunteers and others affiliated with school athletic programs to be trained in recognizing potentially concussed athletes. The bill would also require physician authorization in order for an athlete to return to competition post-concussion.

Here, we ask Bill Meehan, MD, of the Concussion Clinic in Children’s Division of Sports Medicine about concussions and how the legislation can help student athletes.

Why is this legislation important?
Concussions are unfortunately going to happen. Regardless of whether or not an athlete is wearing a helmet, concussions are part of the risks of playing contact sports. This legislation will hopefully decrease, and maybe eliminate, incidences of second impact syndrome, which occurs when a young athlete suffers a head injury after returning to competition before making a full recovery. It can have long-term effects on the athlete, can cause massive brain swell and, in some cases, even be fatal.

What are the symptoms of a concussion?
They include headaches, nausea, vomiting and a sense of being “out-of-it” or feeling foggy. Most young athletes don’t recognize their symptoms as a concussion. Parents can look for signs, like their child being slow to respond verbally, being off-balance and looking spaced-out or glassy-eyed. The bottom line is if you suspect your child has a concussion, he or she should see a doctor.

What types of sports cause the most concussions?
Football is certainly high in numbers, but the greatest percentage of concussions by sport is in ice hockey. We also see patients who play rugby, lacrosse, soccer, basketball, field hockey, swimming and even horseback riding.

How can you decrease the risk of getting a concussion?
Unfortunately, helmets do not prevent concussions. They are made to prevent catastrophic brain injury—which they’re very effective at—so every athlete should have a new, properly fitted, undamaged helmet, but they won’t decrease risk of concussion. The best thing parents and young athletes can do is give proper recovery time from a previous concussion. Another thing that can be done is neck-strengthening exercises, which can help keep the head from snapping backward or forward during impact.

How are young athletes different from adult athletes?
Some studies in younger athletes have shown that they require longer recovery time than studies done in older athletes. This could be because the brain is still developing although it is still unclear and more research needs to be done in this area.

Regardless, concussions directly affect brain function, and when an athlete is concussed, his brain is not functioning properly. Unlike professional athletes, high school and college students also have to worry about academics so with the brain not functioning properly, grades may drop off significantly. Our clinic works with schools in arranging academic accommodations to help athletes while they are injured.

How do you diagnose a concussion?
We take an athlete’s history, conduct a physical examination, perform a standardized balance assessment and use computerized neuropsychological testing. Ideally, the athlete will have had a baseline test taken prior to injury that we can use for comparison. That way we can monitor their scores until they return to where they were before. We offer this baseline neuropsychological testing at Children’s and absolutely recommend parents get their child tested if he or she plays a high-risk sport, like ice hockey, football, rugby or soccer.

What’s the treatment?
Physical and cognitive rest is the main treatment. We remove the patient from athletics and other aerobic activity, monitor progress during recovery, the length of which depends on the type of symptoms and number of his previous concussions. Other times, we treat symptoms with drug therapy. Before putting the athlete back into contact sports, we repeat neuropsychological testing. If needed, also refer patients to our Brain Injury Program.

Watch a video of Meehan talking to Channel 5 about concussions.

Read an article from a local paper about the legislation.


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