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Understanding Concussions in Youth Sports

Posted on Aug 15, 2017

Fall sports are back in full swing. Sports related concussion seems to be on the rise. Patrick Mularoni, M.D., is the medical director of the Pediatric Sports Medicine program at Johns Hopkins All Children’s Hospital.  He is helping parents and coaches better understand concussions and how to treat the student athlete.

What is a concussion?

A concussion is a brain injury that occurs after trauma to the head or body. Concussion can occur in any sport or activity and can be caused by a blow to the body with no hit to the head. Our sports medicine department treated more than 3,000 athletes with concussions in the past five years, and although the majority came from traditional contact sports such as football, lacrosse, hockey and wrestling, we also have seen concussions in gymnasts, competitive swimmers and in recreational sports such as skateboarding. This injury is different from most injuries that we think about because it happens at the microscopic cellular level of the brain. If the brain is imaged with a computed tomography scan or an MRI of the brain, we see no changes associated with concussion. Concussion is sometimes hard to recognize and many people think that you need to have loss of consciousness to have a concussion, which is not true. Actually, fewer than five percent of concussed individuals have loss of consciousness associated with their injury.

So what would alert a parent or coach that a child has suffered a concussion?

If the child has a big hit and suffered loss of consciousness most parents would know that their child may have a concussion and should be seen by a doctor. The harder situation is if a player has an injury but may have limited symptoms like repetitive speech or inability to remember parts of the game that they're playing in.  Some coaches will recognize a concussion in a player who is not playing up to their typical speed or is making mistakes that they normally would not make.  The most common symptoms:

  • Headache
  • Dizziness
  • Problems with balance
  • Difficulty concentrating
  • Irritability
  • Sleep issues

If there is any question as to whether a child has a concussion, you should pull them out of the game and they shouldn't return until they are evaluated by a physician who is comfortable managing pediatric concussion.

It seems that concussion is on the rise, is that true?

We are definitely diagnosing more concussions than ever before so it is true that concussion is on the rise. That being said we need to also think about the fact that organized sports participation is on the rise. Not only are more children playing organized sports but they are also playing year round, which gives more field time and greater exposure.

Another reason we are seeing more concussions is because we have a heightened awareness, and I believe that kids are self-diagnosing concussion now when they were just playing through it in the past.

So, if you think your child has a concussion what is the best thing to do?

  1. Get them off the field. When in doubt, sit them out.
  2. Don’t return to school until they are seen by a doctor.
  3. Stop allowing them to use all screens (computers, phones, etc.).
  4. Rest is best.
Watch Dr. Mularoni discuss Concussion Treatment options 

This information was shared on WTVT-TV’s Doc on Call segment, which is aimed at helping parents learn more about children’s health issues. The segment airs each Monday morning on Good Day Tampa Bay.

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