How to make sure your child safely returns to sports after a concussion injury: a quick guide to parents and coaches.
Concussion is currently the hottest sports injury topic in school sports. With high profile athletes’ lawsuits against their sporting federations being reported worldwide, this has sparked a lot of research activities in sports medicine leading to a better understanding of concussions and well-defined assessment and treatment protocols. The research has pointed out that not only are professional athletes at risk of concussions, but our school athletes are very much at risk. Children seem to be more vulnerable to concussion and have longer recovery periods with emotional disturbance and memory loss affecting children for a long time. The long-term effects of concussion can impair school achievements as it influences cognitive development and delay return to sport participation. There even seems to be an association between concussions and early onset dementia/ Parkinson’s. That is why we must take every suspected concussion seriously.
We hope the following information will help parents and coaches identify when it’s not just a bump against the head and might in fact be a concussion.
What is a concussion?
Basically, a concussion is a non-permanent disturbance in brain functioning caused by trauma (direct/indirect forces transferred to the brain, such as a blow to the head). Very simply put, following an injury, your brain needs more energy to recover but does not get enough oxygen and it's energy producing cells (mitochondria) don’t work as well. This results in the brain not functioning optimally which gives us the characteristic symptoms of a concussion.
What are the symptoms of a concussion?
Symptoms can evolve over 24 hours and can last 7-10 days but in some cases, it can last weeks or even months. The younger the adolescent the longer the symptoms can last.
How to recognize a concussion?
Immediate field side observation and screening is important, preferably by a medical professional with experience in dealing with concussions. If no such medical professionals are present onsite the coach or parents should take charge.
Always suspect a concussion if there was a blow to the head, face or body of the athlete that results in any of the following symptoms:
· Convulsion
· Headache
· Knocked out
· Nauseous
· Unsteady
· Confused
· Dazed
· Dizzy
If any of the above symptoms are present remove the player from the game and seek medical assessment and advice!
As a rule of thumb: when in doubt sit them out.
In cases where there are no obvious immediate symptoms, remove the player from the field and administer the Maddocks score. This is an easy and reliable tool to use if you suspect a concussion. If the athlete scores less than full marks, a concussion should be suspected, and the player should not return to the field that day. Again, seek medical assessment and advice if you suspect a concussion.
My child sustained a concussion, what do I do now?
Have them assessed by a medical professional experienced in treating concussions. The SCAT3 tool should be used to diagnose the severity of a concussion. The SCAT3 is currently considered to be the gold standard in concussion assessment. A physiotherapist trained in concussion management can administer the initial SCAT3 assessment, but the patient should also be seen by a medical doctor trained in concussion management. The physiotherapist should be able to refer them appropriately.
For the first 24 hours following the injury, complete brain rest is recommended.
No cellphone, No TV, No computer, No reading, No studying
Unless otherwise advised by your medical doctor, avoid taking anti-inflammatory medication, aspirin, opioids and sleeping tablets.
After the first 24 hours of complete rest and depending on the severity score as per the SCAT3 assessment, one can start on a graded return to activity and eventually sport. A physiotherapist can assist with guiding a player through the stepwise exertion protocol and to determine when the patient is clear to return to sport.
At PHYSIOXPERT we follow a multidisciplinary approach to concussion management. Depending on the initial presentation of the athlete, we screen the athlete according to the SCAT3 assessment and refer to an experienced Sports Doctor for further assessment. The physiotherapist together with a biokineticist will assess the child according to the stepwise exertion protocol. This protocol is supported by published guidelines and endorsed by various sports organizations. To get the green light to return to play the child should be symptom free in every phase of the protocol.
The goal for the return to play protocol is to get the player on the field as soon as possible without putting the patient’s life at risk.
NOTE: all information was obtained from published research on concussion management and can be provided upon request. for more detailed information feel free to contact us.
Disclaimer: this is not meant for the purpose to diagnose or treat any individual but simply to give a brief overview of concussion in sport.