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By William E. McCormick, MD
South Shore Brain & Spine Specialists
The image that springs to mind with regards to concussion in youth sports is a young football player lying on the field well after the play is over, slowly being assisted to the sideline. In fact concussions occur in both sexes and across the spectrum of youth sports. There is a particularly high incidence in girl’s soccer and girl’s basketball. Concussions are also commonly reported in lacrosse and wrestling, two particularly popular sports in Long Island, and are seen in cheerleading as well. The question is what should we do in the unfortunate instance our child suffers one during a sporting contest?
A concussion is a form of traumatic brain injury that occurs from a bump to the head or a blow to the body that causes the head and brain to move quickly back and forth. It does not have to result in someone being “knocked out.” It is best understood as impairment in consciousness. The signs and symptoms of a concussion may include headache, dizziness, blurry vision, memory loss, difficulty concentrating and loss of energy. It can also involve changes in sleep patterns and changes in mood such as increased irritability or sadness or increased anxiety. Most people with a concussion recover quickly, but for some these symptoms can last for weeks or months.
Any athlete that has suffered a concussion should immediately be removed from play. Athletes who have suffered a concussion and are still symptomatic are more likely to suffer additional concussions. There is also the risk of a rare condition called Second-impact syndrome which involves rapid and potentially fatal brain swelling after a second concussion before the symptoms of the first concussion have resolved.
After their removal from play, youth athletes should be seen by their pediatrician or family doctor who can decide on the need for evaluation by a neurologist, neuropsychiatrist, or neurosurgeon. It is very important that they do not return to their sport or any high risk activity (other sports, physical education, etc…) until all of their symptoms have resolved.
It is important to note that return to school should not be rushed. There is some evidence that returning too soon to full class work in patients with memory or concentration symptoms following a concussion may actually prolong recovery.
Return to youth sports after a concussion should be gradual. Activities can slowly be increased provided the concussion symptoms don’t return. After seeing a young person with a concussion who is no longer having symptoms, we often recommend aerobic low impact exercises such as riding a stationary bicycle or an elliptical. If symptoms don’t return, then we typically advise non-contact training such as jogging or running and carefully assess for headache, dizziness or any of the other symptoms of concussion. Only then are youth athletes allowed to restart full contact sports and continued close observation is recommended.
It is thought that until recently concussions in youth sports have generally been underreported. As awareness increases, it is likely that we will continue to see a rise in sports-related concussions. Properly managing young athletes with concussion often requires communication with teachers, school administrators, coaches, physical education instructors and team trainers. The best way to ensure a full and quick recovery from a concussion is to make sure that coaches and parents know the symptoms, seek treatment promptly, and follow doctor’s recommendations.
Dr. William McCormick is a board-certified neurosurgeon practicing in West Islip and Bethpage. He can be reached at South Shore Brain & Spine Specialists (www.southshorebrainandspine.com) at (631) 422-5371.
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