The arrival of fall sports season is a reminder that coaches, trainers, athletes and parents should be on alert for signs of concussion. Although awareness and management of concussions has improved, symptoms are often not clear-cut and may be overlooked.
As many as 1.9 million sports-related concussions happen to kids every year in the United States, according to a 2016 study in Pediatrics. Most concussed kids do not see a doctor, the study found, pointing to the need for better detection and reporting.
“One of our major problems is our initial assessments of kids who are concussed are subjective,” Dr. Congeni said. “An X-ray, MRI or CT scan is not going to detect a concussion. We have a symptom scale, but there’s a lot of subjectivity to it. One person’s ‘1 out of 6’ headache can be another person’s ‘5 out of 6’ headache.”
There also is the matter of kids who hide their symptoms, often because they want to play or feel external pressures to tough it out. A recent published study out of Youngstown State University found that boys were far less likely than girls to report symptoms, for fear that coaches or peers would think of them as weak.
Another difficulty is athletes who experience amplified symptoms because of anxiety or mood disorders involved with this frightening injury, Dr. Congeni said.
This can lead to irritability, depression and sleep problems seen in over one-third of concussions.
Concussion symptoms may include headache, confusion, memory loss, fuzzy thinking, dizziness, fatigue, nausea and slurred speech. Symptoms can occur immediately, or they may be delayed.
Dr. Congeni shared ideas for improving prevention, detection and management of concussions:
- Shoulder and neck strengthening programs can help prevent the “bobblehead” effect from forceful contact. Concussion occurs when the brain is thrust against the skull, and improving the musculature can help dampen a blow.
- More education and research are needed. Akron Children’s Hospital is engaged in numerous concussion studies, and youth athletes are encouraged to enroll.
- Certified athletic trainers are critical for detecting symptoms of concussion. Many high schools have them, Dr. Congeni said, but junior high/middle schools, travel leagues and other non school-affiliated leagues usually do not.
“It would be wise to have athletic trainers for all youth sports,” he said. “In many non-high school sports, they don’t want to pay for it. But certified athletic trainers are the best people to recognize symptoms and patterns of behavior of concussed athletes.
“Organizers find money for officials and security, but they don’t look to address this safety concern.”
- Educators must understand that concussed athletes often need time to regain mental acuity. They may not be ready to resume normal academic activities initially.
“This is known as brain rest,” Dr. Congeni said. “Just as we ask coaches to return kids to activity gradually, they should be gradually returned to the classroom as well. That’s known as return to learn.”