By Cristine Griffing, ATC and Danielle Trombley, ATC

Your child’s back-to-school schedule likely involves returning to fall sports. Involvement in athletics can boost not only physical fitness in our young population but has added social and learning benefits including increased self-esteem and problem solving skills. With sports participation, comes risk of concussions; staying informed and having a plan to manage a concussion can take the worry out of your fall season. Ongoing research has shed light on complexity of concussions including criteria for diagnosis, treatment recommendations and long term health effects associated with multiple concussions. In 2013, Vermont adopted Act 68, outlining concussion guidelines for schools, consistent with nationally recognized protocols. Whichever sport your young athlete enjoys, understanding and identifying concussion signs and symptoms are critical components of early treatment, management of symptoms and knowing when to seek further care.

Concussions are not solely a result of direct impact to the head; studies reveal that whiplash type injuries, or any direct blow to the body, can equally affect the brain. For this reason, even the best fitting helmet and protective gear may not protect the athlete 100% from a concussion. As symptoms may take hours or days to show up, airing on the side of caution is critical when any symptoms are present. Assessment should include both physical and neurological exam, including balance testing, and be performed by a qualified healthcare professional; Certified Athletic Trainer, Primary Care or Sports Medicine Provider.

Common Signs (observed by others)

  • Confusion or forgetfulness
  • Altered coordination
  • Personality changes
  • Delayed response to questions
  • Forgets events (before/after) injury
  • Loss of consciousness
Common Symptoms (reported by athlete)

  • Headache
  • Fatigue
  • Nausea or vomiting
  • Doubled or blurry vision
  • Feeling sluggish or foggy
  • Problems concentrating or remembering

Note: Seek emergency care if sudden changes in signs and symptoms occur, or the athlete’s overall condition deteriorates. Parents play a key role in helping the child identify symptoms by bringing them to the healthcare provider’s attention when necessary.

Removal from play– Once a concussion is in question, an athlete must be removed from play immediately and remain so for the rest of the day. Decisions to return-to-play are a collaborative decision based on the athlete’s healthcare team and school’s policy regarding concussions. Speak with the athletic trainer, athletic director or school nurse at your school regarding Return to Learn and Return to Play policies.  These protocols are in place to allow symptoms to be closely monitored; preventing further complications and can give the athlete a head start on the road to recovery.

Rest- Physical and cognitive rest are essential to allow the brain to heal. Physical rest applies to any physical exertion and is not limited to the athlete’s sport. Cognitive rest should include limiting screen time and difficult problem solving tasks. Timelines for returning to activity should be created on a case-by-case basis, as each concussion is different. Refer to your school’s concussion policies

Return to Play– After symptoms resolve, it can be tempting to jump back in the game, but a step-wise, incremental process is essential to ensure the athlete remains symptom free while both cognitive and physical demands are increased.  Returning to play may take days to weeks, and vary with each case. Again, working closely with the athlete’s healthcare team to manage return-to- play is crucial to a safe return to athletic participation.

Prevention- While helmets may minimize the blow from direct impact,

they do not offer 100% protection from head injuries. A properly fitting helmet can greatly reduce the occurrence of skull fractures, and are therefore essential in high risk sports. Other equipment such as mouth guards may offer a protective benefit, but the only way to avoid complications of a concussion is to play smart, play careful.

HEADS UP– While local coaches are required to complete the Center for Disease Control’s HEADS UP online education tool, parents and athletes are also encouraged to utilize the program as a resource for up-to-date information on head injuries. For more on HEADS UP, visit www.cdc.gov/headsup. Their motto, “When in doubt, sit them out,” reminds us to always air on the side of caution- you’ve got one brain, and you’re going to need it.

*The information above is not intended to take the place of your healthcare provider; always consult with your child’s healthcare team on how to best manage your child’s care in the event of a head injury.