Child with icepack on head at doctors office

News, Child Health | 18 days ago

Game On: Safeguarding Young Athletes from Concussions and Injuries

While there are many benefits of children engaging in physical activities, it’s important to recognize that participation in group sports comes with inherent risks, including the possibility of concussions. Here, experts with Atrium Health Levine Children’s explain the facts about injuries and concussions in children, and precautions you and your child can take to play it safe.

There can be many benefits to children participating in group sports, including building self-esteem, socializing with other kids, and encouraging teamwork.

But in addition to the benefits that sports can offer, it’s crucial to understand the inherent risks that go along with group sports. Here, experts at Atrium Health Levine Children’s explain the facts about injuries and concussions in children, and precautions you and your child can take to play it safe.

Common injuries in young athletes

Dr. Chad Scarboro, medical director of emergency medicine at Atrium Health Levine Children’s Hospital, says many sports-related injuries are accidental.

“We frequently see injuries from falls during the game resulting in the head hitting the ground,” Scarboro says. “It is also common to see head-to-head contact in football, or an object hitting the head in sports like baseball and soccer.”

Dr. Christyn Magill, pediatric emergency medicine doctor at Atrium Health Levine Children’s Hospital, adds that a number of children and teens are seen for “stingers” (neck pain after a tackle, head-to-head contact or a fall), “FOOSH” injuries (falling on an outstretched hand), forearm fractures or even humerus or clavicle fractures when they fall on an elbow.

Magill says she also sees kids who play soccer, football, and basketball experience lower extremity injuries, including ankle sprains, foot or lower extremity fractures and hip injuries.

Understanding concussions

The Center for Disease Control and Prevention (CDC) explains a concussion as a type of traumatic brain injury—or TBI—caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. It is estimated that between 1.1 and 1.9 million children under 18 years of age get a concussion during sports and recreation activities in the U.S. each year.

Magill says repeated concussions can potentially lead to long term neurological consequences, though they may not be immediately evident. 

“Children can have problems regulating their emotions, they can develop learning difficulties and have trouble focusing and concentrating,” Magill says. “Neurocognitive testing might be recommended for children who have had repeated concussions.”

If your child experiences a concussion, Scarboro says to remove the child from the game or activity until they have been evaluated for a concussion. Magill says to seek medical attention promptly, and notes that not every child will need a CT scan to confirm a concussion.

“Concussions are a clinical diagnosis, not a radiologic one,” Magill says. “But a thorough physical examination is needed following an injury.”

After an evaluation with a medical professional, Scarboro says rest is important following a concussion, especially until all symptoms resolve. This recommendation has changed over the decades. Previous advice suggested that parents should regularly wake up their kids after a concussion to ensure their well-being. However, experts now advise letting children rest and sleep as needed after a head injury. This approach can speed up the healing process for the brain.

“From there, your doctor or trainer will guide you through a gradual return to activity,” Scarboro says. “But the first step is to let your brain recover, much like you would let your arm or ankle recover if those were injured.”

Scarboro notes that for high school and beyond, there are well defined “return to play” guidelines that should be followed by either your doctor or an athletic trainer at your school.

Concussion symptoms and red flags

Since it can be difficult to differentiate between a “mild” concussion and more concerning symptoms, Scarboro says to err on the side of caution in most cases.

“If your child sustained a hit to the head and isn’t acting like they typically would after a game, it would be best to have them evaluated by a medical professional promptly,” Scarboro says.

The symptoms of a concussion can come on immediately or hours after an injury, so keep an eye on your child in case serious symptoms develop. Scarboro and Magill say to seek medical attention immediately if your child experiences any of the following symptoms:

  • A headache that worsens
  • Nausea or dizziness
  • Difficulty with balance
  • Extreme sleepiness or fatigue
  • Poor sleep
  • Mood disturbances (or “roller-coaster emotions”)
  • Feelings of isolation
  • Depression
  • Trouble concentrating
  • Dips in grades
  • Sensitivity to light
  • Intolerance of screen time

Reduce the risk

From football and hockey to gymnastics and cheerleading, young athletes face the reality of potentially experiencing concussions. To minimize the risk for your child, make sure they are wearing proper-fitting equipment, and ensure they are using correct techniques and adhering to the rules.

Scarboro and Magill emphasize the importance of wearing a helmet when applicable to prevent head injuries. This includes sports like baseball, football and lacrosse, as well as anything involving wheels (scooters, bikes, etc.) In addition to helmets, Magill says it’s important to wear proper padding per league rules for football, and elbow and knee guards in biking and skating.

If an injury does occur, Scarboro encourages young athletes to be honest about their symptoms with coaches and parents, and to advocate for themselves if something doesn’t feel right. He also says to take a play – or a game – off if needed.

“There will be many more games in the future that you can participate in, even if you have to sit the current one out,” Scarboro says.

Parents and athletes should also know how to identify a concussion and when to seek treatment. In many states, there are protocols in place for coaches to reference when a concussion is suspected. Magill says parents, coaches, and trainers can play a role in educating young athletes about the signs and symptoms of concussions.

“What may be common sense to adults is not necessarily common sense to children and teenagers,” Magill says. “Children need repeated education about concussions, the symptoms, and the potential complications so that they can identify their own symptoms.”

While injuries are a reality of participating in sports, being armed with knowledge and taking proactive measures can help protect your child’s well-being. When it comes to your child’s health, vigilance and advocacy are paramount. Our experts at Atrium Health Levine Children’s work together with you to help keep young athletes safe and healthy as they pursue their passion for sports.

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