Recently there has been a lot of media attention given to head injuries in pre-teen and teen athletes. Schools, HealthCare providers, & Coaches all have a heightened awareness about this dangerous condition. As a parent, what do I need to know?
A concussion is a form of mild brain injury that can occur after a blow to the head, such as a fall, but is most commonly associated with hits to the head during sports. After the hit or blow to the head, a child with a concussion may lose consciousness, may forget things that happened before or after the injury (amnesia), could have a seizure, or could have one or more of the classic concussion symptoms described below.
•Physical symptoms - headaches, nausea, fatigue, visual problems, balance problems, sensitivity to light or noise, numbness and tingling, vomiting, dizziness
•Mental (thinking) symptoms - feeling mentally foggy, having problems concentrating or remembering, feeling slowed down
•Emotional symptoms - irritability, sadness, nervousness, or simply feeling more emotional
•Symptoms that affect sleep - drowsiness, sleeping more or less than usual, or having trouble falling asleep
More severe "red flag" symptoms that might indicate your child needs immediate medical attention might include a worsening headache, seizures, repeated vomiting, increasing confusion, or unusual changes in behavior, etc.
Parents, teachers, coaches, trainers, and a child who has had a concussion should be aware of all of these possible symptoms as he or she returns to school and sporting activities and should understand the importance of reporting all symptoms. Experts now recommend a six-step gradual return to play plan for kids who have a concussion, with athletes moving to the next stage only if they remain free of all concussion symptoms. Using this plan, the earliest a player with a concussion would be back in a normal game would be six days.
These return to play guidelines includes:
1. No activity - a recovery stage with complete physical and cognitive rest. This means no exercise or sports, but can also mean not going to school, or having a shortened day. This is a time to get lots of rest, get plenty of sleep, and eat well.
2. Light aerobic exercise to increase their heart rate (keep to less than 70% of maximum predicted heart rate), including walking, light jogging, swimming, or stationary cycling, but no resistance training.
3. Sport-specific exercise to add movement, such as skating drills or running drills, moderate jogging, brief running, moderate-intensity stationary cycling, but no head impact activities.
4. Non-contact training drills to raise exercise, coordination, and cognitive load, including progression to more complex training drills and resistance training, sprinting and running, high-intensity stationary cycling.
5. Full contact practice to restore confidence and assess functional skills and following medical clearance may participate in normal training activities
6. Return to play
Keep in mind that you shouldn't move to the next stage until you are symptom free, which can keep some kids in the "no activity" stage for several days or longer. And if the athlete develops symptoms while doing any of the stages, they should drop back to the previous stage and try again. Concussion symptoms should not come back during or after any of the exercises or activities during these return to play stages.
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