Concussed kid? Get Them to Speak Up

Parents Can Help Change the Attitudes Youth Athletes Hold Surrounding Head Injuries

By Greg Gargiulo

When Katherine Price Snedaker received a call from her son Charlie’s school telling her to pick him up
and take him to the doctor, she wasn’t entirely sure what to think.

“They said he might have a concussion from being hit with a soccer ball on the sidelines during recess, and I was confused that something like this could happen when he wasn’t even playing,” she said. “We found out it was a concussion, and it turned out to be the first of many. He was out of school for three and a half months, and that’s when I started my journey to try to figure out what was actually going on.”

This was back in 2008. Since then, knowledge and awareness of the dangers of concussions in youth athletes have become significantly more widespread thanks to the ongoing efforts of researchers, clinicians and parents. But too often, young athletes still fail to report all potential concussion symptoms and receive proper treatment.

Concussions are one type of traumatic brain injury (TBI) that usually result from a blow or jolt to the head, which causes the brain to shift rapidly and possibly collide against the skull. Concussions are classified as mild TBIs, but their impact can be very serious.

Although about 90% of concussions heal on their own within 7-10 days, longer periods of rest are often needed for children and adolescents because their brains are still developing. Returning to play too soon after a concussion–especially in high-risk sports like football and soccer–can lead to delayed healing, increased odds of additional concussions, and long-term mental and physical effects. Additionally, a rare yet often fatal condition called Second Impact Syndrome (SIS) may also develop when an athlete sustains a second concussion before the first one has completely healed.

But research suggests many young athletes are hesitant to tell a coach or parent about lingering headaches or other potential concussion symptoms. In a May 2016 study published in the Clinical Journal of Sports Medicine, only about half of the high school football players surveyed said they would report such symptoms to a coach.

Though increasing knowledge is essential to encouraging young athletes to be more open, several recent studies have found that young athletes’ knowledge about concussions has less of an effect on their willingness to disclose symptoms than their attitudes. A July 2016 CJSM study from the University of North Carolina at Chapel Hill found that these attitudes tend to be even worse in young athletes who have had multiple concussions.

“It seems that attitudes are more linked to kids’ reporting behaviors than their actual knowledge,” said the lead author, Johna K. Register-Mihalik, PhD, LAT, an assistant professor in the university’s Department of Exercise and Sport Science. “Pressure from teammates, parents, or fans likely affects these behaviors.”

Bart Peterson, a certified athletic trainer (ATC) and educator at Palo Verde High School in Tucson, Ariz., who’s also on the board of directors of the National Athletic Trainers Association (NATA), has asked classrooms of students why athletes might not report concussion symptoms.

“Many said because they don’t want to be seen as weak, which can mean getting taunted by their teammates or coaches,” he said.

The fact that a concussion is less visible than other injuries can also be a factor, Peterson said. “Athletes may be treated differently than if they sprained their ankle,” he said. “This can also cause kids to hold back from reporting.”

Returning to play too soon after a concussion–especially in high-risk sports like football and soccer–can lead to delayed healing, increased odds of additional concussions, and long-term mental and physical effects.

Getting young athletes to become more open about reporting concussion symptoms requires action from parents, coaches and school administrators. For parents, it’s a matter of becoming familiar with the symptoms and the importance of disclosing them.

“I think parents definitely have to be very proactive as their children play sports,” said Zachary Y. Kerr, PhD, MPH, also an assistant professor in the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill. “It’s not just about being that team mom on the sideline, but also about doing the research prior to enrolling their child into a league or sport and asking questions about the concussion knowledge of the coach, if there’s an athletic trainer onsite for immediate care, and is there an action plan in place for concussions.”

Today, all 50 states and the District of Columbia have passed laws on concussions in youth sports, which includes high school sports, with mandatory protocols designed to increase awareness and prevent long-term issues.

“In Arizona, if an athlete has a collision, there are 23 symptoms we keep an eye out for,” Peterson said. “In addition to more common ones like headaches, nausea, vomiting, sensitivity to light and noise, dizziness, and balance issues, there are also some hidden ones that parents should look for like trouble falling asleep or staying awake, being tired or slow all the time, feeling ‘foggy,’ and changes in personality.”

In addition to being watchful, it’s also essential for parents to keep an open dialogue with their kids. “You should talk with your children, especially younger children, to explain that coming out of play with a head injury is not the same as quitting,” Register- Mihalik said.

Often, it comes down to positive reinforcement, Kerr said. “It’s a child hearing, when he/she or a teammate reports a concussion, that everyone involved is saying it was the right thing to do,” he said.

If a parent has concerns that their child is returning to play too early, that’s definitely something that needs to be discussed with a coach, or a higher-up administrator if the coach is not responsive, Kerr said.

Snedaker’s journey as a parent to learn more about concussions led her to found two websites for concussion activism (SportsCAPP.com and PinkConcussions.com)

In her eyes, its the responsibility of each parent to make a proper assessment before letting their child play a sport.

“We need to make sure all adults who are supervising our kids are properly educated on the risk factors and signs of concussions,” she said.

Greg Gargiulo is a freelance medical writer based in San Francisco. He has over 10 years of experience, with a specialized focus writing about sports medicine, and the treatment and prevention of common injuries and painful conditions. He can be reached at ggargiulo12@gmail.com or through his website, ggmedwriter.com

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