Concussions in Youth Sports

Concussions in Youth Sports

Mr. Jon Almquist

Administrator, Athletic Training Program

Fairfax County Public Schools

Concussion:

·  A mild traumatic brain injury (TBI)

·  Causes a disturbance in brain function

·  May include a loss of consciousness (LOC)

·  Can be linear (front to back) or rotational (twisting). Rotational is more dangerous.

·  Causes a chemical imbalance (potassium goes out/calcium goes in). As long as there is an imbalance, more energy is needed to do the same work (mentally)

There are physical, cognitive, emotional and sleep symptoms associated with concussions. Symptoms are TEMPORARY. But child will have trouble learning and focusing while recovering.

Physical / Cognitive / Emotional / Sleep
Headache / Feeling mentally foggy / Irritable / Drowsy
Nausea/vomiting / Feeling slowed down / Sad / Less than normal sleep
Dizziness / Difficulty remembering / Heightened emotions / More than normal sleep
Balance problems / Difficulty concentrating / Nervous / Trouble falling asleep
Vision problems
Fatigue/tiredness
Light/noise sensitivity
Numbness/tingling

Identification:

·  There is no test for concussions (at the ER, you would be given an MRI, xray or CT scan, but they would only say if there is any other damage, they cannot detect a concussion)

·  Symptoms are subtle and subjective, so difficult to detect sometimes

·  Symptoms can take hours to appear (maybe even until the next day)

·  Child is “feeling different”

·  Parents & child don’t always report the extent of the injury so that the student can continue to play

VA State Bill 652:

·  Child must be immediately removed from play if concussion is suspected

·  No return to play that day

·  Will need physician clearance to return

·  Parent & child must go through education before child can return to play

At time of Injury:

·  If child is “feeling different” remove them from play

·  Sideline evaluation… send home with instructions or send to ER

·  Notify parents

Send to Emergency Room if:

·  Headaches worsen

·  Repeated vomiting

·  Seizures

·  Neck pain

·  Very drowsy

·  Significantly irritable

·  Unusual behavior changes

·  Slurred speech

·  Weak/numb in arms or legs

Treatment:

·  Immediate: REST – mind and body

·  Ongoing: REST – mind and body

·  Kill the clock – don’t let them see the clock, let them rest/sleep as much as they can

·  MINIMAL external stimulus

·  Waking them up every 2 hours is NOT HELPFUL. If you need to check them, check to be sure they are breathing, but let them sleep.

·  No computer. No reading… rest the brain.

·  Follow the FCPS ATP/ACE Care Plan

·  Monitor changes in signs, symptoms & behaviors

·  Follow up with medical provider

·  School attendance will be based on student’s disposition

·  ImPACT Testing: computerized neurocognitive assessment tool. Students complete a baseline test as freshman in high school. This test will be readministered 24-72 hours after injury.

Classroom Recovery: Schools are required to alter the student’s schedule to meet their needs. This could include: short days, rests or breaks, extra time for homework, limited physical education, delayed testing requirements, online courses.

Recovery Period:

·  Normal: 10 days (42% of cases)

·  Extended: 11-21 days (29% of cases)

·  Very Extended: over 21 days (29%)

Inova Health System is opening a Concussion Center for Excellence.

Return to Activity Progression (each should be given a minimum of 1 day, closely monitor and evaluate progress daily):

·  NO activity or stimulation (rest)

·  Light aerobic activity (walk, swim…)

·  Sport specific activity (running drills, no impact)

·  Non-contact training drills

·  Full contact practice

·  Return to play

** NO RETURN TO ACTIVITY UNTIL THERE ARE NO SYMPTOMS **

Helpful Websites:

·  www.sportsconcussion.org

·  www.fcps.edu/sports

·  http://www.cdc.gove/concussion

Further Resources:

·  Zurich Consensus Statement

·  American Academy of Pediatrics Report