This year the NFL raised the profile of head injuries in contact sports,
highlighting the prevalence of concussions on the field and kicking off
concern among parents of high school and club sports athletes.
Unfortunately, some of what parents are hearing is a fumbling of the facts.
While it is vital that we work to prevent and appropriately treat traumatic
brain injury in youth sports, it is important to keep in mind that nearly
80% of such injuries among children are not related to sports or recreational
activities. Falls and car crashes account for far more concussions among
youths than football.
The medical community would like to tackle some myths to help parents
better understand concussions.
Myth: The term "concussion" refers only to a head injury that
results in a person losing consciousness.
Fact: A concussion is a change in neurological function of the brain that
occurs as a result of head trauma. Common symptoms of concussion are dizziness,
headache and changes in vision, mood and memory. The majority of concussions
do not involve loss of consciousness.
Myth: Participating in contact sports leads todementia later in life.
Fact: Studies do not support this. Research that shows an association between
sports-related head trauma and dementia has involved brain trauma with
prolonged loss of consciousness or a significant cumulative trauma in
professional athletes, such as boxers and football players. Their levels
of trauma are orders of magnitude greater than those experienced by most
high school athletes. It is also important to note that most studies involve
football players from 20, 30 and 40 years ago, when safety equipment was
different and there was little recognition of concussion.
Myth: You should wake up a child every one to two hours to be sure he or
she is OK.
Fact: Sleep is the best treatment for concussion. Deep levels of sleep
restore the brain chemistry that can be put off balance by concussion.
In fact, the complex changes that can occur in a concussion patient are
most notable during the first three days after injury, and sleep deprivation
can make these changes worse.
Myth: If you don't lose consciousness, you can go right back in the
game or walk it off.
Fact: The most vulnerable time for the brain is within the first three
days after injury, so it is important for young athletes to rest to avoid
reinjury. Schools have gotten more involved in setting guidelines for
"return to play" and "return to school" following
concussions. Coaches, school nurses and community physicians work together
to help players return to activity as appropriate. Some schools are starting
to utilize software that can assess an athlete's baseline cognition
to help determine the severity of an injury and the conclusion of healing.
Myth: A child should stay home until completely healed.
Fact: While we used to recommend complete physical and cognitive rest following
concussion, we now realize that isolation can actually exacerbate some
of the symptoms — particularly depression — in young athletes.
Instead, we now recommend keeping kids off the field but allowing them
to participate in team meetings and events in which they can receive plenty
of positive social feedback. While cognitive rest is crucial, finding
that balance is important in aiding healing.
DR. TERYN CLARKE is a neurologist at Hoag Hospital in Newport Beach.