What Parents Should Know About Recurrent Concussions in Children
The topic of concussion is an essential one among parents of young athletes.
Especially for children who participate in youth sports, the topic of repeated concussions – and the later potential effects associated with sustaining them – is understandably a disconcerting one. There are few things more challenging for a parent than hearing that their child has suffered a traumatic brain injury while playing sports (or anytime, really). This is especially true given the news surrounding professional athletes who have recently given first person accounts of the lasting effects they have experienced from repeated concussions. While it is essential to understand the risks of repeated concussions in the youth population, it is also critical to note that engagement in sport at a young age is generally good for the body and the brain. So, knowing that risk of injury exists with participation in any sport, but finding the right risk-to-benefit balance for your child is vital.
First, it is crucial to understand that regardless of age, it is not uncommon for both the youth and the adult population to be more vulnerable to subsequent concussions after sustaining one or more concussions in the past. Several factors may, and likely do, play a role in this. Some of the initial factors include improper identification and diagnosis of concussion, as well as poor concussion management during the early periods of likely recovery. The understanding that while patients, regardless of age, may have symptom resolution following a concussion, the period of physiological vulnerability may persist. This can increase the likelihood of an earlier subsequent concussion, particularly in a return-to-sport setting. Simply put – even when the symptoms of a concussion seemingly “go away,” there still may be healing in the brain taking place that can be hindered by getting back into the game too soon.
For the reasons above, a young athlete must have a team of supportive individuals – from family members, teammates and coaches, to healthcare professionals. These “teammates” should be familiar with the signs and symptoms of a concussion, while also understanding and accepting that not all concussions will present the same way, nor will they resolve in the same way, or in the same amount of time. For example, healthcare professionals on this “team” should be looking for specific trends in an individual’s history, understanding that recovery from a third or fourth concussion may not present the same way as recovery from any previous concussion. For friends and family members, understanding that the right physician will be taking all the necessary measures to ensure an appropriate workup and treatment plan. This helps to assure parents that their child will only return to their sport in as safe a scenario as possible.
Fortunately, from a youth sports perspective, legislative decisions have been made over the last several years to lessen the likelihood of a concussion and head injury, not only at the youth level, but also at the collegiate and professional levels. These include limiting the number and duration of “tackle” practices in youth contact sports, eliminating “heading” the ball in soccer at certain age levels, and in-game rule changes in many sports, to name a few. Another critical factor, particularly for youth athletes and their parents, is education. There was a time in our not-too-distant sports history that concussions were seen as merely a “shaking out the cobwebs and getting back out there” injury. As a neurologist and board certified brain injury medicine specialist, I am proud to say that those days are by-and-large behind us. Education has played a significant role. Helping coaches, parents, and young athletes understand the seriousness of concussion is crucial. Eliminating stigma in brain injury is, and continues to be, a large part of the battle. Fortunately, many people have come to realize that just because the injury can’t be “seen” doesn’t mean that it isn’t present, causing damage, or requires critical time to heal.
There is much that we have yet to learn when it comes specifically to concussion-related brain injury. However, these last few years of concussion-based research have certainly provided clinicians an opportunity to better manage concussions, particularly in youths, in a much more controlled and safer way. That is something parents can take comfort in knowing.