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SALEM COMMUNITY HOSPITAL...Concussions in young athletes on the rise

September 12, 2010
Salem News

According to a September 2010 report published by the American Academy of Pediatrics (AAP), the number of high school athletes taken to hospital ERs due to sports-related concussions has doubled over the last ten yearsAn elbow to the head, a collision with another athlete, a blow from a ball, a tackle or a fall are all some of the reasons why an estimated 10 percent of athletes participating in contact sports suffer a concussion each season.

"Concussions occur when a blow to the head or neck interrupts brain function," explained Pediatrician Banarikammaje Bhat, M.D. "Sports-related concussions are highest in high school-aged athletes, but the number of concussions in younger athletes is significant and rising. In fact, the overall number of concussion cases is thought to be even higher, because the study did not include children with concussions, who were seen in their physician's office or who did not receive any treatment."

A recent report by the Los Angeles Times says that the rise in sports injuries among younger children may be due in part to an increase in participation in "elite travel teams and in competitive youth leagues" across the country. Nearly half of the pediatric patients with sports-related concussions seen in ERs were between the ages of 8-13, the AAP study found. The sports with the highest number of concussions appear to be ice hockey and football, but a significant number also occur in basketball, baseball, and soccer.

"This report points out the increasing evidence that not only are the brains of younger children more susceptible to injury, but these injuries may take longer to heal and can be more damaging than concussions in older adolescents or adults," Dr. Bhat continued. "While awareness about concussions has increased, many parents, coaches and players still don't understand how serious concussions can be.

"There is a common misconception that an athlete only has a concussion if he or she loses consciousness. It is important for coaches, parents and athletes to recognize the signs of a concussion, because many athletes may just have one or two symptoms."

Common signs of a concussion include a headache, which is the most common symptom, dizziness or memory or concentration problems, which many athletes describe as feeling "foggy." Some also may feel sick to their stomachs or have issues with balance.

"If a child has taken a blow to the head and is experiencing one or some of these symptoms, parents and coaches need to assume that the player has suffered a concussion," Dr. Bhat advised. "In addition, concussions may also occur without impact, as a result of the head being shaken. Parents and coaches should err on the side of caution and seek medical evaluation, which is especially important in younger children. It is recommended that no athlete be allowed back into competition on the same day."

According to Dr. Bhat, young athletes are especially vulnerable because their brains are still developing and they may be more susceptible to the effects of a concussion. "Although concussions are more common among older athletes due to the impact of their bigger bodies colliding at higher speeds, concussions have the potential to be more dangerous in younger athletes," he warned.

"Sometimes adults seem less concerned with the injury than with how soon the child can return to sports. However, if the injured child isn't treated properly, then he can have long-term problems like learning difficulties, memory problems or chronic headaches. The treatment for a concussion is mainly rest, both physically and mentally, and to avoid activities that require concentration and focus. This may mean reducing schoolwork and avoiding video games, computer use and TV, which can worsen symptoms.

"Recent research has demonstrated that athletes who have what are commonly considered mild concussions, may no longer experience headaches or other symptoms of concussions but still show significant deficits in processing information. Symptoms of a concussion usually resolve in 7 to 10 days, but some athletes may take weeks or months to fully recover. Retirement from contact sports should be considered for an athlete who has had multiple concussions or who has suffered post-concussive symptoms for more than three months.

"Once an athlete is symptom-free, he or she can progress through increasingly heavy exertion to ensure that there is not a return of symptoms. However, the player should first be evaluated and cleared by a doctor before returning to practice or competition."

There is also a condition called 'second impact syndrome,' which affects children, but is not seen in older athletes. "If a child returns to competition too soon and suffers another head injury, he or she may develop dramatic swelling in the brain and even die following a second injury," Dr. Bhat added.

The AAP study encourages parents and coaches to try to recognize the signs of brain trauma in youth and to get away from the past practice of allowing kids to "tough it out."

"I also emphasize to these adolescents and their parents that they only have one brain, which is a very valuable asset throughout their lives and needs to be protected," Dr. Bhat concluded. "It is OK to miss a game or even a season, instead of risking permanent injury to your brain.

"Part of the difficulty with a concussion is that we have to rely on the athlete to say that he or she is having problems. This is why it is so important for players, parents and coaches to be aware of the symptoms so they can initiate and seek appropriate treatment."

There are several ways to reduce the risk of a concussion, such as using protective gear (like helmets and mouth guards); adhering to the rules of the sport; identifying athletes at risk; and educating parents, teachers, athletes, school administrators and trainers about the dangers of concussions.

Banarikammaje Bhat, M.D., is a board certified pediatrician affiliated with Salem Community Hospital's active medical staff. His office is located at 330 North Market Street in Lisbon, 330- 424-9866.



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