Concussions in youth sports

September 9, 2011

Dr. Sarah Alander

High school sports season can be a busy time with on-field injuries such as broken bones, twisted ankles and concussions.

Concussion is a minor traumatic brain injury that involves damage on a cellular level.

It is also a common sports injury, especially among student athletes participating in contact sports such as football, soccer and basketball. Concussions are often caused by an event that involves a blow to the head, usually a collision with another player, and results in the child appearing dazed or stunned and possibly a brief loss of consciousness. Immediate symptoms are confusion, headache, nausea, vomiting, visual and balance problems.

The Centers for Disease Control and Prevention estimates that nearly 500,000 kids under 18 are treated annually for concussions. While most kids completely recover in seven to 10 days, there is growing concern about the complication of "post-concussion syndrome," a relatively common problem that can persist for weeks to months, interfering with the student's daily living and academic performance. Young people are also at risk for a rare, but often fatal, complication known as 'second impact syndrome" that happens when a young person sustains a second concussion before a mild concussion has completely healed with rest.

The Missouri Legislature recently enacted a law regarding student athletes and concussion. The Interscholastic Youth Sports Brain Injury Prevention Act includes an education program about concussion for coaches, athletic trainers, students and parents. Also, the student-athlete who is suspected of having a

concussion is removed from competition for at least 24 hours and evaluated by a qualified health care provider before returning to play.

This new law supports current guidelines for treatment made by international brain injury experts. In addition to immediate removal of the athlete from competition and medical examination, post-concussion neuropsychological testing and returning to play in a graduated manner are recommended.

Neuropsychological testing measures cognitive skills like attention span and working memory. Graduated return to play means a period of rest followed by aerobic activity, then practice prior to return to full competition. If post-concussive syndrome is suspected the student may benefit from a graduated return that may involve a brief absence from school then shortened school days/reduced workload.

The goal of therapy is to hasten full recovery for the student-athlete and relies on good communication between the pediatrician, school officials, coaching staff, parents and the student-athlete.

Dr. Sarah Alander is a Mercy Clinic pediatric emergency medicine physician with Mercy Children's Hospital. For more information or to find a physician, visit

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