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Concussion Awareness for Parents: Quick Summary

• Concussions, unlike physical injuries, are not always obvious.
• Returning to play with a concussion may result in severe and permanent brain damage.
• Youth participating in contact sports are particularly susceptible to concussions.
• There is an app called “Concussion Recognition & Response: Coach & Parent Version” that can help identify a possible concussion.
• Anyone with a suspected concussion should see a medical professional before returning to play.
• If your child suffers a concussion, he or she should not resume physical activity until all symptoms have resolved, and should follow a gradual return-to-play plan as directed by a medical professional.

Why Concussion Awareness is Important

First, unlike a physical injury on the body, an injury to the brain is not always obvious. The signs and symptoms of concussion are wide-ranging and varied, do not necessarily include loss of consciousness, and frankly can be quite vague. It is easy to miss the signs of concussion if you are not aware of them.

Second, returning to play prior to complete recovery from a concussion may result in severe and permanent brain damage. Even after complete recovery, a second concussion within weeks or months of the first may result in significantly prolonged recovery.
Currently there is a lot of awareness about concussions, but not a lot of knowledge about how to identify a suspected concussion and the necessity of staying off the field until recovery is complete.

What is a Concussion?

A concussion is a minor traumatic brain injury (TBI) that occurs when the head hits an object, or a moving object strikes the head, causing the brain to move rapidly inside the skull. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. Concussions can also result from a fall or from players colliding with each other or with obstacles, such as a goalpost.

Concussion Signs & Symptoms

It may be very obvious that someone has sustained a concussion (i.e., loss of consciousness, vomiting), or symptoms may appear in a more subtle way over the course of hours or weeks. The following summary of concussion signs and symptoms is provided by the SCORE (Safe Concussion Outcome Recovery & Education) Concussion program at Children’s National Medical Center.

Signs & Symptoms

• All concussions are serious
• Most concussions occur without loss of consciousness
• Recognition and proper response to concussions when they first occur can help prevent further injury
• When in doubt, sit them out

The Director of the SCORE Concussion program developed an app to help youth coaches recognize and respond to concussions. The app is called “Concussion Recognition & Response: Coach & Parent Version” and is available for iPhone and Android for $0.99.

Within the app, parents answer basic questions about the signs (what they observe) and symptoms (what an injured child or teen reports) to determine if the child or teen has suffered a suspected concussion and how to respond. Additionally, an email interface allows detailed information to be sent immediately to your physician.

If a Concussion is Suspected

If your child or teen has any signs or symptoms of concussion, they should be evaluated by a medical professional. Typically, a trip to the Emergency Room is the best course of action. If your child or teen is diagnosed with a concussion, you should also follow up with your doctor and/or a concussion clinic. They should not return to play without getting cleared by a medical professional.

Local concussion clinics include the SCORE (Safe Concussion Outcome Recovery & Education) Concussion program at Children’s National Medical Center and the Inova Head2Head Concussion Management Program.

Risks of Returning to Play Too Soon

A child or teen who returns to practice or play when he or she still has symptoms is at significant risk for a more severe or potentially catastrophic injury.

Second-Impact Syndrome (SIS) can occur when a person suffers a second concussion before symptoms from an earlier one have subsided, and results in severe disability or death. Children and teens are particularly susceptible to SIS, and the occurrence of SIS is not dependent on the severity of the initial concussion. Concussion symptoms typically take several weeks to subside and it’s therefore of utmost importance that the athlete does not return to play during this time.

Even after concussion symptoms have fully subsided, a second concussion within weeks or even months of the initial injury will result in a greatly prolonged recovery period. For this reason, medical professionals recommend a gradual return-to-play plan, beginning with mild jogging and progressing over a period of several weeks to individual drills, then limited contact drills, and finally to scrimmage and full play.

Return to Play Guidelines

It is difficult, if not impossible, to predict the length of recovery from a concussion at the time of the injury. The decision to return to a sport is an individualized medical decision, and based on the child or teen’s actual symptom recovery timeline.

Your child or teen should never resume physical activity until all concussion symptoms have resolved. Once all symptoms are gone, a gradual return to play plan should be developed in conjunction with your doctor, a concussion clinic, or another medical professional.

Sample Return to Play Plan

• No physical activity for two weeks after all concussion symptoms have resolved.
• One week of low physical activity, such as walking or light jogging, as long as symptoms do not come back during or after the activity.
• One week of moderate physical activity, such as moderate jogging or brief running.
• One week of heavy, non-contact physical activity, such as sprinting/running, non-contact sport-specific drills.
• One week of full contact in controlled practice.
• Full return to play.