“He’s concussed … again.”
I remember my mom, scared and in disbelief, uttering those sobering words to me during my junior year in college. A helmet-to-helmet hit resulted in my brother Christian’s third concussion, ending his high school football career at the ripe old age of 15. The following year, a fourth concussion from a rowing accident rendered him nearly bedridden.
While the severity of Christian’s post-concussion syndrome is rare, according to the U.S. Centers for Disease Control and Prevention, about 283,000 children in the U.S. visit the emergency room each year with traumatic brain injuries (TBIs)—including concussions.
“There’s no concussion pill,” says Dr. Julian Bailes, the Chairman of the Department of Neurosurgery and Co-Director of the NorthShore Neurological Institute. The doctor, portrayed by Alec Baldwin in the 2015 movie “Concussion,”, explains there is no quick route to healing this kind of injury. Recognizing symptoms and understanding treatment options can help prevent further injury to the already inflamed brain.
Symptoms of a Concussion
Whether your child receives a severe hit or slight bump to the head, symptoms of a concussion should not be ignored.
“Anytime I have an inkling a player may have a concussion, I have the parents come over — I don’t wait,” says John Trkla, head coach of the School of St. Mary football team. “I have [injured players] follow my finger with their eyes and ask them simple questions such as ‘What month comes after March?’”
Dr. Danielle Bass of the Endeavor Health Medical Group, who specializes in Family and Sports medicine, notes that symptoms fall under four different categories:
- Physical (headache, nausea, dizziness, light/noise sensitivity)
- Cognitive (feeling “foggy,” memory issues, concentration difficulties)
- Emotional (increased irritability, anxiety, sadness)
- Sleep (drowsiness/fatigue, sleeping more or less than usual, difficulty falling asleep)
Bass said it’s essential for adults to watch and listen closely to children following an injury because not all symptoms are easily seen, and children, depending on their age, sometimes have a hard time expressing what they are feeling with specific symptoms.
“They know something isn’t right but may be unable to verbalize it,” Bass explained. “It might be something as simple as them saying, ‘I feel funny.'”
Risks of Having a Concussion
Contrary to popular belief, concussions are not solely caused by blows to the head. Any action that causes the head to snap back violently (the jerking of the neck from a forceful tackle) can likewise cause the brain to slide violently back and forth against the inside of the skull. That sliding motion may damage brain cells and cause chemical changes in the brain.
“Most concussions are mild, which means they resolve within a week,” notes Bailes. However, with more severe concussions, the symptoms displayed in the short term may turn into chronic problems.
These longer-term symptoms used to be known as post-concussion syndrome. These days, medical experts are taking a different stance on the issue.
“We say now that they have persistent post-concussion symptoms,” said Jacqueline Turner MSN, APN, FNP-BC, an advanced practice nurse with the Ann & Robert H. Lurie Children’s Hospital of Chicago’s Division of Orthopaedic Surgery and Sports Medicine. “We’re looking at a timeline of about two weeks for adults and four weeks for kids.”
Turner said that about 30% of children take longer than the expected seven days to recover, and researchers are investigating why some patients have slower recovery times.
A Shift In Concussion Recovery Timeline
As more research happens about the effects of concussions on children, the accepted concussion recovery timeline continues to change. In recent years, experts have moved away from keeping children on bed rest for extended periods in favor of a slow progression back into activity.
“We [now] know that physical activity and getting their heart rate up is beneficial for recovery,” Turner said. “An early re-introduction into activity is a huge factor.”
A recent University of Pittsburgh study indicated that prolonged rest may hurt concussion patients’ recovery. Despite this new information, Turner states that a child’s return to activity must be gradual.
“We say give yourself a couple of days to take it easy and then re-introduce your body to everyday life. Maybe start going back to school. Then, introduce light aerobic activity within that first week, if the child can tolerate it.”
Youth Sports Concussion Safety Act Changes the Game
While getting a post-concussion child back into activity is advised, pushing a player to return to school or a sport too soon can lengthen his or her recovery time. For years, a lack of cohesive guidelines meant some children may have rushed back into full-contact activity or been encouraged to play by coaches or other advisors.
In 2015, the Lurie Children’s Memorial Hospital Sports Medicine Team, including Kelly Trainor, APRN, worked closely with Senator Kwame Raoul to create the Youth Concussion Safety Act, which rewrote Illinois legislation to provide specific guidelines to keep children safe.
“The new legislation requires Return to Learn and Return to Play protocols to be implemented in all Illinois schools,” explains Trainor. “This is beneficial because it will allow for a safer return to activity guidelines, keeping children with active concussions from returning to sports or schoolwork too soon.”
Chicago Public Schools Office of Sports Administration spokesman Jerry Gelman said the district works with numerous partners to support student athletes’ health and safety.
“Chicago Public Schools (CPS) takes concussion prevention, symptom management and student-athlete safety very seriously,” Gelman said in an email statement. “The District currently requires all coaches and athletic directors to take concussion management courses every two years following state regulations and also has all schools adhere to the CPS Concussion Management Guidelines, found in official District Policy.”
While regulations cannot guarantee concussion prevention for children, the continuing growth in accepted practices and new information about concussion recovery should give parents more peace of mind when sending their children onto the playing field or playground—both pre- and post-concussion injury.
How To Help
Many organizations work to help minimize concussion injuries through education and providing support for innovative equipment to protect children and adults on and off the playing field. Learn more about these programs and help support them by visiting the links below:
- Concussion Legacy Foundation
- Concussion Alliance
- The Center Foundation
- Brain Injury Association of America
- Chuck Noll Foundation For Brain Injury Research
This story was updated on Aug. 13, 2024 with additional reporting by Marie Rossiter.
