Monday, April 23, 2012

Concussions and the Return-to-Play Roadmap

Concussions are rampant in youth sports today, and appropriate treatment often goes by the wayside. Why? Kids want to stay in the game and often neglect to mention or downplay symptoms.

Disclaimer:  I'm not a medical expert in this area, so please seek professional medical attention if you suspect your child has a concussion.

Our son Cameron suffered a concussion during a hockey game a few months ago. Yes, he took a direct hit to the head. But his symptoms were minor and he stayed in the game. The coach noticed he was mentally responding a tad slower than usual so he limited his playing time.

After removing his helmet at the end of the game, Cameron said that he immediately had a headache and was nauseous.

Later in the evening, Cameron's headache symptoms progressed by the hour. In the morning, the headache persisted and he mentioned that he couldn't concentrate. Ed and I both noticed his focus seemed off.

Mistake #1:  We assumed he was getting a virus and was trying to get out of going to school. Wrong. He was really in true pain with a pounding headache. At a doctor visit later in the day, the doc verified that Cameron had a concussion.

The doctor analyzed the symptoms and administered an Impact test (cognitive baseline test), comparing the results to the test Cameron had taken before the season began.

We (Ed and I) quickly learned that sending Cameron to school was a big no-no. To heal the brain, it is best to rest. That means flat out no concentrating, no focusing, no watching TV and no playing video games.

What the heck? In my day, if your head hurt, you sucked it up. Ed likely had numerous concussions (what hockey player hasn't taken a hit to the head?), yet he never took a day off. Staying out of the game and out of school seemed insane to us.

Times have changed. I can understand why. Cameron was unable to focus. I noticed this immediately upon seeing his schoolwork scores drop in one day. He couldn't answer simple questions with a normal response.

Mistake #2:  We ignored minor symptoms which appeared after Cameron had been cleared by the doctor and returned to practice. Although he had minor headache after returning to physical activities, we allowed Cameron to play in a game (without a re-check by the doctor). The result was a second concussion approximately three weeks after the first.

He barely got hit in the head, yet full-blown concussion symptoms returned later that evening following the game. This time he even appeared much worse as I could see the pain in face. His eyes were half open and his face was definitely flush. He went to watch another hockey game that even and several people noticed that he didn't look well.

So I now emphasis to all parents (and to myself) follow the appropriate return-to-play guidelines. If your child returns too soon after a concussion, there is a higher risk of a second concussion. To see recommended return-to-play guidelines, go to this link.

The most important (and probably the most neglected) guideline is to return to the previous step if any concussion symptoms occur. I beg you to pay attention to this advice.

With a second concussion, Cameron remained out of physical activity for nearly a month. He still has not returned to competitive play two months later. I plan on holding him out as long as possible since the hockey season is now over.

Fortunately his symptoms have not returned. Fingers crossed that his brain heals well enough (and is strong enough) to safely return to the game in time for next season's tryouts (in late May). We will definitely have the doctor preform a re-check shortly before he returns to game play. I pray that we avoid mistake #3.