The new school year is here, and for many parents, that means it’s time to sign kids up for fall sports. But before your child hits the field, you may want to think about their risk of getting a concussion and what to do if they get one.
“You have to think about ‘how do I integrate my concern with my child’s health with concern for my child’s social network, physical development and learning to play on a team?’” said Thomas McAllister, MD, chair of the Indiana University School of Medicine Department of Psychiatry. Dr. McAllister has studied traumatic brain injury for decades and has focused on sport-related concussion as a form of mild traumatic brain injury for about 10 years.
A concussion is caused by some kind of physical force, such as a hit or impact on the brain, that results in a temporary disruption of brain or neurological function. It can cause someone to be confused, lose balance, experience nausea or other symptoms. If someone gets multiple concussions over time or does not allow enough time to recover from a concussion, there could be major damage done to the brain.
How likely is my child to get a concussion?
“As we move from limited contact sports, such as golf, to incidental contact sports, like baseball or softball, to full contact sports, such as football or soccer, we know that your risk of concussion goes up,” said Dr. McAllister. “That makes sense, because the more likely you are to hit your head, the more likely you are to hit it in the way that is likely to produce a concussion.”
Another factor to consider is your child’s age and development. Younger children may be playing contact sports that limit collisions through rules like banning tackling in football or checking in hockey until a certain age. Dr. McAllister says rules like that can lower younger children’s risk of getting a concussion without hurting their athletic development. He also suggests thinking about the other kids on the team or in the league.
“Kids develop at such different rates and around middle school you can have kids who are developmentally a lot bigger and stronger than other kids,” said Dr. McAllister. “I think parents should ask ‘is my child really playing in a league that makes sense for his or her physical development?’ It’s hard for parents to make that call and it’s hard for kids to hear that, but I think that’s the fact of the matter, because as a general rule, the bigger people are, the harder they’re hitting, and therefore the greater the risk.”
How do I know if my child has a concussion?
“If you’re watching from the sideline, they may appear to stumble or have trouble with their balance,” said Dr. McAllister. “Coaches and teammates may notice they are not following instructions as well as they should be, asking repetitive questions in a way that is unusual for them or they may end up on the wrong side of the field.”
Some children may also become more irritable or tearful or experience nausea or vomiting. The tricky part is that sometimes none of these symptoms will appear until hours later.
“There are some people who may play an entire half of a game and appear to be okay, but they don’t remember the game, the score or even who won,” said Dr. McAllister.
“When in doubt, sit them out.”
If you think your child may have a concussion or is showing some of these symptoms, Dr. McAllister says it’s best to be cautious and take them out of the game.
“Concussion can be caused by one really big impact or sometimes it’s the summation of several medium-sized impacts,” said Dr. McAllister. “Just because there is not a fall or big collision of some sort doesn’t mean the person didn’t have a concussion. It remains a clinical diagnosis and when in doubt, sit them out.”
Dr. McAllister says he also advises making sure coaches and parent volunteers are familiar with concussion symptoms and protocols to keep kids safe.
How serious is it?
Dr. McAllister says if a child does get a concussion, they will most likely recover just fine. Many people experience a concussion in life and do not experience any major brain damage, but he also says if symptoms don’t get better within a few hours, it is a good idea to see a doctor.
The bigger concern is when someone has multiple concussions over time, which can lead to chronic traumatic encephalopathy, or CTE, later in life. CTE is a degenerative brain disease that has been found in athletes, military veterans and others with a history of repetitive brain trauma. Researchers are conducting studies to better understand the development, progression, risk factors and diagnosis of this condition. In addition, Dr. McAllister is co-leading the Concussion Assessment, Research and Education (CARE) Consortium. They’re following thousands of college athletes and military service academy cadets across the country over time to learn more about the natural history of concussion and mild traumatic brain injury.
“Don’t be overly cautious.”
Despite all these factors, Dr. McAllister says his biggest piece of advice is don’t worry too much.
“I think it is appropriate to be concerned and it’s appropriate to say, ‘Okay, well how many concussions has my son or daughter had and is it taking less to cause them, are the symptoms lasting longer or are they not recovering completely?’” said Dr. McAllister. “Those are signs that it’s time to rethink your ongoing exposure.”
If your child has not had repeated concussions and you’re wondering whether to let your child play a particular sport, Dr. McAllister says the bottom line is to weigh the risks and benefits, be vigilant and simply use common sense.
“Yes, it can be a risk, but there’s also a risk to biking and a risk to running,” said Dr. McAllister. “Sports in general are fantastic, and I wouldn’t reject contact collision sports out of hand. I think the idea is to just make sure you’re monitoring the children’s health, just like in any other activity.”
Learn more about traumatic brain injury research and education at IU School of Medicine.
