Concussions: A Parent’s Guide

1. Concussions:A Parent’s Guide

2. Concussion Myths – True or False • Having Multiple Concussions is common in sports & no cause for concern. • If there is no visible injury, everything is okay. • You should play through pain. “Get back in the game!” • A symptomatic athlete may return to play as long as the symptoms are “mild”. • A concussed athlete should be awakened every hour. • All concussion grading scales are the same. • May return to play as soon as the symptoms resolve.

3. Definition • Type of traumatic brain injury (TBI) • Caused by: • - Bump, blow or jolt to the head • - Hit to the body causing the head & • brain to move rapidly back & forth • Stretching & damage to brain cells •  • Creates chemical change in brain •  • Disrupts how the brain works • IT’S NOT A BRUISE TO THE BRAIN!

4. Definition • Occurs in any sports or recreational activity • All are serious because it is a brain injury • Loss of consciousness (LOC) – • may or may not happen • for most it does NOT happen • only occurs 10% of the time

5. Concussion Signs and Symptoms • Cognitive • Feeling mentally foggy • Feeling slowed down • Difficulty concentrating • Difficulty remembering • Difficulty focusing • Emotional • Irritability • Sadness • Nervousness • More emotional than usual • Physical • Headache • Dizziness • Balance problems • Nausea/vomiting • Fatigue • Sensitivity to light and/or noise • Sleep • Trouble falling asleep • Sleeping more than usual • Sleeping less than usual

6. Concussion Signs and Symptoms • Signs Observed by Parent: • - Appears dazed or stunned • - Is confused about assignments or position • - Forgets an instruction • - Is unsure of game, score or opponent • - Moves clumsily • - Answers questions slowly • - Loss of consciousness (even briefly) • - Shows mood, behavior, or personality changes • - Can’t recall events prior to hit or fall • - Can’t recall events after hit or fall

7. Concussion Signs and Symptoms • Symptoms Reported by Athlete to Parent • - Headache or “pressure” in the head • - Nausea or vomiting • - Balance problems or dizziness • - Double or blurry vision • - Sensitivity to light • - Sensitivity to noise • - Feeling sluggish, hazy, foggy, or groggy • - Concentration or memory problems • - Confusion • - Just not “feeling right” or “feeling down”

8. Concussion Signs and Symptoms • May develop immediately or up to 48 hours after the injury • Don’t ignore any signs and symptoms regardless of how minor they appear putting a child’s health at risk

9. Concussion Signs and Symptoms • How long does a concussion last? • - Individualized for each athlete • - Adults: on average 5 to 10 days • - Adolescents/Children: on average 2 to 3 weeks • Why longer in Adolescents and Children? • Brain is still developing • Athletes will recover fully and quickly if managed properly. • More serious concussions and/or multiple concussions can require longer recovery.

10. Management • When does an athlete require IMMEDIATE medical attention? • - Any loss of consciousness (regardless of how brief) • - Severe or  headache • - Unequal pupils • - Unusual  drowsiness • - Projectile or repeated vomiting • - Personality changes • - Numbness in face or extremities • - Double vision • - Convulsions • - Bleeding/clear fluid from the ear/nose • - Unusual stiffness in the neck area • - Weakness in either arm(s)/leg(s)

11. Management • What do I do as a parent? • Remove your child immediately from sport/activity if you suspect a concussion and DO NOT allow them to return to activity on the same date. • Must be evaluated by a medical professional (physician or athletic trainer) before can return to sport/activity. Make sure you have a note from a physician. • Do not allow your child to return to sport/activity if they continue to have or complain of concussion symptoms. • When your child is ready to return, have him/her participate in a gradual progression back to activity

12. Management • Once cleared by a medical professional, the athlete will complete a gradual return to play progression. • - Return to play/activity progression consist of 6 stages with at least a 24 hour period between stages. • - The athlete must complete each stage with no concussion symptoms before, during and after before moving to the next stage. • - If the athlete begins to have symptoms during or after a stage, they must stop the activity for the day and rest until the symptoms resolve. • - The intensity of each step will increase.

13. Management – Return to Play Progression • Return to Play Progression: • Stage 1: Symptom-Limited Activity • Stage 2: Light Aerobic Activity • Stage 3: Sports Specific Exercises • Stage 4: Heavy Non- Contact Activity • Stage 5: Full Contact Practice • Stage 6: Return to Competition

14. Management – Return to Play Progression • Stage 1: Symptom-Limited Activities • Daily Activities that do not provoke symptoms • Gradual reintroduction to work/school activities • Physical Rest • Mental rest • Limit exposure to light and noise – use sunglasses, avoid parties, concerts, etc. • For pain/headache relief – use Tylenol (avoid NSAIDS – ibuprofen, Advil, Aleve, Motrin for the first 48-72 hours) and/or ice packs on head/neck.

15. Management – Return to Play Progression • Stage 2: Light Aerobic Activity • 10 to 20 minutes of walking, swimming, or stationary bike • No weight lifting, jumping or hard running

16. Management – Return to Play Progression • Stage 3: Sports Specific Exercises • Increase athlete’s heart rate and incorporate limited body or head movement • Moderate running or brief running or skating drills • Adding movement to running or skating • Non-head impact activities

17. Management – Return to Play Progression • Stage 4: Heavy non-contact Activity • Sprinting/running • Regular weightlifting routine • Non-contact sport specific drills (running passing routes, hitting baseball/softball off a tee, shooting drills)

18. Management – Return to Play Progression • Stage 5: Full Contact Practice • Reintegrate into practice sessions • Including full contact activities if appropriate for the sport.

19. Management – Return to Play Progression • Stage 6: Return to competition • - Athlete should complete the 5 previous stages before returning to a game/competition. • - If they have not completed a full practice in stage 5 before the game, they should not return to a game (i.e. a game cannot be substituted for stage 5)

20. Second Impact Syndrome • Phenomenon seen in athletes 21 years old or younger • Return to play with concussion symptoms • Suffers a second (often minor) hit to the head • Brain loses the ability to regulate pressure • Brain herniates within minutes • Results in permanent disability or death • Mortality = 50%, Morbidity = 100% • Preston Plevretes – E60 • http://espn.go.com/video/clip?id=5163151

21. Prevention of Concussions • Encourage athletes to report their own concussion symptoms or if they think a teammate may have a concussion or is not acting right. • Use Proper Equipment • - Worn and Fit Properly • - Worn for every game and practice • Teach proper sports technique • (i.e. – tackling technique) • Encourage good sportsmanship at all times

22. Questions??? • Thank You!