Concussion – in a game situation

I make no secret that I think there is too great an emphasis placed on kids’ sports.  While I do think children are over scheduled, my criticism is strictly self-serving.  I resent having to keep track of all the practices and I often resent having to go to the games because, quite frankly, the skill level is pretty poor.   I spend enough time with my 5 year old to know what she looks like kicking a ball in the wrong direction.  Why do I have to subject myself to it every weekend?  When the level of play improves, I’ll be there with flying colors.  After all, I love going to a Red Bulls or Yankee game.  Today, though, I realized a benefit of getting your child involved in a competitive sport.  I never played a sport growing up – I know, you are shocked.  I mentioned last week that I started to go to Rise Fitness, where Satan – I mean, Rob, constantly encourages us to work harder, be stronger, be better.  I will blame my lack of athletic experience for the fact that this just makes me giggle.  I have zero competitive spirit but looking around the room, the people that do, look damn good.

Back to concussions.  Today is the important day because, as I said yesterday, it is critical that an injury to the brain is recognized.  Often in a game situation, with adrenaline pumping, parents screaming and balls flying, it is hard to take the time to really assess an injury to the head.

1.  What happens?  A player receives a blow to the head from direct contact with the ground or from interaction with another player.  Hopefully, play stops, but sometimes it doesn’t and the game continues.  It is incumbent upon the adults on the field to take the time to assess the severity of the injury.  Whether time out is called or they pull the player to the sidelines depends on all those rules that I don’t understand.

2.  Loss of consciousness.  Only 10% of concussions result in loss of consciousness.  These should be the easy ones, because the player should be immediately taken to the hospital for further evaluation.  There are some sources that will argue that brief loss of consciousness does not require hospital evaluation, but when it comes to children, losing consciousness, for even a couple of seconds, should buy them a trip to the ER.  It can be tricky to figure out if the player did lose consciousness because he or she may not know.  It is then necessary to rely on reports from those players who had the best view of the injury.

3.  No loss of consciousness.  Once the player can be safely moved, he or she should be brought to the sidelines for further evaluation.  If the athlete reports dizziness, headache, blurred vision and/or nausea, it is safe to say that he or she has suffered a concussion.  It is important to assess the short-term memory.  Questions such as, “What day is it?”, “Who is the opponent?”, “Who did we play last week?”, “What is the score?” are all useful.  Of course, if the players who are young, may have no idea what team they are on even on a good day.

4.  Re-assessment – The player should be re-assessed frequently to determine if any symptoms develop or worsen.

5.  A head injury is especially dangerous because the very symptom that is hailing damage to the brain, may be that the player is claiming that he or she is fine.  Confusion from a concussion is common and it presents its own risk.  If a player says that she feels well, she still needs to be evaluated.  Not only might her commitment to the sport make her want to get back on the field prematurely, the effects of the concussion may seriously cloud her judgement.  In addition to risking further brain injury, a confused, disoriented player is at increased risk for all types of injury.

How important is it that an athlete continues to play?  This is the question that must be asked.  I can imagine no situation where damage to a child’s or a teen’s brain is less important than a potential victory.  As I said, I am not an athlete, so it is possible that I just don’t get it.  You can take it or leave it, but my advice is that coaches and team administrators take head injury very seriously.  There should be a protocol in place — no matter how good the player or how important the game.  It is easy to imagine the situation where the star player is sent back in because the competitive “spirit” is high.  This is dangerous, short-sighted and, quite frankly, a little sad.  Grown-ups, let’s get our heads in the game and keep our eye on the ball.

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