What is a concussion?

A concussion is a type of traumatic brain injury caused by a hit to the head or a rapid jarring motion of the head. There may or may not be a loss of consciousness. In every concussion there is a change in the way the brain works for a period of time following the injury. In most concussions, x-rays or scans of the brain appear normal.

How can I recognize a concussion in my child?

If your child had a forceful blow or jarring of the head AND there is a change in your child’s behavior, thinking, or physical performance, then he or she might have a concussion.

What are the common symptoms of a concussion?

A person with a concussion might complain of headaches, dizziness, nausea, confusion, slowed or foggy thinking, changes in vision, sensitivity to noise and/or light, forgetfulness, concentration problems, or feeling sad or not like himself. That same person might look dazed or confused, seem forgetful or lost, appear unbalanced or clumsy, have a hard time following directions, or seem emotional. There may be amnesia to events preceding or following the blow to the head. Sometimes these symptoms are not immediate and can develop hours or even days after the injury.

What should I do if I think my child might have a concussion?

  1. When in doubt, sit him/her out! Your child has only one brain, and sitting out from play can prevent even more serious injury.
  2. Seek evaluation by a health care professional experienced in concussion evaluation.
  3. If there is a prolonged loss of consciousness (>30 seconds), rapidly worsening headaches, seizures, recurrent vomiting, loss of the ability to move or speak, complaint of numbness, excessive sleepiness, slurred speech, inability to answer simple questions (e.g. where are you? who am I?), rapidly increasing irritability, or neck pain, your child needs to be evaluated in an emergency room.

Can concussions be prevented?

Concussions can happen in almost any sport or recreational activity. There are measures that can be taken to reduce the incidence of concussions and their severity. Teach and practice safe playing techniques. Encourage athletes to follow the rules of play and to exhibit good sportsmanship. Ensure that safety gear fits properly and is used regularly. Make sure your child knows that it is not NOT OK to play injured. The risk of re-injury is higher when playing with a concussion and the severity of repeat concussions is.

Is it OK for my child to strength train or lift weights?

Children can safely participate in strength training as early as they can successfully participate in organized sports. At an early age, strength training can be as simple as doing calisthenics. A child should show interest in doing the activity, exhibit the ability to follow directions, and demonstrate that he or she can do the activity properly. As your child matures he or she will be able to demonstrate mastery of certain exercises without resistance. When techniques are mastered, children can start adding resistance activities into their routines. Initially resistance should be just body weight, followed by resistance bands and then, finally, weights.

What is a safe strength training regimen for my child?

Children should never strive to lift their “max” or to “max out.” A child should be able to lift a weight with proper technique 8-15 times; if he or she cannot do this, then the weight is too heavy. Children should always be supervised when doing resistance training to ensure that techniques are always done properly. The ratio of instructors to children should never be less than 1:10. Instructors should have strength training certification and experience working with children. Children should warm up prior to strength training with 5-10 minutes of aerobic activity and cool down with lower intensity activity and stretching. Children should not exceed more than three strength training sessions in a week, and there should be adequate rest and recovery between the sessions.

What is an overuse injury?

It is an injury to bones or soft tissues like muscles, ligaments, and tendons from repeated activity without adequate rest and recovery time. Pain is the most common symptom of overuse injury. Often times the pain starts only after play, but over time, the pain becomes more persistent and even can impair activities not related to sports.

Should I be concerned about overuse injuries in my child, I thought this was more of a problem for middle aged adults?

Children and adolescents are at increased risk of overuse injuries because growing bones are more prone to stress injuries. Children tend to be less aware that the symptoms which they are feeling are from overuse. Children can feel pressure either from themselves, their teammates, their coaches or their parents to continue an activity even if they are in pain.

Can overuse injuries be prevented?

Be sure your pediatrician is aware of activities in which your child participates. Certain injuries are more common with certain activities (e.g. shoulder problems in swimmers, shin splints in runners, heel pain in soccer players, back injuries in gymnasts, etc..) If your doctor is aware that your child participates in an activity he or she can discuss ways to prevent injury with you. As a general rule, children should be allowed time to increase their strength and conditioning prior to the onset of any sport’s season. Children typically can increase their activity by about 10% per week safely. Cross training has been shown to decrease the incidence of overuse injuries and actually improve sport specific performance. For children under the age of 10 years, three months off per year from any given sport is encouraged. Children should take at least one day off per week from any intense sport. Overspecialization in one
sport prior to puberty can lead to injury and burnout.

Will my child make the NBA? NFL? Olympics? Get a full ride?

Well, maybe. In reality, most young people do not go on to be at the top level of any given sport. As parents we should be promoting well rounded athletes who can enjoy a long lifetime of regular physical activity.

What is heat stroke?

Heat related illnesses increase in severity from heat cramps to heat exhaustion to heat stroke, which is the most serious. Heatstroke is a potentially deadly condition in which the brain’s thermostat malfunctions. Body heat can rise over 105 degrees Fahrenheit within minutes. The problem is then compounded by a loss of the ability to perspire. The symptoms of heatstroke are temperature over 103; red, hot, dry skin; rapid, strong heartbeat; throbbing headache; nausea; dizziness; confusion; loss of consciousness.

What is heat stroke?

  1. Have someone call 911 and then take immediate action to cool the victim
  2. Move the victim to the shade or into air conditioning
  3. Remove the victim’s clothing
  4. Get cool water on the skin especially in the armpits and groin
  5. Aim a fan or air conditioning at the victim
  6. Do not put anything in the victim’s mouth because he may choke or aspirate

What are heat cramps?

Heat cramps are muscle spasms that arise from strenuous activity that causes profuse sweating. If you suspect heat cramps, get the patient into a cool environment, replenish fluids and electrolytes with water and sport drinks, massage the muscles that hurt, rest for several hours even if feeling better. If these measures do not stop the cramps seek medical attention.

Heat exhaustion sounds a lot like heat stroke, what’s the difference?

Heat exhaustion can progress to heat stroke. If the victim’s temperatures rise above 103, heat stroke should be suspected and appropriate measures taken. For heat exhaustion, cooling the victim and replacing fluids and electrolytes is the key to preventing heat stroke. If the victim starts feeling worse instead of better, he or she should be taken to the emergency room.

How can I prevent heat related illness in my athletic child?

  1. Never leave your child unattended in a car, even for a short period of time.
  2. Advocate for sports practices in the early morning or later in the day. Avoid the mid-day heat if possible. Coaches and leagues should assess the safety to play on any given day.
  3. Children can take 10-14 days to acclimate to exercising in the heat, so gradually increasing the amount of exercise done in the heat over several weeks can decrease the incidence of heat related illnesses.
  4. Make sure your child is hydrating well. This means hydrating several hours prior to activity with 8-16 oz of water and continuation of hydration during practice and after play. A child should drink 4-8 oz of water every 15-20 minutes of play. Your child should weigh the same before and after exercise.

What should my child drink?

Water is the ideal hydration solution. Too much sugar in fluids can actually make heat related illnesses more likely. If your child has been exercising for more than an hour in the heat, he or she will require replacement of electrolytes with sports drinks (ideally consume 2-3 portions of water for every 1 portion of sport drink when exertion time exceeds one hour). Caffeine can contribute to heat related illnesses. Energy drinks are strongly discouraged for all children at all ages. Carbonated beverages are not ideal hydration solutions.