Concussion:
I don’t think there has been any injury topic that has generated as much media attention, research and concern as concussions. And rightfully so, since we are talking about something that at the very least impacts one’s ability to function on a daily basis and in some cases may be a life or death situation. We have made tremendous progress in understanding what a concussion is and how to best manage it. During my career, there is no other injury where the evaluation and management has changed so dramatically. And that is good news! Although we associate concussion with collision sports like football, rugby and ice hockey; it is important to understand that the risk exists in any sport.
If the force is sufficient enough a concussion will occur. So, here are some things to be aware of: 1. If a child has sustained a forceful blow to the skull, suspect a concussion. 2. Concussion symptoms may vary per individual and need not all be present for a concussion to be present. 3. Younger children are more at risk and typically require longer to recover. 4. A person who has had a concussion is much more likely to have another. Some researchers state as much as 4x more likely when compared to someone who has never had one. This can be very important information when determining a return to play or even whether to continue playing a sport. 5. Proper fitting helmets are essential for concussion prevention. 6. Proper technique and good neck strength are both important factors involved in absorbing and delivering a blow in contact sports and preventing concussion injuries.
WHAT TO LOOK FOR: As a parent, you know your child better than anyone and are the most important person in managing their care. Successful concussion care requires constant symptom monitoring. Much to your child’s dismay, you will need to nag them even more than usual! Any change in the intensity or nature of a symptom or the presence or disappearance of a symptom is important to know. There is no substitute for appropriate medical care for a concussion but you have an important role to play.
Here are some things you will want to monitor: – -Headache: This is usually the first symptom to appear and the last to disappear. To help improve objectivity when evaluating a headache; ask your child to score the headache on a 10 point scale for you. 0 (none) and 10 (most severe). Don’t ask if they have a headache. Ask, How bad is your headache and ask them to score it.
-Dizziness: This may be observable if severe or you may need to ask them. A simple at home test would be: 1. Have them stand with their feet shoulder width apart and close their eyes. Observe them closely and see if you notice any swaying and/or balance corrections. -Nausea/Vomiting – Ringing in the ears (Tinnitus) – Increased irritability and/or personality changes. Again, you know your child better than anyone and are best suited to notice this. -Increased fatigue -Vision changes such as blurred vision and/or sensitivity to light. -Cognitive Changes. You can perform these at home as well.: 1. Count backwards from 100 by 3’s ( I will usually have them stop at 79 if they have answered correctly to that point). 2. Say the months of the year backward beginning with January. 3. Provide a list of 3 words to your child. Ask them to repeat them back to you. Ask them again 5 minutes later.
*The presence of any of the symptoms presented above can be sufficient for a concussion diagnosis. It is always best to be conservative when managing head injuries, so a medical evaluation is recommended. You are an important part of the care team and will be critical in providing observation and necessary information to the medical team.