National Youth Sports Week spurs concussion conversation with Beacon Sports Medicine pros

Beacon Director of Sports Medicine Fellowship Dr. Linda Mansfield and Washington High School Athletic Trainer Kendra Weber, MS, LAT, ATC, share their experience and expertise in diagnosing and treating concussions in youth athletes as part of National Youth Sports Week October 24–29.

Q: For which sports do you see the most concussions?

A: Dr. Mansfield: Football, soccer, hockey and wrestling — basically anything with high contact, though we do see them occasionally in other sports, too. We’ve had swimmers swim into walls, golfers hit by clubs/balls and cross-country runners run into trees. We do, however, see more team sports players than individual ones.

A: Weber: Football is probably the highest, but I’d say the top four are football, basketball, wrestling and soccer. We do see them in baseball and softball, and we’ve seen them in cases of cheerleaders falling down or being dropped. Any time there is a potential for contact there is a risk of concussion, even if it’s a small one.

Q: What are some of the most common concussion symptoms?

A: Dr. Mansfield: Everybody thinks of the physical symptoms like headache, dizziness, nausea and sensitivity to light and noise, but there are also cognitive symptoms like loss of memory or difficulty concentrating. There are also emotional symptoms, such as irritability, or situations where an athlete might be uncontrollably laughing or crying in a situation that doesn’t warrant it.

A: Weber: Headache is the number one symptom athletic trainers see. Sensitivity to light and sound is also a big symptom among high school kids. Since we know most of our student-athletes, we keep an eye out for an unusual change in attitude or demeanor. A laid back or low-key kid might become anxious, or a super happy-go-lucky kid might become grouchy.

Q: Do you ever run into any problems when making a diagnosis?

Dr. Mansfield: Concussions are a bit tricky to diagnose because the symptoms sometimes don’t show up right away. We take into consideration what the injury was, what symptoms they are having, and then we do an initial exam. We look for eye tracking and balance deficits. Oftentimes, we will re-examine them after 20 minutes to either clear them to play or place them in concussion protocol.

Weber: Kids occasionally lie to you because they don’t want to get pulled out of a sport. A lot of symptoms are very hard to test objectively. Beacon athletic trainers do an excellent job teaching kids concussions are serious and not worth risking an entire season and beyond, so we can often rely on both the individual’s word or other athletes who notice one of their teammates acting irregularly. We’ve educated the teams enough that teammates often become more comfortable reporting when a teammate is acting funny because they’ve started to realize that concussions can be major injuries that aren’t worth risking a season (or beyond) for.

Q: Do delayed symptoms ever occur?

Dr. Mansfield: Sometimes symptoms can show up several hours later. They might have dizziness, or be overly emotional or might have sleep disturbances where they are sleeping too much or too little. They might experience nausea. Occasionally delayed symptoms are actual symptoms that were previously missed somehow.

Weber: Some kids may come back a day or two later with a headache or a change in personality. Some kids might be treated for a different injury such as a neck or shoulder injury that draws focus away from a possible concussion. It is best for everyone to keep an eye on any injured athlete for signs of a concussion, just to be on the safe side.

Q: When should a parent seek immediate medical treatment for their child?

Dr. Mansfield: If they are having a persistent headache in the context of other symptoms they should be evaluated. Not all concussions require immediate medical treatment. That said, if you as a parent have any concerns, it is better to be safe than sorry.

Weber: If I tell a parent I think your child has a concussion, I advise them to look for extreme conditions such as complaining about a worsening headache, vomiting or a severe change in personality. If any of these things occur, they need to seek immediate medical attention.

Q: How is a concussion treated once it has been diagnosed?

Dr. Mansfield: We shut the kids down from any kind of sport or activity and keep screen time and cell phone use to a minimum. We often recommend restrictions on test taking, allowing extended time for assignments to allow the student to work at a slower pace allowing for frequent breaks when doing cognitive activities. Based on recent studies, we encourage light activity such as short five- to ten-minute walks to help the healing process.

Weber: Rest both physically and mentally. Avoid screen time. The more kids can mentally and physically rest, the faster the brain can heal. Every kid heals differently and it takes a varied time for different people. They have to return slowly. Once they are symptom-free, we ease them back into activity in accordance with Beacon’s Return to Play protocol.

Q: What are some good resources for both parents and athletes to find information on concussion symptoms and treatment?

Dr. Mansfield: The CDC has a program called Head’s Up that has a wealth of information. Go to https://www.cdc.gov/headsup/ for more details.

Weber: The Indiana High School Athletic Association has a webpage devoted to concussions as well as other sports injuries. You can find it at https://www.ihsaa.org/resources/health-well-being.

Q: Any other advice for parents and guardians about concussions?

Weber: Our Beacon doctors are very good at giving academic concessions to allow a child’s brain to rest. It helps to take the mental stress off kids, makes it easier for them to rest and lets teachers know this is a legitimate injury. Resting the mind is just as important to recovery as resting the body.

Dr. Mansfield: Not all concussions are a result of direct contact. Any time the brain shakes due to high velocity force there is a potential for injury. My message to parents is, “This is your child’s brain. Don’t take chances. If you have any concerns, get them evaluated by a medical professional.”