Baltimore's Child Baltimore's Child
Participating in sports has obvious benefits for children, including making friends, building self-esteem and learning about teamwork and good sportsmanship.
However, youth sports involves some risk, including the potential for brain injuries. Some of the most common ones area doctors see include concussions and whiplash. Learn more about the potential for injuries in children during this month of March, Brain Injury Awareness Month.
Recognize potential sources for injuries
“Some parents, coaches and athletes think that you have to actually be hit on the head to get a head injury. Actually, it could be any type of whiplash movement,” says Dr. Karen Laugel, medical director for HeadFirst Sports Injury and Concussion Care, a program recently acquired by MedStar Health.
Kids could have a body collision on the field, but other sports could result in injuries. For example, children may fall off an apparatus in gymnastics or hit the boards hard in hockey, which could lead to a jarring of the neck and head.
Laugel notes that parents, coaches and athletes need to be familiar with the signs of a brain injury, such as headaches, mental fogginess, vision problems and being off balance. “Those signs are huge flags to stop playing and come off of the field or court and be evaluated,” she says. “We see that many athletes play through those symptoms. They weren’t hit in the head, so they don’t think they are significant. Even if they were hit in the head and get those symptoms, they still don’t realize the significance of them.”
While on the field, a coach or other adult can ask an injured player questions such as “what field are we on? What team are we playing? What was the last score?” A child’s answers may help determine whether the athlete is having an immediate problem.
A CAT scan and MRI will not be able to diagnosis the presence or absence of a concussion injury. “They will tell you whether or not you have a bleed or fracture,” Laugel says. “They do not pick up the microscopic changes that indicate a concussion injury.”
Eye movements, balance and cognition are the three areas that help doctors to identify a concussion injury. “You are watching how the eyes track, how they focus, how close they can see an object and whether (the athletes) can keep their eyes on a target as they move their heads,” she says. “You are looking at their neurological exam to make sure the right and left sides of the body are functioning symmetrically.”
Doctors want children to wear appropriate safety gear such as helmets and safety goggles, but these items will not fully prevent injuries. “The helmet will decrease the severity by decreasing the chance of fracture or bleeding, but it does not decrease your chance of concussion injury,” Laugel says. “We still encourage kids to wear them … but it is really misleading to think that if you buy a very expensive helmet, your kid has a decreased chance of concussion. That is not the case.”
Dr. Eric Jackson, who serves as an associate professor of neurosurgery at Johns Hopkins University School of Medicine, worries that people may get a false sense of security from a piece of equipment that may actually not be tested or do anything to help prevent brain injuries. “If it makes people feel more comfortable and act in riskier ways, then that false sense of security may actually be more of a problem,” he says.
Get out of the game
In the middle of a game, especially if the score is close or the competiton is a playoff, a player may not want to come out of the game even if he or she is injured. But area doctors say that players need to come out.
“If you get multiple injuries in the same game, you are more likely to have a more serious neurological consequence as well as taking longer to get better,” Laugel says. “This is one of the things we try to talk to the athletes about. They are the first ones to know they are not feeling right. After a head injury or a body impact, if they have mental fogginess or if they have a headache, they need to get themselves off the field even if the coach or their teammates are trying to encourage them to go back. They need to come off and not put themselves at risk for reinjury or prolonged recovery.”
In the setting of a concussion, Jackson notes, a second injury can have a far worse impact than what would be expected. “It’s almost like a synergistic injury where the effects aren’t additive,” he says. “It is multiplied.”
Focus on recovery and prevention
Recovery needs to be taken seriously. “If you go back to doing things too early, sometimes concussion symptoms don’t get better,” Jackson says. “You’re left with persistent headaches, or whatever the person’s concussion symptoms were, that may not improve.”
Neck-strengthening exercises will help to reduce concussion injuries. “If you have a stronger neck, you will have less of a whiplash movement,” Laugel says. “Adding neck strengthening to a conditioning program is very helpful.”
Prevention is another tool for parents, coaches and athletes to focus on. Instead of a soccer player head-butting a ball, the athlete could try to hit the ball with a knee or the chest. Many football leagues are banning head-to-head contact due to the number of injuries sustained by players. Laugel notes this method can lead to a noticeable reduction in concussions. “Trying to encourage kids to play the games in a safer way is important,” she says.
