For the last few years, concussions have been on the forefront of the minds of parents, coaches and athletes across the country, as their risks and prevalence become more well-known. This increase in visibility has raised a lot of concern about both the immediate and potential long-term effects of concussions sustained by children and adolescents. Luckily, research efforts have also increased, leading to a better understanding of how concussions should be managed in young athletes.
At the 5th International Conference on Concussion in Sport held in Berlin, Germany, physicians and researchers around the world came together to collaborate on the treatment of sport-related concussions.
One of the outcomes of the conference was a change in the suggested concussion return to play guidelines, a decision that was based on a vast array of research and scientific consensus from multiple institutions, including Boston Children’s.
I suffered a severe concussion in April 2013 while playing soccer and continue to experience daily intermittent headaches, nausea, fatigue, dizziness and memory deficits. Before my concussion, I was an avid soccer player — I played on three teams including a competitive club team — and also played tennis, hockey, and skied.
I definitely underestimated the severity of my concussion. I went to school the next day and was diagnosed when the baseline test at school revealed red flags. Still, I continued to underestimate. I pressured myself to get back to my soccer team and to keep up in school.
I’ve learned a few important lessons during my recovery. …
Football remains one of the most popular sports for young athletes. But concerns about football injuries are at an all-time high. Many of these concerns focus on head and neck injuries, which account for approximately 5 to 13 percent of overall football injuries. The American Academy of Pediatrics (AAP), on Oct. 25, released a policy statement on tackling in youth football.
Dr. William Meehan, from the Boston Children’s Hospital Sports Medicine Division, co-wrote the statement. He offers five recommendations to help keep youth players safe and healthy and minimize their risk for head and neck injuries.
Play by the rules.
Make sure coaches and officials enforce football rules. Research shows that a significant number of concussions and catastrophic injuries occur because of improper and illegal contact, says Meehan. There should be zero tolerance for head-first hits. Meehan, along with the AAP, suggests stronger sanctions, up to expulsion from the game, for offenders.
Work with your youth football program to reduce the number of hits to the head.
The health effects of sub-concussive blows remain unclear, but limiting impacts to the head may reduce the risk of long-term health problems such as chronic traumatic encephalopathy.
Get familiar with the pros and cons of delaying the age at which tackling is introduced.
Though delaying the introduction of tackling would likely curb the risk of injuries at younger ages, the risks might be higher when tackling is introduced at older ages. That’s because older players are stronger, bigger, and faster, and if they have not previously learned how to tackle and absorb a tackle, they may be at increased risk of injury.
No matter what age tackling is introduced, players should be instructed in proper tackling techniques. But delaying the tackling age prompts a catch-22. “It may be very difficult to teach these skills in a noncontact situation,” notes Meehan.
Build neck strength.
Strength and conditioning exercises that build the neck muscles are likely to reduce a player’s risk of concussion. That’s because a stronger neck may limit the acceleration of the head after impact, which is one factor contributing to concussion, explains Meehan.
Advocate for athletic trainers.
The presence of athletic trainers during football games and practice may help reduce the incidence of injuries. Athletic trainers provide medical management to injured athletes, but also ensure proper hydration, warm-up and injury prevention measures.
Catch up on what you may have missed on Thriving last month. Our staff takes a look back at a few of this month’s favorite posts.
A mother’s intuition—and a fall down the stairs—save a little girl’s life
Liz Beaulieu is likely the only person in the world who can say she saved her child by falling down the stairs.
Her daughter, Arielle, was just 4 days old. Liz was carrying her downstairs when she slipped. Not sure whether Arielle had hit her head, she whisked her to her local ER.
“She seemed fine, and they said that she looked fine,” Liz says. Still concerned, though, Liz kept a close eye on Arielle over the next couple of days. That’s when she noticed something.
“I noticed the slightest flicker of her eyes,” Liz recalls, “and decided that I wanted to get it checked out.” She took Arielle back to the hospital, asking them to do a CT scan. The hospital demurred, but Liz insisted, telling them she needed the peace of mind.
“So they did the scan,” Liz recalls, “and they found an enormous tumor.”
Kyle Cooper was born with hemifacial microsomia (HFM), a craniofacial anomaly that resulted in the left side of his face being underdeveloped. It meant his face was noticeably uneven and barely any of his teeth touched. “I made it through and got used to it, but I couldn’t eat things like meat because it would take me three hours to chew.”
In February, Boston Children’s Hospital Oral Surgeon-in-Chief Dr. Bonnie Padwa reconstructed the 18-year-old’s upper and lower jaws and his chin. He returned to school just in time for prom and graduation.
Fifteen-year-old Esther Lovett’s life turned upside down after she suffered a concussion. An excellent student and star athlete, Esther was seriously challenged by the prolonged affects of her concussion.
For baby Joy, music and medicine are in perfect harmony
James Danna enters the Boston Children’s Hospital Cardiac Intensive Care Unit (CICU) with the tools he’ll use to treat Joy, a 9-month-old patient recovering from open-heart surgery. Instead of a stethoscope or scalpel, James carries only small percussion instruments and a guitar.
He gently opens the door to Joy’s room, taking a quick read of her heart rate—138. Joy is a tiny little thing in a great big bed, under bright lights and tethered to multiple machines. Over the course of her multiple procedures for a congenital heart defect, the noise of the monitors, air conditioning and loudspeakers have made for a very wary baby. Her medical chart describes Joy as “staff phobic,” as most adults who enter her room poke and prick her.
But Joy has met James many times before and knows him to be safe. She locks her eyes on him and waits for the music to begin. Keeping his distance, James quietly hums a tune while strumming a few chords on his guitar.
Joy smiles, crosses her little legs and nods to the beat.
Tyler Bois is a boy with goals. His career aspirations run the gamut. Some days, he dreams of playing football with his favorite team—the Dallas Cowboys. Others, he wants to open a pizza shop, perhaps called “Slice of Ty” or “Ty’s Pizza Palace.”
For now, the nine-year-old stays busy with every day kid stuff—playing with his golden retriever puppy, planning for Cub Scout camp, dancing in the school talent show, skiing and wakeboarding. Somehow between all of these activities, Tyler has squeezed in 20 surgeries.
Born with spina bifida and a Chiari malformation (a congenital defect in which the back parts of the brain slip into his spinal cord), he approaches each surgery with a trademark smile and can-do attitude.