Healthy Living: Concussions in Youth Sports
A concussion is a brain injury; the only known cure for brain injury is prevention. While helmets can protect against skull fractures and more serious brain injuries, they cannot prevent a concussion; therefore, it is vitally important to be well-informed about how to prevent a concussion.
Experts agree that the best ways to prevent concussion are to play by the rules and teaching young athletes to respect the rules of their sport is part of good coaching.
Most concussions resolve with rest within a week to ten days; however, about 10% of concussions take longer to heal and some may have long-term consequences. Many concussions go unreported; an accurate concussion history for an individual typically is not available and experts warn that there is a risk of serious injury when multiple concussions are sustained over time. The risk of second impact syndrome is real and a matter of life and death or long-term severe disability. For all of these reasons it is extremely important that everyone involved in youth sports and recreation understands how to recognize the signs and symptoms of concussion, and knows what to do if a concussion is suspected both on the field and off.
There are a variety of ways to become informed and up-to-date on current concussion issues. When the New Jersey Concussion Law was passed in December 2010 it mandated that each year every student athlete and their parents/guardians receive a fact sheet. The fact sheets must be signed and returned by students and parents/guardians or the student is not permitted to participate in school sports.
Return to play
Subsequent to written medical clearance stating that the student-athlete is asymptomatic at rest the Model Policy states that the graduated return-to-play protocol is initiated and supervised by a certified athletic trainer or school/team physician or, if not available, a regular physician or licensed health care provider trained in the evaluation and management of concussion. If symptoms re-occur during any step in the graduated return-to-play process the student athlete will return to the previous level on the following day.
Graduated return-to-play Protocol:
- Complete one full day of normal cognitive activities without any re-emergence of symptoms. If no symptoms appear move to step 2 the following day.
- Light aerobic exercise. If no symptoms appear move to step 3 on the following day.
- Sport specific exercise – no head impact activities. If no symptoms appear move to step 4 on the following day.
- Non-contact training drills: progressive resistance training. If no symptoms appear move to step 5 on the following day.
- Full-contact practice and participation in normal training activities. In the Model Policy step 5 is initiated FOLLOWING MEDICAL CLEARANCE (This can be a verbal consultation with the student’s physician). If no symptoms appear move to step 6 on the following day.
- Return to play involving normal exertion or game activity.
Cognitive activities encompass any activity where thought is involved. They include, but are not limited to: attending a full day of school, studying, watching practice, interacting with peers.
The student should continue to proceed to the next level if asymptomatic at the current level. Generally, each step should take 24 hours so that an athlete would take approximately 1 week to complete the protocol when symptoms do not re-occur. If any symptoms re-occur during the protocol, the student returns to the previous step after an additional 24 hours of rest and progresses accordingly.