A concussion is defined as a blow to the head, face or neck or a blow to another part of the body that transmits force to the head. This results in an impairment in neurological function. It was recently published that 3% of all sports related injuries that presented in emergency departments were head injuries. Sports related head injuries accounted for 18% of all serious head injuries in children younger than 10 years old, 53% in children aged 10 to 14 years and 42% in children aged 15 to 19. Having said that it is more difficult to diagnose concussions in children because they may not be accurate in there recollection of what happened or they may not be able to precisely describe their symptoms. As a result, it is important that as a parent or coach you are aware of the signs and symptoms of concussions. Firstly and most importantly concussions do not always result in a loss of consciousness. Your child or athlete may complain of headache and dizziness, seeing stars, having ringing in the ears, double or blurry vision and having a stomach ache. They may also demonstrate poor coordination and balance, have slurred speech, are slow to follow directions and answer questions. They may demonstrate general confusion, not know the time, date, place, and not be able to remember things that occurred before or after the injury.

If you suspect that your child has sustained a concussion it is imperative that they DISCONTINUE PLAYING IMMEDIATLEY! He/she should then be taken to see a doctor. If the child has lost consciousness, they should be taken to the emergency department.

Concussions are treated with rest. Once all of their symptoms are completely better at rest, then they will slowly re-integrate their regular activities back into their schedule. It is important that they follow up with their doctor before returning to activity.

Children/athletes should not be allowed to return to activity until all of their signs and symptoms have resolved at rest. Then after having clearance from their physician they can return to activity following the stepwise protocol.

Step 1: Complete rest

Step 2: Light exercise for 10 to 15 minutes (i.e. walking, stationary biking)

Step 3: Sport specific activity for 20 to 30 minutes (i.e. skating in hockey, running in soccer)

 Step 4: On field practice with no body contact

Step 5: On field practice with body contact, but must be cleared by physician

Step 6: Game play

If at any time during the stepwise protocol should symptom reappear, they should rest for 24 to 48 hours and then try to progress again at the level that they were symptomatic at. Each step should take a minimum of 24 hours.

Concussions can occur while your child is in the playground or on the playing field. They can be serious if not treated appropriately. It is important that all parents, coaches, and athletes are aware of the signs and symptoms and the appropriate management of concussions.