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As a parent, watching your child or teen enjoy participating in their favorite sport can be both exciting and fulfilling. In addition to keeping them physically fit, sports can teach your child valuable life lessons like teamwork, respect, and commitment. Unfortunately, though, with sports comes the possibility of injury.

If you are parenting a child who plays a contact sport like football, concussions may be at the top of your list of concerns.

“A concussion is one of the most common injuries in sports. Some obvious examples of concussions include football players’ heads striking against each other or the ground during a tackle, or basketball players bumping heads when going up for a rebound. Some less often recognized concussions occur in other sports, such as a soccer player heading a ball or a wrestler hitting the mat,” said Anthony Elkins, a physician at Iredell Primary Care.

It’s important to note that concussions can occur in non-contact sports as well, like tennis or gymnastics.

While most coaches will recognize the signs of a concussion during a game or at practice, you know your child best. It’s your job as a parent to help spot these symptoms on and off the field and ensure your child gets the care they need.

So, what is a concussion, how do you know if your child has one, and what are your next steps if they do?

Understanding Concussions
A concussion is a type of traumatic brain injury. It occurs when the brain is shaken within the skull. This is commonly caused by a sudden blow or jolt to the head, but any abrupt force that changes the movement of the head, neck, or body can cause a concussion.

“Concussions are not simply a bump on the head that causes a headache and resolves without consequences. A true concussion is actually a brain injury, with damage to neurons (the brain’s nerve cells) that are often irreversible,” said Elkins.

While most concussions are mild, serious concussions can cause bleeding or bruising within the brain.

“The direction of the force, the size of the object striking the head, the part of the head that sustains the impact, and the presence or absence of protective gear can all influence the severity of a concussion,” said Elkins.

Warning Signs and Symptoms
Some concussions may be obvious, especially if you witness the incident firsthand. Others, however, can occur after a mild or unrecognized impact, and symptoms can be hard to spot.

“Most commonly, symptoms of a concussion occur soon after the impact, but some develop hours or days later,” said Elkins.

Since every concussion can be a little different, signs may vary from child to child. However, more obvious signs of a child who has a concussion may include:

• Headache
• Confusion
• Brain fog
• Dizziness
• Vision changes (blurry or double vision)
• Unsteady gait

A child who’s had a concussion may also simply report that they “don’t feel right” after a bump, blow, or jolt.

More subtle symptoms include personality or behavior changes, slowed reaction times, or emotional changes.

If your child exhibits any of the signs below, it may indicate a more serious head injury and require emergency attention. These signs include:

• Loss of consciousness, even for a brief period
• Loss of neurological function, such as unable to move an extremity, or vision loss
• Vomiting
• Incontinence
• Mental status changes, such as being unable to stay awake

“Most concussion symptoms last several days to weeks but vary based on the nature of the injury, the presence of protective gear, the athlete’s underlying medical conditions, and history of previous concussions,” said Elkins.

If Your Child Gets Hit
If you are watching a game or practice and notice your child sustained an injury to their head, you should make sure they are taken out of play.

“Any athlete who sustains an obvious head injury, or is displaying neurological symptoms like acting confused, forgetting plays, or walking with an unsteady gait, should be removed from play and evaluated on the sidelines by medical staff or a certified athletic trainer,” said Elkins.

If trained personnel are not available on the sideline, the child should be taken to a medical facility for evaluation.

According to Elkins, if you suspect your child has sustained a concussion and was not evaluated at the time of injury, you should take them to their primary care provider, an urgent care, or the emergency room for evaluation.

Treating a Concussion
In the case that your child does have a concussion, they will need to take a few days to rest and relax to help their brain heal.

“Initially, a period of ‘brain rest’ is recommended, in which no physical or mental exertion occurs. This may mean resting in the bed or on the couch. There should be no reading, doing homework, watching TV, or looking at electronic devices,” said Elkins.

You should make sure your child is well-hydrated during this time of healing. If they have headaches or body pain, your child can take acetaminophen (Tylenol) to ease the symptoms. Severe symptoms, however, should be treated by a medical professional.

Returning to School
To get your child ready for school and play, a gradual increase in mental and physical activity is necessary to see if the child develops any symptoms.

All North Carolina schools are required to have a concussion protocol describing the guidelines for returning to school after a concussion. The North Carolina High School Athletic Association enforces the “Return-to-Learn” and “Return-to-Play” protocols.

Return-to-Learn
According to Elkins, the Return-to-Learn protocol may include a shortened school day, more time to complete assignments, alternative, quieter environments, and the use of ear plugs. This also includes the avoidance of testing, as this will not asses your child’s true knowledge.

Return-to-Play
The Return-to-Play protocol typically beings with a low-intensity activity like walking. If no symptoms are experienced, your child can try moderate-intensity activities like jogging. If your child remains symptom-free, they can move to high-intensity activities like interval training, sport-specific agility drills, and non-contact activity.

“Return to play protocols exist not only to ensure that a concussed athlete is safe to play but also to prevent more serious brain damage should another head injury occur,” said Elkins.

To further explain the importance of the Return-to-Play protocol, Elkins compares these guidelines to an injury on your skin.

“As an example, imagine an open wound on the skin. If the wound is covered and protected, healing will occur most quickly and completely; however, if the wound were repeatedly scratched, picked, or rubbed at, it will take longer to heal, often with a larger scar.”

“This is the same as the healing of injured brain tissue. This is why it is critical that no concussed athlete return to play who is still experiencing symptoms. The brain is not yet fully healed,” he explains.

In order for your child to return to their sport, a healthcare professional must provide their approval and sign your child’s Return-to-Play form. You, as a parent, must sign the form as well to give your consent.

Concussion Prevention
Repeated concussions may cause serious complications, longer recovery times, and even permanent symptoms.

“Each concussion is a learning opportunity on how to prevent a future one,” said Elkins.

In this way, prevention of an injury is just as important of a skill as the sport itself. Make sure your child is using proper techniques when playing to avoid injury, like learning how to tackle properly and safely in football or “head” the ball in soccer.

You should also ensure your child is always wearing the appropriate protective equipment. While helmets and pads do not eliminate the possibility of a concussion, they may reduce the likeliness of one.

Learn More
Although most concussions are mild and have temporary symptoms, some can be more severe and result in long-term damage.

“All parents of student-athletes should be vigilant for signs of a concussion. Many athletes are conditioned by their coaches and teammates to just ‘walk it off’ and ‘man up!’ However, parents are their child’s best advocates. They should stay involved with their child’s coaches and ensure that proper attention is given to children who are injured,” said Elkins.

Elkins practices at Iredell Primary Care in Mooresville and is accepting new patients. He treats patients of all ages, from babies to seniors. Though Elkins can treat all your primary care needs, he also provides specialty sports medicine consultations. If your child experiences an injury on or off the field, Elkins can help. To schedule an appointment with Dr. Anthony Elkins, please call the office at 980-435-0406.