Christopher Adams’ 16-year-old son has always loved playing hockey. But two years ago, he received his first concussion when he slammed his head against the rink glass even though he wore a helmet. Adams, 52, says, “My son started playing hockey when he was just 7, so it’s been a lifelong passion of his — there is no doubt he wants to keep playing.”
This year Adams’ son got his second concussion towards the end of the season. Both times his doctor recommended that he take some time off. Adams says, “He is very good at what he does, and we don’t want to hold him back, but it is also our job to protect him.”
Next year Adams will be faced with the decision of whether he should allow his son to play hockey again. He says, “As he gets older, the competition gets fiercer; so does his chance for injury. It’s up in the air now if he will play again next season or not.”
The Center for Disease Control and Prevention
The Center for Disease Control and Prevention (CDC) defines a concussion as a traumatic brain injury caused by a bump, blow or jolt to the head. A 2017 survey found that 15.1% of students reported having at least one concussion related to sports and 6.0% reported having two or more. After a child is cleared by a doctor to return to sports, parents must decide if they should allow their child to return to the sport and team, since there is a risk that it could happen again.
Diagnostic assessments
Before making this decision, says Dr. Vincent E. Schaller, who formed the Mid-Atlantic Concussion (MAC) Alliance, it is important for your child to receive the correct objective diagnostic assessments to screen for a concussion. He recommends that doctors use the ImPACT Concussion test, Vestibular Ocular Motor Screen (VOMS) and Right-Eye Infrared Eye Tracking. “If a patient goes to their doctor and they do what’s called the gross neurological exam, it will not detect a concussion,” he says.
Some hospitals have sports concussion clinics that can properly assess and treat kids who experienced concussions. Or you might be able to find a specialized clinic. In any case, it is important to see a specialist who can identify and treat the symptoms.
Schaller explains that if you send a kid back into the field when they aren’t fully recovered, they are statistically at a three to four times increased risk for another concussion because their brain isn’t functioning well. He stresses the importance of your child being fully recovered before you even consider allowing them to return to playing the sport.
Long-term effects of concussions
Parents may want to consider the possible long-term effects of concussions when figuring out if they should allow their child to return to sports. Schaller says that some possible long-term effects that could occur after one or multiple concussions are migraines, memory loss, tremors, seizures and new onset of anxiety, depression and/or ADHD. The number of concussions that a child receives isn’t significant. What is important is how the child recovers and scores on the objective tests.
“I’ve had patients who I followed that had concussions from middle school, through high school, through college, who had five concussions, but they were spread apart by at least three months; each one’s fully recovered with all of the objective measurements back to normal. And they’re functioning beautifully as an adult with a job in the real world,” he says.
Symptoms
Parents should be on the lookout for symptoms that are not typical of a concussion. “Parents can educate themselves about the signs and symptoms of a concussion, not just within 24 hours with the vomiting and the headache,” says Schaller. He explains the importance of paying attention to other symptoms like “[t]he subtle ones, that could pop up months or weeks later from a concussion, like anxiety and depression symptoms. Or kids just not behaving like themselves, like their grades are dropping. Things that only a parent could easily know.”
Many kids want to return to their sports even though they had multiple concussions. “If you do treat each concussion to full recovery and they’re over three months apart, you can play all the sports you want, as long as each time you get a concussion, you fully recover,” says Schaller.
