Concussions in Young Athletes: How Far Will We Go to Win?

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As a former chief neurosurgeon for the U.S. Air Force in Iraq, I cared for numerous soldiers with combat blast concussive injuries during Operation Iraqi Freedom. They suffered from confusion, headaches and mental processing issues after repeated improvised explosive device attacks. Now, as a pediatric neurosurgeon at Lucile Packard Children’s Hospital Stanford and Stanford Children’s Health, I see the same symptoms in young athletes with a history of one or more concussions. The similarities between combat and youth sports are very concerning to me.

Nearly 4 million sports-related concussions occur in the U.S. each year and, according to the Centers for Disease Control and Prevention, the majority of these cases affect young people. Concussions can have devastating consequences, including impaired cognitive function and other long-term neurological effects. We are now seeing the long-term effects of concussions on professional athletes; this is a wake-up call to all parents and coaches.

Now that kids are preparing to return to school and their sports teams, it’s critical that parents, coaches, trainers and athletes be aware of concussion symptoms. We must train our young athletes to be honest about symptoms and to report them to their coaches.  If there is a suspicion of a head injury, doctors recommend coaches remove kids from the game, following the mantra, “When in doubt, sit them out.”

Fortunately, we now have laws in place that prohibit athletes under the age of 18 from returning to the field without the clearance of a medical professional; however, we have a long way to go to protect our kids.

As an avid basketball fan, I know that athletes and soldiers share the same sense of teamwork, solidarity and pride. They want to win, and when something interferes with that, it affects team morale – leading some athletes to feel that they “let down” their teammates if they are sidelined by a concussion.

But when is it time to get back in the game?  Kids with a concussion are vulnerable, and a second blow can cause irreversible brain damage or even death. They should not return to the field until they regain their full cognitive function, and it can take up to 10 days before they are cleared to return to sports.

After a concussion, I recommend parents help their kids recover by slowly and systematically allowing them to resume their normal activities. Light reading a day or two after an injury is one good option – as well as making sure your kids connect with their friends, as maintaining a strong social identity can be an effective tool in their road to recovery. I would also favor successful return to the classroom before the playing field.

Unfortunately, the prevalence of pediatric concussions is an issue that is not going away. But as we approach the fall sports season, it is important for everyone to take concussions in child athletes seriously. We must alter the definition of winning from merely scoring points to keeping our young athletes healthy and safe — and parents, trainers, coaches and athletes have to work together toward that end. For our kids, we must teach them that a full recovery is acceptable — and is a form of winning in itself.

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