Parents often ask, ‘how soon after a concussion can their child return to playing school sports?’ It’s an important question given there are forces such as a student’s drive to achieve and enjoy sports, and their coach’s pressure to return to play faster. Concussions can be subtle, and there are a lot of misunderstandings and common assumptions that are just not true about concussions.
Here we will explain some of those things to know and to watch out for in your kids playing sports before you let them return to play. There are things you can do to help them heal faster.
Return To Play After Concussion: How Long Does My Child Need To Wait?
The big fear surrounding concussions is severity and persistence. Though most of our kids are fortunately, not going to die from concussions, we do need to be aware of the problem of getting multiple concussions, or stacking inflammation on top of inflammation with multiple brain injuries. Parents also need to recognize that whiplash without a head impact can also result in the brain striking the skull on the inside, which can lead to a concussion without head impact or even a mark on the head or face.
A helpful rule is, if the neck is injured, there is enough force present for a mild concussion
It’s important to look carefully for signs of neck injuries as well as the more obvious injuries seen with head impact. Professional athletes have shown us unfortunately, that death can occur from what is known as the double concussion syndrome. Double concussion syndrome is described as two concussions within a three-month period that have a multiplying effect leading to death. We have also seen what aging looks like in the chronically concussed. These problems can be avoided by healing more fully and looking for signs of persistent concussion.
Child Concussion Symptoms: What Do They Look Like?
Children display different symptoms than adults because they have different tasks and levels of engagement.
- Teenagers can be moody. It can be hard to tell the difference between daily moods and aggravated moodiness due to being concussed.
- Difficulty doing math, navigating, forgetting due dates and appointments are all signs of being concussed.
- Look for anything uncharacteristic in the behavior and performance of your teen. Excess sleep or insomnia changes can occur after a concussion.
- Regulation of the immune, endocrine, and emotional systems can be affected such as altered periods, coming down with more cold and flus, skin and gut reactions, hormone and digestive problems, and headaches and vision problems are possible when the brain does not regulate systems as well as it should or used to.
- Problems in school performance in certain subjects but sometimes not in others can indicate focal brain injuries affecting math but not English, for example, or vice-versa in different brain areas.
Younger children may act out more, be lethargic, change their food cravings and aversions, and cry more or withdraw from affection.
- Bowel movements and schedule can change after head injury, and reflux and colic are common.
- Eczema breakouts can suddenly appear and fussiness can increase.
- Sometimes alterations in crawling or walking may show as asymmetries of movement on one side of the body.
Parents often think their kids have just become sickly, but it can actually be a weakened immune regulation from a brain injury as a root cause.
What Is Done For A Child With A Concussion?
Children of all ages who have suspected concussion should be observed carefully. Ideally, they should have a neurological screening exam by a qualified doctor of chiropractic, nurse, medical doctor, or medical or chiropractic neurologist. These exams should thoroughly check for injury to the sensory, motor and cerebellar system, and vestibular system. They will want to check for vascular problems, and even peripheral nerve and spinal injuries too.
Asking your children questions is important. Check in on them and ask, “Are you more forgetful?” “Do you have new headaches or blurry vision?”
- In rare cases we order MRI of the brain to check for bleeds and swelling, and we also check the neck for damaged ligaments using bending x-rays-flexion and extension films of the neck. These x-rays can show ligament injuries from impact and infer forces that could have also affected the brain.
- QEEG is quantitative electro-encephalography. This is a passive measure of brain waves while the eyes are both open and closed and the person is sitting still. These studies can show problems with local or global brain waves and direct care.
- ERP tests are Event Related Potentials. These are active tests of brainwave responses to faces or sounds. There are lots of scientific studies on these methods and how they can show imbalanced brainwaves, especially when the MRI of the brain is normal.
Lots can be done for brain injuries in children. Some of these methods include natural anti-inflammatory diets and supplements, neurofeedback and neuromodulation, biofeedback, and detox methods. Believe it or not, glyphosate (Roundup Herbicide) levels are rising alarmingly in children and exposure to this neurotoxin impairs healing of brain injuries, so we need to eliminate exposure from our food and the environment. Detoxing this poison will help the brain cells heal.
When Should I Be Concerned About My Child’s Concussion?
If there are symptoms of a neurological brain nature after a concussion the child should be removed from play.
Such symptoms may commonly include new onset of:
- Blurry vision
- Confusion
- Loss of short term memory
- Poor school performance
- Moodiness
- Uncharacteristic behaviors like violence or passivity
- New sleep changes
- Lack of or excess energy
- Hormone or immune changes after the injury
- Different sized pupils or headaches should especially be addressed immediately.
What Is The 3 Concussion Rule?
The three concussion rule is a very old rule of thumb that says that if a person has three concussions in a single season, they should be pulled from play for the rest of the season. This is possibly a good rule for developing children’s brains, but there is a problem.
If we wait until the third concussion to pull them, and do not carefully examine and question them, we risk missing injuries after the first or second concussion that may merit pulling them from play earlier until they heal.
Look for new and uncharacteristic changes in your kids after a possible brain impact. Take a good history by asking them specific questions about how they feel, perform and recover. Remember that both kids and adults want to get off the bench and back on the field, so they may hide their real symptoms. Get a professional examination and consider imaging as indicated.
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