Concussions, which, according to the Mayo Clinic, are traumatic brain injuries that alter the way the brain functions, represent just 9 percent of all high school athletic injuries. But, because they are brain injuries, they cause much more concern than routine sprains, strains, contusions, and fractures. And high school athletes are at an even higher risk of serious complications than professional or college athletes. According to studies in The Journal of Pediatrics, Clinics in Sports Medicine, and others, as well as the Center for Disease Control and Prevention’s “Morbidity and Mortality Weekly Report,” research shows that high school athletes take longer to recover and may experience more severe symptoms.
Concussion risk is present in contact sports, including football, lacrosse, and soccer, and in athletic activities that pose a falling risk, like gymnastics and cheerleading. (And, no, helmets don’t protect against concussion.) The resulting brain injury can lead to prolonged symptoms and learning difficulties for life. And there is growing awareness that returning to play before the brain fully heals may lead to “second-impact syndrome,” a potentially fatal complication.
Two or three years ago, Eric Small, MD, a Mount Kisco-based physician who specializes in sports medicine, saw five concussions a week. Now it’s 20 to 30 because, he says, “we’re more focused on it. But we still need to do a better job of educating parents of the risks of playing through concussions.”
One of his patients, a 9th-grade girl, was concussed after a collision playing soccer. She returned two weeks later, but, after a week of practice, couldn’t sleep and had trouble reading without developing a severe headache. Ultimately, she missed six months of school and received cognitive and vestibular therapy. “I have about five [cases] very similar to that right now,” Dr. Small says.
In her book, It’s All In Your Head: Everyone’s Guide to Managing Concussions, Ann L. Engelland, MD, physician for the Mamaroneck and Harrison school districts, underscores the serious nature of these injuries. She mentions a public talk given by Sophie Altchek, a young woman from Rye whose dream of playing collegiate-level soccer was snuffed out after she sustained four concussions in four months as a high school and club-league soccer player. Sidelined by headaches, fogginess, and exhaustion, Altchek took medical leave in February 2010, returning to school the following September to repeat her junior year. Now 20, she will begin her freshman year at Harvard in the fall.
In June 2012, New York State enacted legislation establishing minimum guidelines for treating and monitoring students with concussions. The law requires school districts to remove from play any student believed to have sustained a concussion. He or she may resume activity only after being symptom-free for 24 hours and obtaining written and signed medical clearance from a physician.
What parents can do: Short of yanking your kid from a head-injury-prone sport, Dr. Engelland preaches the four Rs: recognize and respond to symptoms, enforce rest, and have a physician reassess your child’s condition.