How to Protect Your Child Against Concussion

While concussions can occur from car accidents, falls, and fights, one of the most common — and preventable — causes of concussions in youngsters is contact sports.

As a young man. Robert Cantu, MD, played baseball for a college team. While at bat, a pitch that came in high and tight hit him in the head. The ball cracked the useless cap liner players wore decades ago before the importance of adequately protecting heads from sports injuries was recognized as a serious concern.

Bleeding from his scalp, Cantu was taken to the hospital, his coaches mortified that he might have a skull fracture. He didn’t, but in retrospect he knows he did have a concussion based on his serious symptoms.

“In those days, it wouldn’t have occurred to anyone in either dugout that I might have had a concussion,” he noted in his book on the subject, “Concussions and Our Kids.”

Cantu, a neurologist and neurosurgeon and director of clinical research at the Emerson Hospital Cantu Concussion Center in Concord, Massachusetts, has seen many examples in his career of young people suffering from concussions. (Young people are more vulnerable to concussions than adults.)

While concussions can occur from car accidents, falls, and fights, one of the most common — and mostly preventable — causes of concussions in youngsters is contact sports.

That’s why it’s important to recognize how to lower the odds of head trauma to protect your child against concussion when they participate in sports, especially the contact type. It’s also important to recognize when a concussion has occurred and what actions to take.

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Concussions aren't rare in the young

Long referred to as simply “getting your bell rung” or “seeing stars,” a concussion is no longer a sign of toughness if a youngster gets up and brushes off a blow to the head during a sporting event. Concussions are now recognized as traumatic brain injuries (TBIs).

TBIs are anything but rare in children and teens. Between 2010 and 2016, an average of 283,000 youngsters were seen each year in U.S. emergency departments for TBIs. Almost half of these injuries were associated with contact sports, most often from a blow to the head while playing football, according to the Centers for Disease Control and Prevention (CDC).  

There were likely many more children, teens, and college students not included in the emergency department statistic because they were seen by their primary care physicians. Other youngsters with concussions may have never received treatment, the American Academy of Pediatrics (AAP) points out.

As pediatricians and sports organizations have helped spread the word about contact sport safety to parents and coaches over the past decade, there is growing evidence that concussion rates in youngsters are declining.

The CDC reports the number of youngsters needing emergency care for contact sports-related TBIs visits dropped significantly over the past few years, primarily due to an almost 40 percent decline in football-related concussions between 2013 and 2018. This good news is due to strategies increasingly put in place by football coaches to help avoid and reduce head injuries.

The CDC notes that identifying similar prevention strategies for other contact sports, including making sure youngsters wear appropriate protective helmets, could likely reduce TBIs even more.

Recognizing symptoms of concussion

A concussion temporarily disrupts normal brain function. It's the result of a blow or jolt to the head or from a forceful slam into the body that causes the head and brain to move quickly inside the skull. When this happens, chemical changes in the brain can cause a variety of concussion symptoms; brain cells are sometimes damaged, too.

Signs of a concussion can be immediate after a bump or jolt, or they may not be evident for a few days. The AAP urges parents to pay attention if their child says they “just don't feel right" after a bump, blow, or jolt to the head or body. They may have a concussion or another type of TBI.

Symptoms can include appearing dazed, losing consciousness (even very briefly), not remembering what just happened, mood and behavior changes, and clumsy movements. Older youngsters may also complain of nausea, pressure inside their heads or headaches, dizziness, light and noise sensitivity, and feeling oddly foggy or sluggish.

The AAP emphasizes seeking medical care immediately if your child has any of the below potentially serious symptoms. Don’t hesitate: Call 9-1-1- or head to an emergency department.

• A worsening, continuous headache
• One of the pupils in the child’s eye is larger than the other
• Slurred speech
• Weakness and numbness
• Extreme agitation
• Seizures or convulsions
• Losing consciousness (even for a few seconds)
• Inability to wake up or extreme sleepiness
• Vomiting repeatedly
• Confusion or memory problems
• Refusal to eat

How to protect your child from concussion

Benjamin Franklin famously said, “an ounce of prevention is worth a pound of cure.” That’s good advice for reducing the odds of many problems in life, including reducing the risk of concussions in children.

Aside from keeping your kids in a cage or plastic bubble, they’re going to get their share of scrapes, bruises, and bumps. You can’t even prevent all concussions. It could happen to your kid despite your precautions. What’s more, physical activity and participation in sports have a host of physical and social benefits that outweigh the risk of injuries.

Still, you can take measures to lower the risk of your child having a concussion.

“When it comes to prevention, No. 1 is to avoid head trauma whenever possible. You can eliminate 60 to 70 percent of head trauma by taking it out of football practice,” Cantu explained in an Education Week interview. “It’s not necessary to bang heads in practice… Especially at the youth level, don’t bang bodies (in practice). Hit pads, hit tackling dummies, don’t hit heads on heads.”

In addition to football, other sports, including soccer, hockey, basketball, rugby, wrestling, and lacrosse carry a risk for concussions, as does cheerleading, skateboarding, riding bikes, and climbing trees.

Concussion isn’t limited to sports either. Babies and toddlers are enthusiastic explorers of chairs, tables, and other objects and, without proper supervision, this can result in a head injury that leads to a concussion. In fact, children age 4 and younger are more likely to get concussions than older kids. So, provide young children with a safe place to play and explore.

Children should wear helmets (make sure they fit well and are in good condition) for any riding activities, including riding a horse or a bike, skating, or skateboarding.

Young athletes should be taught about safe playing techniques and the importance of following rules. The risk of concussions goes up substantially when kids hit their teen years and peer pressure can result in more risky behaviors, the AAP points out. Even encouraging your kids to practice good sportsmanship at all times may help prevent what could cascade into trauma.

Talk to your child's coach and school about concussion policies. Coaches play a key role in preventing concussions and recognizing when a youngster should be taken out of a game after a possible concussion-causing blow. The CDC’s HEADS UP Concussion in Youth Sports initiative is a good resource for coaches, parents, and young athletes for up-to-date information about preventing, recognizing. and responding to concussions.

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