Concussions In Youth Sports

MaryBeth Flynn and Andrea Steensen both have middle-school-aged daughters who have suffered through concussions during their soccer careers.

“I came out to the event to get more information about concussions locally,” Steensen said.

Flynn, from Holmdel, and Steensen, from Marlboro, were among 20 parents and coaches who came to a presentation about concussions in youth sports Wednesday at the Robert J. Collins arena at Brookdale Community College in Lincroft.

Three panelists used Powerpoint to explain issues related to concussions and concussion prevention.

Panelists included Stephen Rice M.D., Pediatric Sports Medicine Director at Jersey Shore University Medical Center; Physical Therapist David Bertone; and Head Athletic Trainer at Brookdale Community College, James Anderson.

In his basic overview of concussions, Rice used the analogy of an old-fashioned telephone analog board with the wires being unplugged. The brain, as the operator, will put the “plugs” back in its proper place but the telephone service needs time to recover to maximum capacity. 

“A concussion is an obstruction of service that will take time to get back,” Rice said. “A concussion is not a structural problem. It is a functional problem,” he said.

A concussion is a short-lived injury to the brain that could take several days to several weeks to heal, or if the injury is not attended to it could take several months to heal, Rice said.

The highest incidences of concussions occur when a person is under the age of 19, said Dave Bertone, PT, DPT, OCS.

A concussion has immediate symptoms, including nausea, disorientation and amnesia. The symptoms do not appear later on, if so this may indicate another brain injury, Rice said.

James Anderson, ATC, said when analyzing whether someone has suffered from a concussion, a person should look for the mechanism of what happened, locations of pain, symptoms the person and the athlete’s level of consciousness.

Symptoms such as nausea, dizziness, headache, tinnitus, amnesia, weakness and blurred vision are signs of a concussion or if severe a further brain injury, Anderson said.

“If the person shows any signs, pull them out,” Bertone said. “The first concussion isn’t the problem, It’s the second. It’s the third. It’s not worth the risk.”

In order for the brain to heal from concussions, the body delivers sugar to the brain, while the brain is not stimulated, Rice said.

The emergency room may not be the best place to take a person after they have had a concussion, Rice said.

“If you are comfortable that the concussion is following the clinical course or expected pattern, the emergency room is not necessary,” Rice said.

Emergency rooms are loud and noisy and very stimulating but if someone is taken home, put them in a dark room for “cocoon” therapy where there is "no TV and no texting" just a dark room and let them sleep, Rice said. The person can then recover in a non-stimulating environment.

Because the presentation was centered toward youth, Rice suggested parents call up the child’s physician and let the child be evaluated by the doctor after the child has rested.

Once the child finishes their “cocoon” therapy, they can begin physical therapy, Bertone said.

Prolonged rest can lead to fatigue, reactive depression and physiological deconditioning so the person is retrained through therapy beginning with exercises that don’t involve head movement such as the stationary biking and continuing slowly building upon those exercises, Bertone said.

“Most concussed athletes recover completely within seven to 10 days,” Bertone said. “But that doesn’t mean they are hitting the field on the tenth day.”

By New Jersey law, a child who suffers a concussion needs to be cleared by a doctor before they can return to school and sports, Rice said. Although some players want to head on the field, the injury needs to heal first.

“You only have one brain," the doctor said. "When in doubt, sit them out."