Wednesday, January 8th, 2014
A new study has confirmed what doctors have long advised–that children who suffer concussions should engage in “brain rest” and abstain from cognitively challenging activities including reading, playing video games, and sending text messages for several days after the injury. More from The Boston Globe on the study:
A new study conducted by researchers at Boston Children’s Hospital tracked 335 student athletes who were treated for concussions incurred on the playing field. They found that those who took the most time off from tasks that required a lot of thinking had the quickest recovery from headaches, dizziness, nausea, and other concussion symptoms.
A majority of those who got the most cognitive rest were symptom-free 40 days after their head injury, but it took 100 days for symptoms to resolve in the majority of those who got the least amount of rest, according to the study published Monday in the journal Pediatrics.
While the study couldn’t determine exactly how much rest was optimal, study co-author Dr. William Meehan said the results confirmed the sensibility of recommendations to avoid mental challenges right after a concussion.
“For the first three to five days, we tell our patients with concussions that they should really aim to be at a zero level or complete cognitive rest,” said Meehan, director of the sports concussion clinic at Boston Children’s. That means no reading, homework, text messaging, or video game playing; basically, it’s fine to lie in bed quietly, watching TV or listening to music with the volume on low.
“Those experiencing severe symptoms may prefer to be resting anyway,” Meehan said, “but those with mild symptoms may think they can go back to school or resume exercise right away, which may delay their recovery.”
After a few days, kids can slowly add mental activities such as doing a crossword puzzle or sending a few text messages to see how they feel. “If symptoms exacerbate, they should go back to resting,” Meehan said. If they’re feeling okay, they can continue to gradually add mental challenges, resuming some school work on a lighter schedule. Throughout, they should continue to assess their symptoms and cut back if the headaches or dizziness return.
The brain likely needs to rest from mental processing to reserve its precious energy to balance its systems after the injury. Neurologists believe that the blunt trauma to the brain triggers nerve cells to release a flood of chemicals causing an imbalance that leads to concussion symptoms. At the same time, there’s often reduced blood flow to the brain following an injury which lowers the brain’s supply of glucose for energy. Any glucose expended for mental challenges means less energy is available to restore a biochemical balance.
“Concussions are really a problem with brain function and the movement of ions, or charged particles, around the cell membrane,” Meehan said. This type of malfunction, though, doesn’t appear on brain imaging tests, though technological advances may enable such imaging in the future.
For the time being, parents helping their kids recover from concussions may need to explain why rest is necessary when the brain scan looks fine.
Image: Kids playing soccer, via Shutterstock
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Tuesday, September 3rd, 2013
Youth football programs are continuing to thrive, despite repeated warnings about the danger of head injury and other issues related to repeated hits and even minor concussions. Parents are hearing the warnings that sports-related injuries happen every 25 seconds in the US, research shows, and programs are instituting concussion prevention and care rules. But kids are playing football at the same or even higher rates than in the past. Today.com has more:
While many football parents can’t help but worry when their kids play the sport – after all, you send your kid to battle in a helmet and full gladiator gear – there’s no major indication parental fear is resulting in fewer kids playing, according to current statistics.
Pop Warner, the largest and oldest youth football organization in the U.S., has seen the number of youth players – close to 250,000 – remain steady from 2011 to 2012, according to Josh Pruce, national director of media relations at Pop Warner headquarters in Langhorne, Penn.
And Pruce says in the five years prior to 2012, there was a consistent, steady growth of 1 percent to 2 percent of players each year.
Pruce says that he has seen an increase in questions and concerns about head injuries related to the sport. “It’s something we hear from parents and coaches. But we tell them safety is Pop Warner’s number one priority.”
Image: Young football player, via Shutterstock
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Friday, August 9th, 2013
Young athletes suffer injuries–mostly strains, sprains, and fractures–about once every 25 seconds, resulting in around 1.35 million emergency room visits each year, according to a study by the organization Safe Kids Worldwide. Sports injuries, the group found, account for 20 percent of all ER visits by children. More from CBS News:
“We uncovered some surprising and disturbing data about how often our kids are being injured playing sports,” Kate Carr, president and CEO of Safe Kids Worldwide, said in a statement.
For the new report, researchers from the child injury awareness organization looked at emergency room data collected in 2011 on injuries related to the top 14 sports for kids, including basketball, soccer, baseball, softball, cheerleading and ice hockey.
The most common injuries were strains and sprains, followed by fractures, bruises and scrapes.
Especially concerning though were the researchers found about 163,000 of those ER visits — or 12 percent — were for concussions. That’s about one child concussed every three minutes, Safe Kids points out. Nearly half of the concussions (47 percent) occurred in children between 12 and 15 years old, a “disturbing” trend because younger children take longer to recover from concussions than older ones. Serious and potentially deadly brain swelling is also more common in young people with traumatic brain injuries than adults, the report added.
In March, the American Academy of Neurology issued new guidelines recommending that kids sit out of games after suffering a concussion until they have been cleared by a doctor.
Image: Boy playing football, via Shutterstock
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Monday, May 13th, 2013
The number one killer of young athletes is not concussion- or head injury-related, a group of youth sports safety advocates announced at a recent conference in Washington, DC. Instead, sudden cardiac arrest, typically brought on by a pre-existing, detectable condition that could have been treated, is the culprit in most sports-related deaths. Another lethal threat is heat stroke, which is considered to be completely preventable. The New York Times reports on the findings, and how safety advocates are trying to raise awareness of these risks:
Concussions are receiving attention nationwide, but death from a blow to the head is exceedingly rare. In contrast, a young athlete dies from a cardiac incident once every three days in the United States, researchers say. In hot months like August, heat stroke often causes the death of a young athlete every other day on average.
“Concussion victims almost always get a second chance,” said Laura Friend, an attendee at the Washington summit whose 12-year-old daughter, Sarah, died of sudden cardiac arrest while swimming at a Texas community pool in 2004. “When your heart fails from something that could have been treated — which happens all the time — you don’t have another chance. As someone told me, sudden cardiac arrest is not rare; surviving it is.”
Heat stroke, also known as exertional heat illness, has been a focus of sports safety advocates because of simple, common-sense preventive measures, like introducing gradual levels of exercise at the beginning of a sports season in hot temperatures.
“When my son died, people treated it as a freak thing,” said Rhonda Fincher, whose 13-year-old son, Kendrick, died in 1995 from heat stroke sustained during a season-opening football practice in northwestern Arkansas. “The ignorance was unacceptable because, unfortunately, it is not infrequent. And we should all know that.
“No healthy child should be sent off to a routine practice and die from it.”
Leaders of youth sports acknowledge that concussions have long been overlooked and that the injury deserves a period of heightened awareness, especially because of the potential for long-term consequences. But as the focus of the February conference organized by the National Athletic Trainers’ Association suggests, there is a mounting worry that more hazardous health concerns are being disregarded because of the intense emphasis on brain injuries.
A sudden heart-related death is “so incredibly tragic and stunning that people aren’t comfortable putting it into the everyday conversation,” said Dr. Jonathan Drezner, the president of the American Medical Society for Sports Medicine.
“I do wish, to some extent, it was something people talked more about,” Drezner added, “because we are getting to a place where we could prevent many of these deaths.”
Image: Girl with soccer ball, via Shutterstock
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