As an athlete, determination and a love for competition drive the desire to compete. So when an injury occurs, it can be that much more difficult to see teammates performing while time is needed on the sidelines for recovery. Sometimes the thought of not being able to feed their passion and help their team can lead youth players to return to the playing field too quickly.
This is especially important when an athlete has suffered a concussion. Unlike a broken finger or a sprained ankle, a concussion can be a challenge to diagnose because it is an injury to the brain caused by a blow or jolt to the head that disrupts the function of the brain in some way. The signs and symptoms of this type of injury can be hard to detect, so making sure a youth player receives medical attention - and then a follow-up clearing the athlete to play after an evaluation - are surefire ways to make sure an athlete is not returning to action too prematurely.
"Kids shouldn't be returned to any strenuous physical activity or even strenuous mental activities and emotionally difficult situations until they've been evaluated," said Centers for Disease Control and Prevention expert Vik Kapil, DO, FACEP.
Even if a youth player does not realize he has suffered a concussion, parents and coaches are critical in realizing that something is wrong. Some signs and symptoms to be aware of indicating that a player has suffered a possible concussion can include appearing dazed or stunned, moving clumsily, answering questions slowly, losing consciousness (even briefly) and overall confusion. An athlete can also experience headaches, nausea, balance problems and blurred vision.
"Some of these symptoms and after effects may not be seen at the big game Friday night," said Centers for Disease Control and Prevention expert Marlena Wald, MPH, MLS. "When mom and dad sit down for breakfast Saturday morning with their son or daughter, some of this may show up then in the quiet of the home away from the hustle and bustle of the game.
"Parents need to know about these possible after effects and the variety of symptoms. They need to feel comfortable to ask their athlete how they're feeling and to be comfortable with knowing what to look for."
This is why Dr. Stan Herring, a team physician for the Seattle Seahawks and the Co-Medical Director for the Seattle Sports Concussion Program, wanted to spend a day in Canton, Ohio, to address 100 youth league commissioners and high school coaches about concussion awareness at the NFL-USA Football Youth Football Summit held from July 28-31.
"This is where the culture change must start," Herring said of today's youth parents and coaches following his July 29 presentation. "It's important to understand that sometimes you can play with a cast or a splint on, but that does not apply to athletes with concussions."
And Herring's most important message to the group was simple:
"When in doubt, sit them out," he said. "Let this be a medical decision."
Under guidelines set by the American Academy of Neurology, a study found that in 100 high schools across the country nearly 41 percent of athletes who suffered a concussion returned to action too soon from 2005 to 2008. A lot of pressure is put on athletes to perform - even at youth and high school levels - and some of this has to do with the demands kids face from their peers.
"Sometimes kids feel pressure; they themselves put that pressure on or they feel pressure from their peers, so it's very important that they're educated on the potentially very serious consequences of these types of injuries," Kapil said. "Kids should be educated in advance along with all team members so they know to watch out for these signs in their fellow teammates, and it's important to make sure coaches, assistant coaches and trainers are also aware.
"Kids shouldn't feel pressure to return to their activity if they're not feeling right. If they're exhibiting some of these kinds of symptoms, they need to feel comfortable in bringing this to the attention of a responsible adult."
Because concussions don't always depict such noticeable signs and symptoms, youth athletes should not participate in drills, practices or games until receiving clearance to play from a medical professional following an evaluation.
"The key here is that a concussion is a brain injury and it's an injury," Wald said. "If your ankle is wrapped in a bandage or you've got a cast on your leg, that's the obvious visual cue that you're not going to be going to practice for awhile.
"But a brain injury - because you don't see that outward sign - people observing you may say, 'Why aren't you going to be playing in the Homecoming Game?' Well you've got an injury and even though it's internal, it needs to be cared for appropriately."
