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Kids’ concussions: It’s not all about football

OHSU concussion expert offers tips for families weighing the pros and cons of contact sports
two teenage soccer players about to head a soccer ball
People usually associate concussions in prep athletics with football, but a 2017 study shows that there are now a higher proportion of injuries in girls soccer. (Getty Images)

Even before the school year begins, the prep sport season is already in full swing with practice underway on fields across the region. At the same time, news broadcasts are full of coverage of the hazards of playing contact sports, especially football. Parents rightfully wonder: Is playing any of these sports a good idea?

No student should have to suffer a life-altering injury in the pursuit of an active lifestyle. Sound medical guidance can help young athletes survive and thrive on the field of play.

As a parent myself, and as an OHSU physician who has specialized in concussions for more than two decades, I can attest to the value of participating in team sports. Plus, I wholeheartedly endorse the idea of kids staying off screens and on the field. However, it’s worth keeping a few things in mind.

Take care with other sports

News coverage focuses on concussions and even deaths caused by football, from high school to the NFL. In Oregon, participation rates are declining – quite possibly in response to the health concerns of parents. Yet the fact is, in many respects the game has actually become safer than ever. We’ve changed how we coach the sport, we’ve set and enforced rules to reduce head-to-head contact, and athletic trainers and coaches are doing a better job of recognizing concussion and pulling injured players off the field.

Concussion can and does occur in other sports besides football. For example, girls soccer has become surprisingly problematic. In fact, concussions now account for a higher proportion of injuries in girls soccer than in football, according to a study published in 2017 in the Orthopaedic Journal of Sports Medicine. This may be due to overly aggressive play and year-round competition, combined with desperation to succeed in a sport due to scholarship aspirations.

Signs of concussion

Concussions, also known as mild traumatic brain injuries, can occur at any time – not just in the cringe-inducing tackles that find their way onto sports highlight shows. They can occur at any point during a contact sport, a fall, or a bicycle or car accident.

Once their young athlete is involved in a sport, families and coaches should watch for the following signs of concussions:

  • Physical: Headache, nausea or vomiting; balance problems; dizziness; fuzzy or blurry vision; sensitivity to light
  • Cognitive: Difficulty thinking clearly, concentrating or in remembering new information
  • Emotional: Irritability, sadness, or anxiety
  • Sleep: Having trouble falling asleep, or sleeping more or less than usual

When to return to play

The Oregon School Activities Association has established a set of “return to learn” guidelines intended to recognize concussion when it occurs, and ensure that the player doesn’t return to competition until ready.

Students who have suffered a concussion and have severe symptoms may need to take a few days off from school and limit homework, especially assignments that require prolonged computer use. Our clinic recommends a two-day period of rest and at least a weeklong break from full-contact practice or games. Parents can have confidence in the OSAA’s return to play protocol.

However, research being conducted at OHSU suggests that too much rest can be detrimental and slow the recovery process.

Jim Chesnutt, M.D., is an associate professor of family medicine in the OHSU School of Medicine. He is the medical director for the OHSU Concussion Clinic and also serves as team doctor for the Portland Trail Blazers.

Chesnut co-authors a new set of guidelines published in the journal Neurosurgery characterizing five subtypes of concussion


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