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Doctor cautions against kids returning too quickly to sports after concussions

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Younger children are more likely to return to the field less than 24 hours after being diagnosed with a concussion compared to older athletes, according to a recent study from Jama Pediatrics, and that’s a problem.

“We really need to be more stringent about the policies that we have about returning youth to play after a concussion,” said Dr. Javier Cardenas, director of the Barrow Concussion and Brain Injury Center at Barrow Neurological Institute.

Cardenas said there are two main points that came out from this study.

“The first is across the board, there are actually a number of patients who take longer than normal to recover,” he said. “So about 15 percent of athletes will take 30 days or longer to recover, which is considered longer than average.”

The second is youth athletes were returning to play within 24 hours at a higher proportion — 10 percent — compared to college athletes, which fell around 4 percent, and high school athletes, which ranked less than 1 percent.

“Across the nation there are rules and policies that primarily affect high school athletes (and) there’s also a lot more education,” he said. “But youth, there tends to be this big gap.”

When we’re not identifying concussions in kids,  Cardenas said, we’re not educating kids as well about concussions and we’re not educating the people that take care of the kids about concussions as well as we are in the high school and college levels.

“The message to parents when it comes to sports is that when you’re looking at youth you want to make sure that number one you’ve identified a concussion,” he said. “And they might not articulate it very well.”

Parents need to ask probing questions, he said, following the injury such as: Does your head hurt? Does it bother you when you’re running?  When you shake your head do you feel dizzy? Do you feel weird? Emotional? Sad?

“Those are things that can be more specific to really get to the changes that can occur after a concussion,” Cardenas said. “We need to be probing more when it comes to our youngest athletes that are participating in sports.”

The current recommendations are that you definitely remove somebody in the event of a concussion from play; they don’t return that day, he said. We typically like to see an athlete free from symptoms at rest, and then we gradually enter them into basic physical activity.

“Not into competition, but enter them into physical activity over several days, before they can actually compete,” he said. “And many times up to a week and sometimes longer.”

That’s really the message. If they sustained a concussion one day, you don’t send them back the next day, he said.

“Even if they might report that they’re doing OK,” he said.

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