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Injury in Youth Sports Part 2: Concussion

Of the many types of athletic injuries sustained by children and adults alike, concussion is perhaps the most misunderstood, yet it is on the rise among young athletes. A recent study revealed that diagnoses of concussion multiplied 500 percent for children and young adults under age 22 from 2010 to 2014. Thanks largely to professional football players, the long term repercussions of athletic brain injury are now being taken seriously, and concussion awareness is on the rise among athletes, coaches and parents.

Understanding Concussion

Concussion, increasingly referred to as traumatic brain injury, or TBI, occurs when an athlete sustains a blow to the head or a hit to the body that causes the neck, head and brain to move rapidly back and forth. The brain then bounces and twists around inside the skull, stretching and damaging brain cells and causing chemical changes. TBI is often overlooked or ignored because its symptoms are not as obvious as a musculoskeletal injury.

Symptoms of TBI include:

  • One pupils larger than the other after a hit or blow
  • DrowsinessWorsening headache that will not go away
  • Slurred speechDecreased coordination
  • Nausea, vomiting, dizziness
  • Agitation or confusion
  • Loss of consciousness

In the past, athletes have often been encouraged to “walk it off,” and have even been shamed for not being able to take a hit. However, TBI is increasingly being acknowledged, diagnosed and treated.

Youth TBI Statistics, an organization that tracks healthcare claims, has uncovered a number of revealing statistics about TBI in youth sports:

  • The highest incidence of TBI occurs in September and October, correlating with football season, but also the time when kids are returning to sports after taking the summer off.
  • Boys are more likely to be diagnosed than girls, although that does not necessarily mean boys sustain more TBIs.
  • Forty-six percent of TBIs diagnosed under age 22 occur in athletes aged 15 to 18, typically the high school years.

Return to School

Many young athletes who sustain a TBI report impaired cognitive function for weeks or even months after their injury. That can mean dire consequences for kids hoping to get into college, especially on an athletic scholarship. There are formal support services available for students with ongoing symptoms of TBI, including the Response to Intervention Protocol (RTI), the 504 Plan and the Individualized Education Plan (IEP). The Centers for Disease Control and Prevention (CDC) has its own program called “Heads Up,” aimed at raising awareness and providing guidelines to schools, coaches, parents and health care professionals.

Return to Sport

Determining when it is safe for a young athlete to return to sport is a touchy issue after TBI. Athletes eager to get back on the playing field often mask or under-report their symptoms, and some coaches may be all too ready to let them play. Yet most health care professionals agree that an athlete should not return to sport until they are completely symptom-free. It is generally agreed that an athlete should wait at least 30 days after TBI to return to play, yet that decision should not be made based on time alone.

The CDC recommends the following progression of activities after TBI:

  • Back to school
  • Light aerobic exercise for 10 to 15 minutes bouts to elevate heart rate
  • Moderate intensity cardio and strength training
  • Heavy non-contact activity including running, resistance training and agility drills
  • Return to controlled practice and contact
  • Full return to competitive play


Fitness professionals who want to help children need to understand the basics about youth nutrition and physical activity, and the liability of working with children. W.I.T.S. has everything you need to get started. Begin with a certification like Personal Fitness Trainer, Youth Fitness Specialist and Lifestyle Fitness Coach. Continue your education with Nutritional Concepts, Youth Fitness Foundations, Fundamentals of Sport and Exercise Nutrition, Exercise Program Design for Special Populations, and much, much more!


Centers for Disease Control and Prevention: Returning to Sports and Activities Concussions in Children and Young Adults

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