Dr. Herring, what are some symptoms parents can look for hours after a game ends and our child is at home?
It can take time for symptoms to fully develop. The important thing is to make sure that you continue to observe your son or daughter after a suspected concussion. The most common symptoms are headache, confusion and a sense of lethargy or fatigue, but the symptoms can be quite variable. So to answer your question, watch for any symptoms including headaches, nausea or dizziness, but also watch for confusion, lethargy or even mood changes. If your son or daughter's symptoms are getting worse - for example, an increasing headache or increasing nausea and vomiting, you should seek emergency care.
What are some basic things that parents or coaches can do at the youth level of football to help prevent concussions for players at a young age?
The first thing is education. Education of the parents and athletes to understand the signs and symptoms of a concussion with readily available materials. The CDC has, for free, information for parents, coaches and athletes about concussions. You can download this information on their site. Secondly, the development of a culture under the direction of the coach, where the athletes are encouraged to report their symptoms. It's important to be tough in sports, but no one has a tough brain. Finally, make sure after a suspected concussion that there is a medical evaluation.
What is the ideal time a high school football player should sit out for a standard concussion?
This is a very important question because the answer is that there is no "set " time. Each athlete's response to a concussion is very individualized. Usually, for high school level athletes, in the best of circumstances, a concussion is a 7 to 10 day recovery period, but it can be much longer depending upon a number of circumstances. Factors to consider include severity, proximity and number of previous concussions, as well as other modifiers, such as age, sport, learning disability and others.
Do you think that the recent crackdown on the NFL helmet-to-helmet hits will help decrease concussions int he NFL? How can youth coaches help discipline their players on this matter without taking away from the game and creating fear in a defensive player's tackling abilities?
The recent moves by the NFL and the NHL are an important step in keeping sports safer. The NFL has not only suggested the "crackdown," but they've also been working hard on other aspects of concussion management. The moves that the NFL and NHL have made are an important part to keeps sports safe, but it's not the only effort each organization is making. There has been attention given to research and education by both.
The answer to the second question is that coaches must remember that, ironically, it is often the injury is to the player who leads with his head while tackling . For the safety of all players, proper tackling technique is important. The game certainly can be played competitively while still encouraging techniques that protect both offensive and defensive players.
Is there evidence that a good mouth peice can minimize the effects of concussion, or completely keep a player from getting a concussion?
Mouthpieces are helpful for dental protection and their use should be encouraged. However, there is no compelling evidence that they prevent concussions. While in some particular circumstances they may be helpful, one cannot state that a mouth guard will prevent concussion.
Are you aware of any particluar football helmet that will reduce the chances of a player sustaining a concussion?
This is also a very important question. There is no one helmet that has been proven to decrease concussions. Helmets are effective doing the job for which they are designed. And helmets were designed to prevent focal brain damage, such as a fracture or a bleed. Rigid, hard, plastic helmets were not designed to prevent concussions. With ongoing research, changes in helmet design may be helpful in limiting concussions, but realistically, the solution for concussions management is not going to be in helmet design alone.
If a player suffers a concussion, are they more prone to future concussions?
Statistically, after a player has suffered a concussion, he or she may be more prone to future concussions. This is certainly true after a player has suffered two or three. Once again, each athlete's response is individual, but we do counsel athletes who have suffered one or more concussions about increased risks for future concussions and that the future concussion may last longer and be associated with more symptoms.
Is there a point where you recognize that a child has had too many concussions or is it relatively safe if they were spaced out, like one a year for three years in a row?
There is no one answer for an athlete's concussion history. So, given many factors, such as how severe the concussion was, how long it lasted and other individual factors, those decisions are made on a case by case basis. Some athletes could suffer two or three concussions spread out over a period of time and be allowed to return to play, but another could receive one severe concussion and removal from contact sports be suggested. In general, the younger the athlete, the more conservative the treatment. But it is important that those athletes are seen by a health care provider who understands the diagnosis and management of sports concussions.
My son loves football -- he plays in organized youth football and soccer leagues. Our football coach handed us helpful info re: concussions symptoms before this season, but neither his soccer coach or our soccer league president have done this. Can you really get a concussion from playing soccer?
It's very important to understand that concussions are not a football or boys injury only. Concussions do occur in all contact sports. The rate of concussion in high school girls soccer is almost as high as in high school boys football. And the rate of concussion in women's collegiate soccer is actually higher than collegiate men's football. So efforts for concussion education and proper management need to extend across all sports.
Dr., I coach young kids and the concussion issue is scary because I am not a doctor and I want to make sure that my kids don't get seriously injured. What resources are out there for someone like me to get better educated? Thanks.
A wonderful question and the type of question we like to hear. There are many resources:
For youth football resources, USA Football has many educational modules, one of which is on concussion education for coaches. They aslo have a campaign called "Put Pride Aside for Player Safety," which addresses a culture of proper awareness about concussions.
The CDC has outstanding resources as well for parents, coaches and athletes on their Web site.
What I would suggest to you that if there is any suspicion that one of your athletes is injured, sit them out. When in doubt, sit them out. And remember that return to play is a medical decision.