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Milwaukee's Daily Magazine for Friday, Nov. 28, 2014

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In Sports

Football isn't the only sport that can cause concussions in children. And, you don't need to prevent your child from playing the sport. (Photo: spirit of americ

In Sports

Girls are also prone to concussions, especially in sports like field hockey. (Photo: Shutterstock.com)

Ask the Doctor: Need to know information regarding kids and concussions


It's kids and family week here at OnMilwaukee.com and, more than ever, we'll feature articles and blogs about children's health, education, travel, fun and more. Kids and family week is brought to you by Aurora Health Care.

There are few hotter topics in sports than concussions and the effects they have on children, but while brain trauma is serious there are measures that can be taken to not only keep your child healthy, but keep them in the sports they love.

Being that it is Kids & Family Week here at OnMilwaukee.com, we decided to tackle some of the questions facing parents and coaches today regarding concussion awareness and management.

Participating in our question and answer format are Dr. Kevin Walter, program director of Pediatric & Adolescent Sports Medicine at the Children's Hospital of Wisconsin, as well as an Associate Professor of Orthopedics at the Medical College of Wisconsin; and Dr. Kevin Dahlman of Aurora Health Care – sponsor of Kids & Family Week – who is a pediatrician and often the first stop of children who come in for sport physicals or for parents who feel their child has suffered a concussion.

"A couple things have happened. Number one, we're diagnosing them more because we're recognizing the symptoms more," Dahlman said. "The other realistic factor is that we're seeing more concussions, I think because kids are participating at a level of competitiveness that wasn't seen a generation ago.

"But, we don't want the parents to be saying, no, you're never allowed to play football or play basketball or play soccer. We've got to allow that brain injury to heal. I think the biggest challenge for us in the health care business is to really educate coaches and parents and students themselves in the signs and symptoms of concussions.

"There is always going to be a risk of injury and we want to play safe and we want to recognize that there are signs and symptoms of concussions but it shouldn't prevent you from playing. We want kids to be out there on the sports field playing as hard as they can."

OnMilwaukee.com: What is one of the first things parents need to think about, or be aware of, when it comes to concussions in youth sports?

Dr. Kevin Walter: One of the huge problems we have with concussions is self-reporting. We know athletes don't necessarily want to say that they're injured or they have a concussion because they know that they're out. So, what I always encourage is for athletes to immediately report their symptoms and get off the field of play. There's actually research evidence that shows the sooner you identify the injury and begin appropriate treatment, even if it means coming off immediately and staying on the sideline instead of playing five more minutes, the people that do the right thing earlier get better faster.

It's all about awareness, recognizing they may have an injury – not oh my gosh, I have one, or I'm not sure, maybe I'll play with it a little while – if you think you may have an injury report it right away and get evaluated on the sidelines. Or by the doc in the ER or wherever.

The other thing that I push to parents is know your coaches education level. It's OK to question the coaches in the preseason – what do you do when there's a concussion? What do you know about concussions? How have you been educated? If you're not comfortable with their response, that should be a big red flag. Everyone thinks football because of the NFL, but even soccer, sports like basketball, baseball and softball – those are ones where I find that families don't really connect it together. They don't think they're big concussion sports. They happen in volleyball and track.

Dr. Kevin Dahlman: If we treat these appropriately, get in to the doctor and they can manage this correctly, then there's no reason to believe that there is not 100 percent recovery from these concussions. But of course it has to be dealt with professionally.

OMC: At what age do you need to be more aware of the possibility of injury?

KW: I don't worry quite as much at the five, six, seven-year-old level for concussions because those kids don't get them at the same rate as the middle schools and high schools. Eight to 10 is when you start seeing an upswing in concussions because the kids are getting bigger, but they still don't have great body control, and they still don't have great technique, so that eight to 10 is when I tell parents to watch and if you see your child acting funny, you hope that education of awareness and reporting kicks in and they come over to the sideline. Then if they're not acting like themselves or not playing like themselves, that's a red flag and you need to get them over (to the sideline).

OMC: Not every parent is going to do a baseline test of their kid – what should they look for at home?

KD: Let me give you a scenario, typically what I see. What will generally happen is a kid is on some kind of sports field – it doesn't have to be football – or could be in a car accident. There was no loss of consciousness. And most concussions, 90 percent of concussions do not have any kind of loss of consciousness – so, that's the first rumor I try to dispel. The big thing I'm looking for is any kind of headaches, does the kid say they have a dull headache that just won't go away. You could have nausea, a little dizziness or unsteadiness. Sensitivity to light or noise. Some kind of mental fogginess. And usually parents can pick up on this. They'll say if I ask them a question, she seems to be a little bit slower in answering that. Those are the things I really look for and ask the patient if they're experiencing any of those symptoms. So, by definition, if you've had a hit to the head and you experience any of those symptoms, that's a concussion. It'll be really key to pull a child out of sports at this time so there is adequate healing and then follow the evidence-based guidelines in a step-wise fashion slowly return the student-athlete to sports and activities as tolerated up until full clearance.

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