You’re in the stands cheering on your kid as he or she is playing their favourite sport, when suddenly, they take a hard hit to the head. You panic, rush to the sidelines, and make sure they are alright.

Checking for signs of a possible concussion, you and the coach agree to remove your child from the game and you head straight to the doctor.

Well done! The first step is to always take a significant hit to the head seriously. Here are some of the symptoms to watch for:

Most symptoms show up within minutes or hours, but others may take longer to appear. Getting to the hospital is always the right thing to do.

But what happens after the doctor confirms a concussion? What does the road to recovery look like and what should you do as a parent?

While each concussion is different, medical experts pinpoint early detection and brain rest as the first steps to helping concussed kids recover more completely. At their young ages, the brain is still developing and improper diagnosis, treatment, or too quick of a return to normal activity may lead to long-term problems.

Pediatric neurologists say that at minimum, two or three days of rest can help with such blows to the brain. That doesn’t just mean no sports or running around, but also no electronic devices, school work, video games, and anything else that can challenge or stress the brain.

A hard hit needs to be taken seriously. In Canada, 39% of all kids between 10 and 18 who visited an emergency facility following a sports-related head injuries were diagnosed with a concussion, while another 24% showed signs of possible concussion. Three sports in particular – football, soccer, and hockey – show a greater increase in reported head injuries in the decade between 2004 and 2014. Of course, sports are not the only cause of a concussion: falls, car crashes, and other whacks to the head can also cause a concussion. But no matter the cause of the injury, your focus needs to be on treatment and recovery.

There’s good news, though! Medical researchers in Nebraska found that 80 to 90% of sport concussions resolve in two to three weeks. This is if the child has been treated and follows medical advice. Doing so can also help prevent more serious brain injuries at a time when the child is vulnerable to other jolts to the head. If the problem persists beyond that point, another trip to the doctor is in order.

Catching a concussion early, preventing further activity, and seeking immediate medical attention are all helpful steps to healthy attitudes and healthy kids.

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There’s no denying that the NFL has a serious issue with concussions. After years of trying to sweep it under the rug, they’ve since come around to establishing procedures for dealing with concussed players. But what about the NHL? Is the group that governs the professional league of Canada’s most loved sport playing in the same headspace?

A leading expert on traumatic brain injury (TBI) speaking in Vancouver last month suggested that professional hockey may be in the same state of denial football found itself in a few years back. Examining the incidences and consequences of concussions and brain injuries on NFL players, there are parallels and concerns for all players – whether they’re sporting cleats or skates.

Dr. Frank Conidi presented findings of an initial study of 40 retired NFL players (the study has since expanded to include 80 to 100 participants). Most shockingly, he reported that almost half of those in the study showed evidence of brain abnormalities.

Speaking in April at the 2016 annual meeting of the American Academy of Neurology held at the Vancouver Convention Centre, Dr. Conidi pointed out that players came to him with other serious problems resulting from their head injuries. Anxiety, depression, sleep and attention issues, as well as executive functioning, learning, and memory problems were experienced by many of his patients.

“You see NFL players retiring over head injuries,” Condini added. Given that the median age for the players in the study was just under 36 years, these are serious concerns for a group of men in the prime of their lives.

In the defensive zone

Dr. Conidi is no stranger to treating patients with sports related brain injuries. He’s the director of the Florida Center for Headache and Sports Neurology, specializing in the treatment of sports related neurological disorders. He’s also team neurologist for the Florida Panthers and a consulting neurologist for the Miami Dolphins and NY Mets.

A former hockey player, Conidi knows the risks associated with our national pastime: “Hockey has the highest incidence of concussion per participant, at any level.”

With many high profile hockey players experiencing concussions, Conidi’s research shows that our love for sport must be tempered by an equally dedicated drive for protecting players from brain injury.

 

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Tyler Sash was just 27 when he was found dead in his Iowa home from an accidental overdose of pain medication. After 16 years of playing football, Tyler won a Super Bowl in just two seasons with the New York Giants – it ended up costing him his life.

After Tyler was fired from The Giants in 2013, he dealt with confusion, memory loss and minor fits of temper which affected his ability to get a job. “Now it makes sense,” Sash’s mother told the New York Times. “The part of the brain that controls impulses, decision-making and reasoning was damaged badly.”

After his death, the researchers at Boston University and the Concussion Legacy Foundation diagnosed Tyler with chronic traumatic encephalopathy (CTE) and they concluded that the disease had “advanced to a stage rarely seen in someone his age.” His family donated his brain to be studied for CTE as the disease can only be confirmed posthumously.

The CTE scope rates severity from 0 to 4 and Tyler was at Stage 2, approximately the same stage Junior Seau was at when he committed suicide.

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A great fitting football helmet is crucial to safety on the field according to VICIS, a Seattle-based company. The company’s neurosurgeons and engineers designed a football helmet that lessens linear and rotational forces.

Dubbed the Zero1, the new helmet utilizes four layers which work together to mitigate brain impact.

Joseph Chernach, committed suicide in 2012 at the age of 25 as a result of depression caused by chronic traumatic encephalopathy (CTE).  He played organized tackle football in a Wisconsin-Michigan Pop Warner football league from 1997 to 2000.

Debra Pyka, Joseph’s mother, has filed a wrongful death lawsuit against Pop Warner, the largest youth football organization in the United States. She claims that Pop Warner was negligent in protecting her son from the dangers of head trauma.  Pyka’s lawsuit came just eight days after researchers released a study that found NFL retirees who began playing tackle football before they turned 12 were at increased risk of developing cognitive problems.

“Other parents out there should know what happened to my son and be aware of all the dangers and symptoms,” Debra Pyka told NBC News. “I don’t want to see this happen to anyone else’s child.”

Before his death, Chernach was suffering from the disease Dementia Pugilistica, which is associated with CTE. He was also suffering from Concussion Syndrome which included symptoms such as memory loss, impaired judgment, impulse control problems, aggression, depression and dementia.

In a statement to BuzzFeed News, Pyka’s lawyer Gordon Johnson, said “children should not be exposed to the dangers of youth football, but if parents do choose to allow their children to play the game, there should be greater care taken to protect the most vulnerable amongst us.”

The Chernach family is seeking $5 million in damages.

Complaint Chernach v. Pop Warner and Lexington Insurance

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TIME continues to discuss the tragic risks of American Football in their latest issue. A new study from Wake Forest Baptist Medical Center in Winston-Salem, NC says high school football players display notable brain changes, even in the absence of a concussion.

The study monitored 24 high school football players between the ages of 16 and 18. Researches mounted sensors to their helmets to assess the frequency and severity of helmet impacts. While the players wearing the helmets were not concussed

The latest cover of TIME features a young football player with the words “He died playing this game. Is football worth it?”

The boy on the cover is Chad Stover; he passed away after suffering from a traumatic brain injury. He was an active sixteen year-old from Tipton, Missouri who played football for the Tipton Cardinals as a defensive back.

The Cardinals were trailing 27-18 during a game on Halloween in 2013. Chad dove to tackle with his arms outstretched when he brushed the opposing player and his helmet hit the ground.

Football has adopted a new standardized system for rating a helmet’s effectiveness in protecting against concussions. It has been credited with helping parents and players make better decisions about what helmets are best at reducing concussion risks.

The new standard is a five-point rating scale called the STAR system. It was developed by scientists and engineers at Virginia Tech, later used by the school’s football team in 2011. The football helmet rating system quickly caught on, encouraging manufacturers like Riddell and Rawlings to improve their helmet’s design.

Parents, too, have been listening. Sales of helmets with a five-star rating have spiked, whereas sales for low-rated helmets have plummeted. Even the NFL promoted the STAR rating system and posted ratings in every locker room around the league.

It’s now time for hockey helmets to improve.

Should you enroll your kids in contact sports?

It’s a question more and more parents are struggling to answer.

Not surprising, given the vast body of research highlighting the dangers of concussions and head injuries in youth sports.

While our national hockey teams have proven their dominance at the international level, recent surveys have found that youth hockey participation is actually down in Canada.

Chronic Traumatic Encephalopathy (CTE) is the degenerative brain disease diagnosed in an increasing number of ex-NFL football players. It’s linked to depression and dementia. There is no cure.

Until now, CTE has only been diagnosed in post-mortem autopsies. A diagnosis is made when an examination of the brain reveals a buildup of an abnormal protein call tau. Tau strangles brain cells in areas that control memory, emotions and other functions.

But ESPN reports that an expert research team has come up with new brain scan technology that can diagnose CTE in living patients.