There's no such thing as 'just' having your bell rung

Why all concussions should be taken seriously

Have you ever heard the expression that an athlete just had his or her “bell rung”?

This is often said when someone is hit in the head during a sporting event. But this type of injury should never be taken lightly. A concussion can occur when a person has a trauma such as a blow to the head or the head being shaken. In fact, concussions can happen whether the person is actually “knocked out” (loses consciousness) or not.

Concussions are a common issue among school aged children and teenagers, especially if they are active in sports. In the United States alone, more than 300,000 concussions occur per year as a result of sports. An athlete who plays a contact sport, such as football, wrestling, basketball or soccer, is estimated to have a 19 percent chance of suffering a concussion in a single season. Other activities such as gymnastics, cheer, skateboarding, bicycling, or even jumping on the trampoline also come with an increased risk of concussion.

Can my child still get a concussion if he or she is wearing a helmet?

Yes. Although helmets do protect your child from a fracture of the skull or an injury that causes bleeding to the brain, they do not necessarily prevent concussions. It is possible to sustain a concussion while wearing a helmet because the helmet protects the bones of the head, but cannot stop the brain from making contact with the inside of the skull.

But what exactly is a concussion?

A concussion is a type of brain injury that interferes with the way the brain functions. It can cause symptoms such as:

Headaches
Nausea and vomiting
Vision changes
Irritability
Difficulty concentrating
Memory problems
Balance issues
Sleep disturbances

The majority of concussions (80-90 percent) resolve within 7-10 days, but may take longer for children and adolescents. Sometimes, the symptoms of a concussion will linger or worsen. If symptoms become persistent, your child may require further treatment to help symptoms resolve so they are able to return to attending school and participating in normal activities. Even a child with a “mild” concussion should be evaluated by a physician. A doctor will be able to decide if any tests are needed to check for more serious injuries. He or she will also check your child’s symptoms to find out the severity of the concussion, and determine whether referrals to other healthcare providers, such as a physical therapist, are required.

As a parent, what do I need to know to help my child get back on the playing field after a concussion?

Patience is key when it comes to safely returning to sport following a concussion. Every young athlete is eager to get back to sports or activities as soon as possible. It is up to the parents to make sure that this process is not rushed and happens in a safe way. More and more research studies are proving that the effects of concussions can compound and have long-term effects if another concussion occurs before adequate time for recovery is allowed. If an athlete or child returns too soon, he or she may be susceptible to negative effects of post-concussion syndrome such as depression, memory loss, fatigue, chronic headaches or pain. Parents should be diligent with following up with healthcare providers to get appropriate treatment prior to returning to sports.

How can a physical therapist help an athlete return to sport after a concussion?

Physical therapists will assess the need for treatment of any musculoskeletal injuries that occurred at the time of concussion. If your child has pain in the muscles or joints of the neck or spine as a result of injury, a physical therapist can help decrease this pain with hands on techniques or exercises. An injury to the brain can affect the brain’s ability to tolerate physical activity, movement, and balance. Sometimes these symptoms interfere not only with an athlete returning to his or her sport, but also with every day activities such as attending school, reading a book, or playing video games. A physical therapist will also assess the athlete’s tolerance for activity, function of the vestibular system (a part of the inner ear), and balance.

A physical therapist has the ability to monitor a patient’s symptoms while safely progressing from light aerobic activity, to sport-specific drills and eventually to non-contact drills. This allows the athlete to return to full practice and eventually to his or her sport. The vestibular system is a part of the inner ear that sends signals to the brain regarding a person’s movements and position in space. Additionally, the vestibular system is closely associated with an athlete’s ability to maintain balance. Balance can be affected when a child suffers a concussion, and can require rehabilitation from a physical therapist. Physical therapists can use specific exercises designed to strengthen the vestibular system and improve balance to prepare your child to safely return to sport or activity.

So what’s the bottom line when it comes to concussions?

1.Head injuries, or “getting your bell rung”, should not be taken lightly.

2.Helmets protect the skull, but do not always prevent concussions.

3.It is important that a physician evaluate your child after an injury to the head.

4.Parents and athletes must be patient in order to safely return to activities in order to allow concussions to fully heal.

5. Physical therapists can treat patients who have had a concussion to help with musculoskeletal or vestibular system issues, tolerance for physical activity, and balance training to help safely return to sport.

For more information:

About the author

Jessie L. Diebold, PT, DPT, OCS, is a SPORTS physical therapist at Cook Children’s. Cook Children’s SPORTS Rehab is a leader in the community in sports injury. Additional information and helpful tips can be found on the Cook Children’s SPORTS Rehab website. Cook Children’s SPORTS Rehab is a leader in the community in sports injury prevention.

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