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13:31 PM

Sports Concussions: 5 Things Parents Should Know

Dr. Brian Harvey, Sports Medicine Center

When parents think about sports concussions, football immediately comes to mind. Some parents may argue whether kids should even play football because of the risk. But it’s not just football, concussions are relatively common in other contact sports (soccer, basketball, lacrosse, hockey and wrestling) as well. According to the Center for Disease Control and Prevention, 10 percent of all contact sport athletes sustain concussions yearly.

Who’s at Risk?

Sports concussions can happen at any age, from pee-wee to collegiate sports, and recreation leagues to competitive sports. Contact sports (football, soccer) have a higher risk than non-contact sports (tennis, volleyball). We know there is an increased risk for our young developing athletes when compared to adult athletes.

Female athletes also have an increased risk for concussion versus male counterparts when you compare them sport-to-sport, such as soccer to soccer, basketball to basketball and softball to baseball. We don’t know why this is the case, but it reiterates the need for further research as anyone can sustain a concussion while playing a sport.

How to Prevent Injuries

The first is to play by the rules of the sport and avoid head contact. Athletes are more likely to be injured during a game versus practice, especially during very competitive play. The data shows up to 25 percent of athletes are injured when not following the rules. That’s why there’s been a recent focus on rule changes in football and soccer to limit head injuries and make contact sports safer.

Second, student athletes should wear equipment that fits appropriately. That means football players should wear a helmet that fits. If it’s too big it increases the player’s risk for a concussion.

Currently, there isn’t any protective headgear or a mouthpiece on the market that prevents concussions, but there are things athletes can do to lower the risks. However, there are ongoing studies to look at equipment that may help.

Signs of a Concussion

We’ve seen an increase in concussions because more education is provided to athletes, coaches, parents and medical personal to recognize the signs and symptoms of concussions. We’re also doing a better job removing athletes from competition with signs of a concussion and documenting their injury better.

Losing consciousness is often thought to be associated with concussions, but actually only happens to less than 10 percent of concussed athletes. Instead, symptoms typically are physical, emotional and cognitive. A concussion should be suspected in the presence of any one or more of the following:

  • Headache
  • “Pressure in head”
  • Neck pain
  • Nausea or vomiting
  • Dizziness
  • Blurred vision
  • Balance problems
  • Sensitivity to light

Symptoms frequently last two to four weeks and can also include:

  • Sensitivity to noise
  • Feeling slowed down
  • Feeling like “in a fog”
  • “Don’t feel right”
  • Difficulty concentrating or remembering
  • Fatigue or low energy
  • Confusion
  • Trouble falling and/or staying asleep
  • Drowsiness

If there’s any concern an athlete has a concussion, the athlete should be removed from play and not allowed to return until evaluated by a physician. A player should go to the emergency room immediately for repeated vomiting, worsening headache or slurred speech.


If an athlete is diagnosed with a concussion, we recommend an active recovery to get back into a regular routine as quickly as possible, which includes a healthy sleep routine, attending school and even light exercise, as long as their symptoms are not getting worse. We recommend working with the school and following a return to learn protocol or progression of getting back into school.

With an active rehab, the average recovery time is 3-4 weeks. Once asymptomatic, we recommend a return to play protocol.

Return to Play Protocol

Step 1: Light aerobic exercise for 20 minutes (stationary cycling/brisk walking) to increase heart rate. If there are not return of symptoms after 24 hours, athlete can proceed to Step 2.

Step 2: Sport-specific moderate exercise for 20 minutes (skating in hockey/running in soccer). If there are not return of symptoms after 24 hours, athlete can proceed to Step 3.

Step 3: Non-contact drills (shooting, dribbling, etc.) and may start lifting weights. If there are not return of symptoms after 24 hours and cleared by a physician, athlete can proceed to Step 4.

Step 4: return to full-contact practice. If there are not return of symptoms after 24 hours, athlete can proceed to Step 5.

Step 5: Return to full competition or game play. If the athlete has any future symptoms or concerns, remove from play immediately until evaluated by a physician.

If concussion symptoms return during any step, the athlete should rest for 24 hours. After resting and asymptomatic, start the protocol again with the previous step.

Questions Parents Should Ask

Before playing a contact sport, parents should ask these questions.

Does the school provide academic support, education to their teachers on concussion or offer baseline neurocognitive testing?

As part of the recovery, the school should be an active participant in helping the athlete return to the classroom effectively. This can happen with the use of academic support as well as with education of administrators, nursing staff and teachers. A baseline test is a computerized assessment that measures reaction time, memory and speed of mental processing. If a student is injured, the same test is administered to compare to the baseline in order to monitor the subtle deficits in the way the athlete thinks and processes information.

Is there an athletic trainer on staff?

Ask if there is a certified athletic trainer on staff and if that athletic trainer covers both games and practices. Athletic trainers play a vital role in helping diagnose and manage concussions, getting the athlete back on the field as safe and effectively as possible.

Have the coaches participated in concussion education?

Education is key. What resources do the coaches have, are they teaching players proper techniques to avoid injury, and confirming athletes are wearing equipment appropriately.

What is the concussion protocol?

Who is responsible for recognizing concussions during practice and games, and what is the plan if a player has a concussion.

For the most part, contact sports are relatively safe and the benefit of playing sports is much greater than the potential risk of having a concussion or getting injured. Having the proper equipment, playing fair and asking the right questions will help protect athletes so they can continue playing the sports they love.


Learn more about Concussion Treatment and Sports Medicine at Children’s Mercy.

Learn more about Athletic Training Services at Children’s Mercy.