“My daughter hasn’t been playing up to her normal standards. She seems really sluggish on the ice and isn’t making the great passing plays she used to be known for. She has been complaining of a headache for about a week now since her last game which was against a really aggressive team. Could there be a real problem?”
Dr. Montelpare: “Your daughter is showing signs that there could be an underlying injury, possibly a concussion. If she suffered a blow to the head during the game against the aggressive team last week, her poor play and headaches could be attributed to a concussion. You need to take her to be assessed by a professional. Until that time she should not be allowed to continue playing hockey. Any further trauma to her brain could make the situation much worse.”
Concussion can be a “hidden” injury that is difficult to identify and players may not be willing to tell anyone they are hurt. If your child has a concussion they may experience some or all of the following:
- Thinking problems:
- Doesn’t know time, date, place, score in game, opposing team, etc.
- General confusion
- Can’t remember what happened before or after injury
- Loss of consciousness
- Physical complaints:
- Feels dazed (e.g., like in a fog)
- Feels “dinged” or stunned (e.g. “bell rung”)
- Sees stars, flashing lights, double or blurry
- Loss of vision
- Ringing in the ears
- Stomach ache, pain and/or nausea
- Difficulty sleeping, sleeping less or more than usual
- Other Problems:
- Poor coordination, balance
- Blank stare, glassy eyed
- Slurred speech
- Slow responses to questions, directions
- Easily distracted
- Poor concentration
- Strange or inappropriate emotions (e.g., laughing, crying, anger)
- Not playing well
Concussion can be caused by a direct or indirect hit to the head, face, neck and/or elsewhere on the body. For example, a player may be hit in the head, face, neck or other body part when being checked and this may result in the sudden jarring of the head causing a concussion. Some of these may appear to be obvious causes, while others less so. The key is any contact that causes a “jarring” of the head and brain can result in a concussion.
“My son took a hard hit against the boards last game. It didn’t look like it hurt him because he stayed standing while the other player fell, but his head bounced off the glass pretty hard and he started complaining of headaches”
Dr. Montelpare: “Your son’s symptoms don’t lie- he most likely has suffered a minor concussion when his head struck the glass. While the incident may not have looked severe, it is hard to measure what damage has occurred to the brain. You should have your son checked out by a doctor to ensure his safety and to gain information about recovery steps for concussions.”
Other Problems from Concussions
The signs and symptoms of concussion frequently appear immediately following the injury and often last about 3 weeks in children and adolescents and around 7 to 10 days for adults. However, caution is warranted as symptoms/signs can last as long as 60-90 days. Recovery is different for everyone.
“My child suffered a concussion three weeks ago. Most of their symptoms disappeared after the first week, but they still complain of the occasional headache. I made sure they didn’t get back on the ice until these headaches stopped completely.”
Dr. Montelpare: “Fantastic job. It is very difficult to keep a child from participating in sport because they are often very eager to compete. You did the right thing to keep your child off the ice while they still are suffering symptoms. Recovery periods vary from person to person, but if these headaches keep occurring I advise you take your child to the doctor to make sure everything is OK.”
Subsequent concussions require longer recovery times!
What Can You d0 if You Think Your Child Has a Concussion?
The injured athlete should stop playing immediately! Then they should be monitored closely and taken to their doctor as soon as possible that day. If they lose consciousness call the paramedics and get them to the hospital via ambulance right away! Try to see a doctor who has experience dealing with concussions if at all possible.
The best treatment is REST! This means no training, playing, exertion (especially with weights) or even being on the computer.
For how long – until the athlete is symptom free. After that they can gradually return to activity.
Consult a physician trained in recognizing and treating concussions. Unfortunately the “family GP” is not always trained to recognize and deal with concussions. Be sure to seek the advice of a knowledgeable practitioner.
Steps to Recovery and Return to Play
A concussion is serious, but you can recover if the proper guidelines are followed. Remember the key is REST!
When can your child return to sport?
It is very important that your child not go back to practicing or playing if he/she has any concussion symptoms or signs. Return to physical activity must follow a step-wise approach:
- No activity, complete rest. Once back to normal and cleared by a doctor, go to step 2.
- Light exercise such as walking or stationary cycling, for 10-15 minutes. If symptom free, then move to step 3.
- Sport specific activity (e.g., skating), for 20-30 minutes. Again, only progress to the next step if symptom free.
- Practice such as puck-handling drills, shooting drills, and other activities with NO CONTACT (i.e. no checking). The player can move onto step 5 if they continue to be symptom free.
- Practice with body contact, once cleared by a doctor.
- Game play.
Remember: These are steps not days. It takes time to progress through each step and will vary for each individual. If your child has any symptoms of a concussion (e.g. headache, feeling sick to his/her stomach) that come back either during activity, or later that day, your child should stop the activity immediately and rest for 24 hours. Your child should be seen by a doctor and cleared again before starting the step wise procedure again. Returning to play without full recovery increases the risk of additional concussion and enhances the magnitude and duration of symptoms!
(Adapted from: http://www.safekidscanada.ca/SKCForParents/)
“After hearing about the damage that multiple concussions can cause the brain we made sure that our child followed the proper return to play guidelines”
Dr. Montelpare: “Great job. Concussions are on the rise in hockey, but you are taking the right step to ensure that your child does not suffer a second one. They may not be happy with you keeping them from hockey right now, but they will thank you in the future!”
Please note: The above list is not exhaustive nor does having one or more of these symptoms mean that someone has a concussion. It is merely a guide to possible concussive symptoms. It is important to seek medical attention immediately to receive a diagnosis and treatment.