Recognizing the Dangers of Youth Sports Concussions

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Youth sports concussions are rapidly rising, but why? Dr. Mitul Kapadia, assistant clinical professor of pediatrics and director of the Physical Medicine and Rehabilitation program at UCSF Benioff Children's Hospital, helps us understand how to recognize the dangers of sports concussions. He reveals what we’ve learned and how parents, coaches and teammates can recognize when there is a problem. Dr. Kapadia explains why more clinics around the country, like UCSF, are specializing in adolescent brain injury, what childhood concussion may mean later on in life, and why seeking expert care is critical.

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Well, any parent who has a child who does sports these days worries about concussion, whether it's your daughter playing soccer, your son playing football.  I have one that plays lacrosse.  Any kind of contact thing, and, of course, there are other sports like skiing as well, you worry about head injury.  You worry about concussion.  You watch the sports channels, you hear the stories of NFL and college athletes who develop brain conditions late in life, Alzheimer's, etc., and you worry, am I setting the stage for that?  Well, unfortunately, sports concussion is on the rise, and we worry about it, as we said, very much with our children. 

Joining us is an expert to help us understand where we are with this now and how important it is to get really expert care in an evolving field.  Joining us now is Dr. Mitul Kapadia.  Dr. Kapadia is the medical director of pediatric rehabilitation at UCSF Benioff Children's Hospital.  Dr. Kapadia, welcome to Patient Power.  

The outliers are those that are not fully able to recover because they haven't sought medical attention or just have not had a chance to recover, and that's where we get into danger.  So when we have a head injury, we haven't recovered from it, and we have a second head injury and then a third injury, that impact is not really even additive.  It's exponential.  And that's where we're learning more and more about the outcome of things like NFL where we're thinking that the repeated head injuries of tackles is essentially having repetitive head injuries without recovery, and that exponential impact is what we're learning more and more about every day.  Something called chronic traumatic encephalopathy, or CTE, is the finding that has kind of come out recently in the NFL players and also now in college?level athletes, when they've looked at the brains of these athletes, some of them who have passed away, they're seeing essentially signs of early Alzheimer's disease.  But the difference is those were athletes that didn't really seek medical attention for those concussions and were having these repetitive injuries without recovery. 

And the information is evolving in terms of how we manage this, and that's why we really feel like having expertise centers that can kind of be go?to places for this is essential in really effectively and properly managing these athletes. 

And the motto that we kind of tell everyone is when in doubt, keep them out.  So if there's any concern of a head injury or a concussion that occurs during a football game or a soccer game, a lacrosse game, skiing, we need to take a break at least for that day and seek some guidance because the impact of going back into the sport if there was a concussion can be quite traumatic.  And so beyond that and having an awareness of these symptoms, we want our kids to be active.  We want them to enjoy their sports and be able to do them without this fear, but it's important to have that awareness of what could potentially happen and when to seek guidance when a head injury does happen. 

The famous case in terms of how we manage concussions in athletes was a child named Zachary Lystedt, who was in Seattle, and in 2009, it was a similar story.  He actually was 13 years old at that time and had a head injury from a tackle that he had made, was a little bit wobbly on his feet, felt a little bit like he had a headache but went back into the game and continued playing.  And after that game, he essentially couldn't stand anymore. 

He had a traumatic brain injury, and he ended up having to go to the hospital, had to have life-saving surgery including removing both sides of his skull because he had such significant swelling.  He ended up spending seven days on a ventilator and three months in a coma.  I mean, that's really where the Zachary Lystedt Law and this idea of “when in doubt, sit them out” first became a law in the state of Washington.  And now it exists in 43 states including California and the District of Columbia. 

And that law is that when there are any concerns of a concussion happening or head injury happening, the athletes have to be taken out of the game and cannot return and that they need clearance from a healthcare professional before they return.  And that's the awareness that's really helped from the professional athletes because we know that the outcomes can be quite devastating, and we've seen these kinds of cases in the news, and so we want to avoid that at all cost. 

We do a wide variety of tests in our clinic when a patient comes in, so there are evaluations at multiple levels.  We do this impact testing, which allows us to get some information in terms of neurocognitive processing, how the motor speed awareness is, and different components that help us guide the process of recovery and getting kids back into school and physical activities.  We do balance testing. 

We have a neuropsychologist that sees the majority of our children as well.  So there's a wide spectrum of things that we're doing and looking at when we're making decisions, and the goal is to get our kids back into school and then get them back into physical activities.  But it really takes a kind of comprehensive evaluation, a comprehensive look. 

Thank you so much for being with us, Dr. Mitul Kapadia, and we wish you well in your work, but we hope that we'll get past this problem someday.  Wouldn't that be great? 

Please remember the opinions expressed on Patient Power are not necessarily the views of UCSF Medical Center, its medical staff or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on May 9, 2014