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Q&A: What should I do if I suspect my high school athlete has a concussion?

We asked University of Minnesota Health Sports Medicine Physician Jennifer Oberstar, MD, to share tips for identifying concussion symptoms, and what you should expect during your child’s concussion treatment.
University of Minnesota Health Sports Medicine Physician Jennifer Oberstar, MD, works directly with local high school sports teams to ensure the health of athletes and protect them from injury—including concussions. Oberstar shared some tips for identifying concussion symptoms, what to do if you think your athlete may have a concussion and what to expect during treatment.
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The fall sports season is nearly upon us and with it comes the possibility of sports-related concussions among student athletes participating in high school activities, including high school football.

University of Minnesota Health Sports Medicine Physician Jennifer Oberstar, MD, works directly with local high school sports teams to ensure the health of athletes and protect them from injury—including concussions. We asked Oberstar to share some tips for identifying concussion symptoms, what to do if you think your athlete may have a concussion and also what to expect during treatment.

Concussion screenings for high school athletes are available at our Sports Medicine Clinic, University of Minnesota Health Maple Grove Clinics, Fairview Ridges Hospital and at our soon-to-be opened Pediatric Specialty Clinic in Woodbury.

What exactly is a concussion?

A concussion is a traumatic brain injury—ranging from mild to severe—that can be caused by a direct or indirect blow to the head. It does not have to include loss of consciousness, although that can occur. It can also cause short-term and long-term impaired brain function.

Impaired brain function? What are the signs and symptoms?

There are a variety of signs that are associated with a concussion; some symptoms may occur right away, while others may not appear until hours or days after the injury. Some may experience headaches in the wake of a concussion. Those headaches can be accompanied by dizziness or physical unsteadiness. A person who has sustained a concussion may appear confused or have amnesia surrounding the traumatic event. They might experience a ringing in the ears. In the days after a concussion, a person may also display irritability or changes in personality, as well as light sensitivity and sleep disturbances.

Learn more about our University of Minnesota Health concussion care services.

What should a parent expect during a concussion screening process at a local clinic?

When someone comes in with a potential concussion, we usually conduct a symptom evaluation. We ask them questions such as: Do they have blurred vision or neck pain? Patients are then asked to rate those on a scale of 0-6, with zero being “none” and six being “severe.” And then we perform a cognitive and physical evaluation, asking about their memory and concentration. We do a neck exam, a balance exam, a coordination exam and check for delayed recall. If a concussion is more severe, an athlete would likely go to the emergency room to undergo a brain imaging study and neurologic exam.

If I think my child has a concussion, how quickly should I get them checked out?

I personally like to see kids earlier rather than later. We use a scoring system—called SCAT3—that tells us the severity of symptoms the patient is experiencing. Later on, we can compare that with the results from additional brain function tests. Additionally, once sports seasons begin, high school athletes must pass a series of steps before they can play again. So if they want to participate in the next “Friday night lights,” we have to start working with them right away.

What are the “Return to Play” standards for high school athletes in Minnesota?

A physician must initially diagnose the athlete with a concussion and athletes must have a note from a physician before they’re cleared to return to play in a game. Throughout the recovery process, a high school’s athletic training staff will work with the athletes The trainers will keep in contact with a physician and make sure the athletes are symptom-free for 24 hours for each of these steps. If an athlete is symptomatic at any step, they return to the previous step. Here are the standard steps leading to return to play:

  1. Absolutely no activity: An athlete needs physical and cognitive rest. We need to see that an athlete is asymptomatic before we can move onto Level 2.
  2. Light aerobic exercise: We encourage athletes to walk or perform another low-stress activity to try to increase their heart rate and to see if the symptoms return or become worse.
  3. Sport-specific exercise: An athlete may return to skating drills in ice hockey or running drills in soccer. Basically, we add some sport-specific movement to see if that brings on any symptoms.
  4. Non-contact training drills: During non-contact training drills the athlete experiences a higher level of exercise and increased coordination. It requires cognition of what they’re doing. We want the drills to be the focus here.
  5. Full-contact practice: At this point, if they have cleared each of the steps we’ve given them, we allow them to return to full-contact practice. We want to restore the athlete’s confidence and assess their functional skills.
  6. Return to play: The athlete returns to their regular sport and is cleared to play in a game with a note from a physician.

Would you recommend that I bar my child from playing contact sports?

No. We know there are certain sports that put players at higher risk, but the rules of high school sports have been modified to be safer and high-contact sports are not the only way children can get concussed. High school athletes certainly need to follow the rules, and it’s also important for parents to talk to their children if they think they’re noticing any symptoms. You may not always be able to prevent a concussion, but you can talk to your children about safety on the field and help them safely recover after a head injury.

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