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Experts urge proper healing before heading back to school sports

By Michelle Castillo / CBS News 4:13 PM September 2, 2013

Report says 1.35 million emergency room visits each year are due to severe sports injuries

A recent report from Safe Kids Worldwide says that 1.35 million emergency room visits each year are due to severe sports injuries – about one child injured while on the field every 25 seconds.

While injuries can be painful, experts are more concerned that children get the time they need to heal and aren’t being rushed back on to the field. As the school year starts and kids gear up for team sports, doctors are warning that players, parents and coaches need to be cognizant of injuries that require extended periods of time off.

“One of the biggest risk factors of being injured again is incomplete recovery or rehabilitation,” Michael F. Bergeron, executive director of the National Youth Sports Health and Safety Institute, told CBSNews.com.

A competitive spirit may be driving young athletes to want to get back on the field, even if they are too injured to play. A May survey of high school football players showed that 53 percent would still play even if they had a headache that they sustained from an injury, which may be a sign of a concussion. Only 54 percent said they would report worrisome concussion symptoms to a coach.

It might be up to the parent or the coach to tell the player that they need to take some time off. However, Bergeron warns that personal motivations may cause adults to push kids back into the field of play before they are ready.

“Parents and maybe even coaches are sometimes more interested in the short-term, acute performance of this young athlete rather than the long-term health and the more optimal development of the this child,” he said.

While a kid may seem to be okay playing on a knee they hurt, a lot of times people compensate for an injury by adjusting how they land or move. This could lead to further problems come adulthood.

Perhaps one of the most concerning injuries to children are concussions. Besides the immediate injury, there is evidence that it may cause long-term effects in the developing brains of kids.

The American Academy of Neurology updated its recommendations on concussions in March. Instead of grading the severity of a concussion and how long recovery might take, the organization now recommends “if in doubt, sit it out.” Dr. Christopher C. Giza, a neurologist at the David Geffen School of Medicine and Mattel Children’s Hospital at UCLA, explained at the time that any athlete suspected of having a concussion should immediately be removed from the playing field.

Multiple concussions may require longer recoveries. A Pediatrics study in June revealed that patients who have multiple episodes may need more time off. Kids who had a prior concussion before their current one needed 24 days to recover, compared to first-timers who only needed 12 days. Those who had a concussion the year prior to their current concussion had symptoms for up to 35 days.

Bergeron said parents should be aware of the signs and symptoms of a concussion. It includes a dazed stare, headache and sensitivity to light and sound. There may be changes to reaction time, balance, memory, speech (like slurring), judgment and coordination. Loss of consciousness or a “blackout” may happen, but only occurs in 10 percent of cases.

“Pay attention,” he said. “If things don’t look right, they’re probably not.”

He also cautioned about devices on the market that say they may prevent concussions or other injuries, but don’t have the evidence to support those claims. In some cases, he’s heard of coaches urging parents that they can put their injured children back in the game with this added “protection,” even if the doctor recommended more time off. A lot of these devices say they minimize the risk of concussion, but the truth is there aren’t enough tests to show that they do besides the information the manufacturer provides, Bergeron pointed out.

There are some devices that may detect when a hit is hard enough to cause a concussion. The Newcastle, Okla. football team outfitted their players with a device in their helmets that reportedly transmits information to an iPad about the severity of a blow.

“Even if they got their bell rang and they are a little dizzy, they don’t want to come out,” head coach Keith Bolles told CBS News. “But this tells us to check them. It takes some of the load off and we check them, and if that kid does not meet the baseline requirement they had, then we know there might be something, and we take them out.”

While this sounds good in principle, Bergeron worries that if people rely on the devices they might not think kids are injured unless they get a notification that it was a hard hit. He points out that not all concussions are caused by a direct hit to the head. A strong hit to the body can cause enough force to shake the brain against the skull. He urged parents to err on the side of caution, and be advocates for their children if they think they suspect something is wrong — even if it means missing a few games.

“Except for very, very few sports like gymnastics, no one really remembers the champions at 12, 13 and 14,” he said. “It’s when you’re 19, 20 or 21.Those who are successful early on are rarely the champions later. Parents should say, ‘Let me be sure that he or she is not hurting so they can be healthy and continue on.’”

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