Concussion - Boston Children`s Hospital

Concussion - Boston Children`s Hospital
Injury Prevention Series
What is a concussion?
A concussion is a brain injury that occurs when
a blow to the head causes the brain to spin in the
opposite direction from where the head was struck—
what doctors describe as a “rapid, rotational
acceleration of the brain.” Players with concussions
may feel dizzy, have headaches and vision problems,
experience nausea or a need to vomit. Concussions
vary in severity.
Sport-related concussions are common, but statistics
vary on how many occur each year. This is largely
because coaches, parents and players are often not
trained to recognize the symptoms of a concussion.
What’s more, some athletes may pretend that they aren’t
hurt so they can stay in the game.
Still, concussions make up about 15 percent of all high school sports injuries and 6
percent of college sports injuries. Of all pediatric patients diagnosed with concussions,
between 30 and 50 percent are sustained during athletic practices or competitions.
Player Safety
Who’s at risk?
Football The game accounts for
the majority of team sport-related
concussions—about 250,000 each year.
Helmet-to-helmet hits, blows to the
head from opponents and hard falls
to the turf are a few ways that players
can sustain a concussion
while playing football.
Ice Hockey Collisions
with other players, a stick to
the head, falls to the ice and hard
contact with the boards around the
rink may cause concussions.
Baseball and softball Concussions
may result when players collide with
other players, run into fences and
backstops or are hit by a ball or bat.
Basketball Hitting your head on the
floor or being hit in the head by an
opponent may cause a concussion.
Soccer Head injuries may be caused
by falls and player-to-player contact.
“Heading” the ball is not
considered dangerous, but
improper technique may lead
to injury, particularly in young
Lacrosse Falling to the
ground, getting hit by the
ball and collisions with
other players
may result
in head
Skiing and snowboarding About 20
percent of skiing and snowboarding
injuries are head injuries. Hard falls and
collisions with trees, signs and other
skiers may lead to concussions.
Wrestling, boxing, and martial arts
Blows to the head are central to boxing
and some martial arts. Hits to the head
are not allowed in wrestling, but
takedowns may produce head injuries.
Cheerleading Risky stunts, like tossing
a participant high in the air, have led to
an increase in cheerleading concussions.
Bicycling When a rider traveling at
a high speed falls from a bike, serious
head injuries can occur.
Boston Children’s Hospital offers Sports Medicine care at locations in BOSTON, LEXINGTON, PEABODY AND WALTHAM, MA
injury prevention
What you need to know about concussions
What causes a concussion?
A blow to the head, often caused by a fall
or a collision with another player or piece
of equipment.
How do you know it’s a concussion?
Dizziness, headaches and nausea are
common concussion symptoms. Still,
concussion symptoms aren’t always
apparent or immediate, so coaches, staff
and parents should pay close attention for
at least 24 hours after a player has been
hit in the head.
Back in the game
Players suspected of sustaining
a concussion should be removed from
the field and medically evaluated.
Players should only be allowed to
return to their sport when a medical
professional determines that they
have completely recovered from their
concussions. If a player keeps playing the game with a concussion, risk of brain
hemorrhage, swelling and other long-term problems increases.
Repeated concussions
Studies have shown that players who suffer one concussion have
a greater chance of sustaining another. The reason for the increased
risk is not known, but researchers suggest that some people may be born
with a vulnerability for brain injury or that a concussion may cause
changes in the brain that increase future risk. Other researchers believe
increased risk of concussion is simply a matter of increased playing time or the
result of risky and aggressive playing style.
Helmets have been shown to
reduce the risk of some head
injuries. Wearing a helmet,
however, does not fully protect
against concussions.
The rules
Overly aggressive and dirty play in
contact sports may lead to head
injuries. In games such as
football, ice hockey, soccer and
lacrosse, coaches, staff, parents
and players should insist on
strict adherence to the rules.
A good way to reduce
the risk of concussion
is to strengthen the
neck and shoulder
muscles. Strength
training that works
these areas can help the body
absorb the shock of a blow to the
head. Overall fitness is also key:
the stronger the athlete, the less
likely he or she will
be injured.
One thing is clear: over time, athletes who have sustained several concussions can
experience memory loss and a decline in their ability to think, concentrate and reason.
Many sports leagues and organizations require players to undergo baseline neurocognitive
testing before they can take part. Neurocognitive testing is used to measure brain functions
like memory, decision-making and reaction times. Baseline tests are compared to tests
performed after a concussion to assist athletic trainers, neuropsychologists and doctors in
determining when players who have sustained concussions are ready to safely return to the
game. No athlete should be allowed to resume play until all symptoms are gone.
Reviewed by William Meehan, MD, Director,
and Dr. Michael J. O’Brien, Associate Director,
Sports Concussion Clinic, Boston Children’s Hospital
This piece is part of an informational series on sports injury
prevention produced by the Orthopedic Center/Sports
Medicine Division at Boston Children’s Hospital. For materials
on preventing injuries in other sports, call 617-355-3501
or visit
© 2013, Boston Children’s Hospital
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