For many children, fall signals the start of organized sports. From football and cheerleading to field hockey, baseball and soccer, sports can be a great way for kids to have fun, learn new skills and develop character. On the flip side, sports accidents happen, concussions in particular. The CDC estimates, 1.6-3.8 million sports and recreation-related concussions occur each year in the U.S. Ryan Lockwood, a physical therapist at Children’s Hospital of Richmond at VCU’s Fredericksburg Therapy Center, discusses what concussions are, how they happen and what you can do to help prevent them.

Q. What is a concussion?

Ryan Lockwood: A concussion falls under the umbrella of a traumatic brain injury, which is an impairment of your cognitive abilities, your physical functioning, and/or a disturbance in your behavioral or emotional functioning.

Q. How do concussions occur?

Ryan Lockwood: Usually by a jolt or a blow to the head or body. You do not have to have a loss of consciousness or be knocked out to sustain a concussion.

Q. Which sports pose the greatest risk for concussions?

Ryan Lockwood: Football, lacrosse, soccer and cheerleading are some of the organized sports that have a higher incidence of concussion. Recreational sports often do not have the same amount of supervision and safety rules and regulations making them a higher risk as well.

Q. What are the signs and symptoms to watch if you believe your child may be concussed?

Ryan Lockwood: There are physical symptoms like sensitivity to light, sensitivity to noise, vision- related problems, dizziness, balance issues, neck pain and headaches. There are cognitive symptoms like changes in school performance, difficulty with concentration, difficulty remembering, forgetfulness and confusion about events and when they happened. There are emotional symptoms like increased irritability, sadness, anxiety and possibly depression-related concerns. There can also be sleep-related symptomology—trouble falling asleep, or sleeping too much, as well as disruptions to the normal sleep-wake cycles. The amount and types ofbsigns and symptoms are highly variable from one person to the next.

Q. How soon do concussion symptoms show up?

Ryan Lockwood: This can be highly variable from one person to the next as well. Some symptoms show up immediately, especially some of the physical symptoms like sensitivities to light, headache, dizziness and balance issues. Some of the cognitive symptoms like memory and concentration are often seen immediately as well. Other symptoms may not show up as a problem until a few days to weeks later, when some of the other symptoms have started to resolve.

Q. What should I do if I suspect that my child has a concussion?

Ryan Lockwood: When in doubt pull them out. If you suspect your child has had a concussion do not let them continue to participate in the sport/activity the same day. Seek medical attention to evaluate if your child has in fact experienced a concussion. Seeking medical attention from providers that have experience and training in concussion is highly recommended.

Q. How are concussions diagnosed?

Ryan Lockwood: A diagnosis of concussion is made via clinical exam. Collecting a good history about the injury and how the injury happened. Was there a loss of consciousness? Are there any memory gaps? Were they dazed and confused and if so for how long? Collecting information about signs and symptoms they have experienced, and are currently experiencing. An evaluation of several of those physical symptoms like sensitivities to light and sound,
how well their eyes are moving, how well their vestibular (balance) system is responding. Additional evaluation on things like short term memory and delayed recall memory. It’s a combination of many different clinical assessments to
determine if this is a change from their normal- prior to injury.

Q. How are concussions treated?

Ryan Lockwood: Education and support is the first step to any treatment. Explanations about why they are experiencing symptoms, what the triggers are of the symptoms, and getting them started on some activities focused on sleep hygiene, diet, and activities to do to reduce the amount of time they will experience the symptoms. Assisting with managing the stress of having an injury including identifying and recognizing the cognitive, physical and emotional sources of stress and trying to reduce those.

Therapy services like physical or occupational are often used to address symptoms and issues associated with balance, dizziness, eye-related concerns, and neck pain. Speech therapy is used to address symptoms related to inattention, memory, organizational skills, and assist with the return to learn process. All children should be fully returned to their academic/school requirements successfully before initiating a return to play plan.


Q. How can we prevent concussions?

Ryan Lockwood: Concussion and other sport related injury risk can be reduced by wearing appropriate protective gear, using appropriate equipment (size and purpose), having proper training and conditioning that replicates performance needed, and having appropriate supervision including coaches training and parent education.

There have been many changes to rules and regulations in sports that have been intended to reduce the risk of injury as well (ie. No heading the ball in soccer, penalties for illegal hits in football and lacrosse as some examples).

Q. Any parting wisdom you want to pass on?

Ryan Lockwood: The benefits of sports participation and an active lifestyle far outweigh the risk of injury associated with participation. It’s important we have sports available, and that we’re choosing to allow our children to play in sports. Participation develops leadership skills, self-confidence, dealing with success and failure, and teamwork. Additionally, the exercise habits that sports promote are often lifelong. Stay safe. Play with purpose! Have fun!

ChildrensTherapyCenterCould your child benefit from occupational, physical or speech therapy?

Call CHoR’s Fredericksburg Therapy Center to learn more:

Fredericksburg Therapy Center
10530 Spotsylvania Avenue
Fredericksburg, VA 22408