Concussions in Youth Sports:
Risks, Prevention, Diagnosis and Treatment

“Returning to play too soon can have serious consequences,” said Dr. Chopra, a sports medicine specialist, at co-founder of Genesis Orthopaedic and Spine, with five locations in NJ. “It’s crucial that young athletes receive the care they need before resuming sports.”

TAPinto had the opportunity to interview Dr. Chopra and discuss concussions, prevention, diagnosing, and what to do if you or someone you know may have a concussion.

TAPinto: Dr. Chopra, thank you for your time today. How do you define a concussion in everyday words?
Dr. Chopra: A concussion is a type of traumatic brain injury that occurs when the brain is jolted or shaken inside the skull, typically as a result of a blow to the head or neck or body. This impact can cause the brain to move around and potentially collide with the walls of the skull, which causes a series of biochemical changes, leading to a range of symptoms such as confusion, dizziness, headache, and memory problems. Concussions are considered mild forms of brain injury, but they need to be taken seriously and monitored by a concussion specialist.

TAPinto: More and more we hear about children and teen athletes with concussions. What sports do you see in your practices, are more likely to result in concussions?
Dr. Chopra: Sports that involve physical contact and fast-paced movement are more likely to result in concussions. Some of the sports with the highest rates of concussions include football, soccer, hockey, rugby, boxing, and wrestling. Additionally, sports like basketball, cheerleading, lacrosse, and skiing also have a higher risk of concussions due to falls or collisions.

TAPinto: How is a concussion diagnosed?
Dr. Chopra: If someone suspects that they or someone they know has a concussion, they must seek medical attention as soon as possible. In our practice at Genesis Orthopaedic and Spine, concussion diagnosing includes Credentialed ImPACT® Consultants (CIC). This means our team has completed an extensive training program that allows us to provide top-of-the-line concussion diagnosis, assessment and care.

The Genesis team performs neurobehavioral and neuropsychological tests and assesses the patient’s symptoms. We may use the Biodex BioSway™ machine to help analyze balance and coordination. The machine includes a platform for the patient to stand on and an attached screen. The patient is encouraged to make certain movements and changes in their stance with games and training instructions.

The Genesis team uses the BioSway throughout the individual’s treatment to assess progress and make sure the person is ready to get back to school, work, or sports once they recover.

TAPinto: What is second impact syndrome, and how can it be prevented?
Dr. Chopra: Second impact syndrome in concussions is a rare but potentially fatal condition that occurs when an individual sustains a second head injury before symptoms from a previous head injury have fully resolved. This can lead to rapid and severe swelling of the brain, resulting in catastrophic consequences such as coma, seizures, and even death.

TAPinto: That is frightening and further supports that if you think you may have a concussion, but are not sure, it is so important to be seen by a physician such as yourself. How can second impact syndrome be prevented?
Dr. Chopra: To prevent second impact syndrome, it is important for athletes and individuals to allow for proper recovery time after a concussion before returning to physical activity. This includes following appropriate return-to-play protocols as outlined by medical professionals, which often involve a gradual increase in physical activity and monitoring of symptoms. It is crucial to prioritize the long-term health and well-being of individuals who have experienced a concussion to reduce the risk of second impact syndrome.

TAPinto: When can a young athlete who is diagnosed as having a concussion expect to return to their sport, post-concussion?
Dr. Chopra: Each case is different. The time it takes for a young athlete to return to their sport after a concussion can vary depending on the severity of the injury and the individual’s recovery process. In general, most young athletes can expect to return to their sport within 1-4 weeks after a concussion, following a gradual return-to-play protocol. It is important for athletes to be cleared by a concussion specialist before returning to sports to ensure they have fully recovered and are not at risk for further injury. Objective testing such as neurobehavioral, neuropsychological, and balance testing can be helpful.  It is also important for athletes to follow all recommended guidelines for returning to play to reduce the risk of re-injury or long-term consequences of a concussion.

TAPinto: What precautions can students, parents, and coaches take to prevent/ensure proper recovery from concussions?
Dr Chopra: It’s important for everyone involved to be educated on the signs and symptoms of concussions, as well as the importance of proper recovery protocols. If a concussion is suspected, the player should be immediately removed from the game or practice and evaluated by a healthcare professional. The player will need to rest, both physically and cognitively, in the days following a concussion.

This may include reducing screen time, avoiding physical exertion, and ensuring adequate sleep.

Once they are cleared by a concussion specialist through objective testing, the individual should gradually return to physical activity, starting with light exercise and gradually increasing intensity.
Coaches and parents should communicate regularly with the student and physician to monitor their recovery progress and ensure they are following proper protocols.

It is important to follow up with a concussion specialist to ensure that the concussion has fully healed and to address any lingering symptoms. Parents, coaches, and healthcare professionals should monitor for any long-term effects of a concussion, such as memory problems, difficulty concentrating, or changes in mood or behavior.

Coaches should always ensure that players are wearing appropriate safety equipment, such as helmets, to prevent concussions. At the school level, it’s important that students are made to feel comfortable reporting any symptoms of a concussion to their coach or parents, and coaches and parents should take those reports seriously.

TAPinto:  What is the best course of action to take for concussion care?
Dr Chopra: If you suspect a concussion, consult a concussion specialist right away. They can assess the severity and recommend appropriate care. For someone with a concussion, rest is crucial. They should limit physical activities to avoid further injury. This includes avoiding sports, heavy lifting, and strenuous exercise, but they should also reduce activities that require intense concentration, such as reading, using electronic devices, or studying.
While recovering, stay away from alcohol and recreational drugs as they can impair judgment and delay recovery. It’s important to keep an eye out for worsening symptoms such as severe headaches, repeated vomiting, confusion, or difficulty waking up. If these occur, seek immediate medical attention. Always adhere to the specific recommendations provided by your concussion specialist.

TAPinto: When symptoms begin to improve, when can normal activities resume?

Dr. Chopra: Once symptoms improve, gradually reintroduce physical activities, starting with light exercise and progressively increasing intensity based on your tolerance and medical advice. It’s a good idea to reintroduce cognitive tasks gradually, ensuring they don’t worsen symptoms.
Some individuals experience prolonged symptoms, such as headaches, dizziness, and cognitive difficulties. If symptoms persist beyond a few weeks, consult your healthcare provider for further evaluation and management. Make sure to attend any follow-up appointments with your healthcare provider to monitor your recovery progress and adjust the management plan as needed.

TAPinto: What about the mental health impact of a concussion?

Dr. Chopra: Concussions can even affect your mood and mental health! If you experience anxiety, depression, or significant mood changes, consider seeking support from a mental health professional.
Avoiding re-injury after a concussion should also be a priority. Protect yourself from situations where another concussion might occur. This might involve modifying your activities for a while or using additional protective gear.

During your recovery, you need to seek immediate help if your symptoms worsen suddenly, or if you experience severe headaches, repeated vomiting, severe confusion, difficulty waking up, or seizures.
Concussion care requires a balanced approach of rest, gradual reintroduction of activities, and monitoring for any ongoing symptoms. Always follow the guidance of your healthcare provider tailored to your specific situation.

TAPinto: Thank you Dr. Chopra! 

This article is sponsored by Genesis Orthopedics and Spine, the trusted destination for comprehensive care in orthopedics and spine. In concussion cases, the Genesis Orthopaedic and Spine team works closely with physical therapists, neuropsychologists, and other specialists to ensure a rounded treatment approach and a comprehensive recovery. Your physician lets you know when it is safe to fully resume sports, school, work, or other activities. Request your concussion evaluation by phone or online at Genesis Orthopaedic and Spine promptly after your injury. You can call one of the following Genesis locations: 

Westfield (908) 588-2311

West Orange (973) 434-9575

Morristown (862) 345-7955

Ridgewood (551) 284-4600

Middletown (732) 788-3769

The material provided above is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care. If there is a serious emergency/health threat, dial 911.