Young athletes with concussions need longer recovery time: expert

By Michael Lightstone

Sidney Crosby is perhaps Nova Scotia’s most well-known, multiple concussion sufferer.

By the spring of 2017, the Pittsburgh Penguins captain sustained at least his fourth of his storied National Hockey League career.

Last May, during a playoff series, Crosby was the recipient of an opponent’s elbow to the head, prompting concerns about yet another concussion.

The veteran athlete, a Cole Harbour native, is 35 years old. When Crosby was diagnosed with concussion no. 4 he was 29.

For younger athletes, such as junior high school, high school and post-secondary competitors, recovery and the return to routine activities stretch beyond the playing field, gym, court or ice rink.

Concussed kids need to be healthy enough to resume their education, a public talk hosted by Dalhousie University heard Wednesday.

Jennifer Fletcher, a sport-medicine doctor and concussion-management expert, said young brains are still developing and student athletes will need more recovery time after a concussion than adults.

She said a multi-stage process, which includes rest for the first 48 hours, will help school competitors with head injuries eventually get back to class.

“Once the athlete is able to do two 30-minute segments of cognitive or thinking activity, … then they can start back to school part time,” Fletcher said during Dalhousie’s “mini-medical school” event.

“Then they slowly, progressively increase their time at school over a couple of weeks until they’re fully back without accommodations.”

Fletcher said a concussion affecting a student athlete who happens to have a learning disorder or an emotional problem, such as anxiety, depression or attention deficit disorder, makes for a longer recovery period – and a tougher time getting back to school.

With respect to concussion prevention, Fletcher said rule changes in sports that affect player behaviour can lower the risk of head injuries.

“If we can alter player behaviour, to not have that intent to injure the other player, then perhaps we’ll have less concussion,” she said.

Concussions are traumatic brain injuries resulting in brain-function effects that are most often temporary, says the Mayo Clinic in the United States. It says they’re usually caused by a blow to the head, but violent shaking of the head and upper body can also cause them.

Researchers are studying the consequences, over time, of repeated head trauma. The Centers for Disease Control and Prevention in the U.S. says “there is growing concern about the long-term effects on the brain of people who experience multiple or repeated head impacts.”

According to the Brain Injury Association of Nova Scotia, there are more than 17,000 people annually in this province who sustain such an injury. Head injuries can be caused by such things as workplace accidents, vehicle crashes, assaults, falls and participation in sports.

Regarding concussions, the Canadian Medical Association Journal says “the young brain is more susceptible to concussion than the adult brain. Also, it is now known that, after a concussion, there is greater susceptibility to sustaining another concussion.”

For student competitors, concussions aren’t diagnosed only in athletes playing such violent, contact sports as football, rugby and hockey. Post-secondary administrators began addressing the issue in earnest years ago.

“We see (concussions) in soccer, we see them in basketball, we see them in volleyball. We see them in virtually every sport which is why … we are starting to implement baseline testing across the board,” the university’s athletic director told The Dalhousie Gazette in 2016.

During Dal’s online-only presentation, Fletcher was asked if it’s possible for a soccer player to get a concussion from hitting a soccer ball with their head.

“Yes,” she answered matter-of-factly.

“In younger soccer players, I would say like middle school age, I’ve certainly seen it,” said Fletcher, who runs a sport concussion clinic for young athletes in New Brunswick and is an orthopedic surgeon.

She said coaches and other adults affiliated with youth sports teams, who aren’t medical professionals, can educate themselves about the signs of a concussion and the procedures required to deal with student athletes with a suspected head injury.

Dal’s mini-medical school program, which is open to all, runs Wednesday nights until early March. Future topics include medical assistance in dying, cancer treatment and arthritis.

The program’s schedule can be found here.

Michael Lightstone is a freelance reporter living in Dartmouth

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