During cheering training in April, Jana Duey’s sixth-grade child, Karter, sustained a injury when she fell several feet headfirst onto a gym floor bed. Time after, Karter also had a headache, drowsiness, and sensitivity to light and sound.
Karter spent a month and a half at her house in Centennial, Colorado, before returning to school when her injury signs were manageable, first for only half-days, with modifications that made it easier for her to work on paper rather than a camera and take extra time to get to and from classes. Karter went to the surgeon’s office when she had a toothache, Duey said. After the injury left her unable to compromise on her feet, she began physical therapy to repair her neck and begin rehabilitation.
After kids get concussion, a major issue for them and their parents or caregivers is when they can go back to activities, said , Julie Wilson, Karter’s physician and a co-director of the Concussion Program at Children’s Hospital Colorado in Aurora. Important first steps in concussion recovery are returning to school as soon as possible, with appropriate support, and getting light exercise that does n’t pose a risk of head injuries, in accordance with the most recent research.
” It’s really important to return kids and teens to their regular daily activities as soon as possible,” Wilson said.
In August, the Colorado Department of Education , updated guidelines , dispelling prevalent myths about injuries, such as a loss of consciousness being needed for a trauma treatment. Evidence-based best techniques regarding how returning to school and exercising you speed treatment are included in the revised guidelines. Health experts believe it is crucial to inform families and institutions about the new guidelines, especially given the rise in concussions from basketball and soccer in the fall.
More than , 2 million children , globally had been diagnosed at some point with a trauma or brain injuries, according to the 2022 National Health Interview Survey.  , A burst of studies , in the past decade , have shown , that children recover more quickly from injuries and decrease the risk for persistent signs by exercising quietly, for example on a stationary bicycle or with a fast walk, two days after a trauma. As long as the children can handle any unresolved trauma symptoms, that moment frame might also be the ideal time to return to the classroom.
” Even though the mind is not a body, it acts like one and has a use-it-or-lose-it phenomenon”, said , Christina Master, a physician and sports medicine and mental harm expert at Children’s Hospital of Philadelphia.
According to Master, students may return to school with additional support from teachers and cuts in their schedules to reduce symptoms like headaches or weakness with the aim of steadily doing more than once.
Every state has return-to-play rules for student-athletes that include procedures such as elimination from sports, medical clearance to return, and learning about injuries. While some states, such as Virginia and Illinois, have “return-to-learn” policies, Colorado is not among them. It and , 15 other states , have community-based concussion management protocols.
Colorado updated this summer with that information. REAP— which stands for Remove/Reduce, Educate, Adjust/Accommodate, and Pace — is a protocol for families, health care providers, and schools to help students recover during the first four weeks after a concussion. For example, school personnel can use an email-based system to alert teachers that a student sustained a concussion, then send weekly updates with details about how to manage symptoms, like difficulty concentrating.
” We have new protocols to support these kiddos”, said Toni Grishman, senior brain injury consultant at the Colorado Department of Education. ” They might still have symptoms of concussion, but we can support them”.
Most concussion patients go home after one month of experiencing symptoms. However, patients with ongoing symptoms, called persistent post-concussive symptoms, can benefit from a multidisciplinary care team that may include physicians, physical therapists, psychologists, and additional school support, Wilson said.
David Howell, director of the Colorado Concussion Research Laboratory at the University of Colorado Anschutz Medical Campus, is studying how children and their families cope with the physical, cognitive, social, and emotional impacts of concussions. In some studies, adolescents wear sensors to measure exercise intensity and volume, as well as common symptoms of concussion, like sleep and balance problems. In some cases, children and their parents respond to inquiries about how the recovery process is perceived and envisioned.
” What you bring to an injury is oftentimes exacerbated by the injury”, Howell said, citing anxiety, depression, or just going through a difficult time socially. Recovery can be influenced by peer and family relationships.
Duey claimed that Duey’s recovery from Karter’s illness, including losing her team’s final game in Florida, was the most challenging. Karter, now 12, watched practice and supported her teammates in the spring, but missing out tore her up inside, Duey said.
” There were a lot of tears”, Duey said.
While recognizing a concussion and acting quickly can help anyone, in practice, more than half of students in Colorado may slip through the cracks with undiagnosed concussions, according to Grishman’s estimates.
According to Grishman, there are many causes of missed diagnoses, including a lack of education, barriers to medical care, parental disinterest in sharing information with schools about a concussion because they fear their child will be cut out from activities, or not taking symptoms seriously in a student with a history of behavioral issues.
Getting schools to follow concussion guidelines, in general, is a challenge, Grishman said, adding that some districts still do not. She expressed concern about how many schools followed Colorado’s education department’s recommendations last year, but she anticipates better data collection this year will provide more details. Grishman and her colleagues taught 280 school personnel in Colorado’s 50 school districts concussion management during the past school year.
Athletic trainers should always be present to cheer on student-athletes, according to Master, and athletes should be aware of concussion symptoms in both their and their teammates and immediately seek medical attention.
Concussions can occur on other sports like football and soccer as well as in the classroom. Adventure sports like parkour, slacklining, motocross, rodeo, skiing, and snowboarding also pose concussion risks, Wilson and Grishman said. According to Howell,” crying is actually one that has a lot of concussions associated with it.”
Duey claimed Karter occasionally experiences headaches, but she recovered with the aid of physical therapy, and she no longer exhibits the symptoms of her concussion. She is back cheerleading and getting ready to compete.
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