Managing Concussions In Children

Concussions: Do Different Rules Apply To Pros?

By Brooke de Lench

When Boston Red Sox centerfielder Johnny Damon collided with teammate Damian Jackson during the fifth and decisive game of the team's American League Division Series with the Oakland Athletics in 2003, laying unconscious on the field for several minutes, he suffered what all three major concussion grading systems term a Grade 3 concussion.

Damon's return to the playing field just four days later, however, should not be viewed by parents of student athletes as an endorsement of a quick return to play after a severe concussion. Under even the most lenient of the return-to-play guidelines issued by the American Academy of Neurology, Damon should not have been permitted to return until after two symptom-free weeks. Guidelines issued by the Colorado Medical Society and Dr. Robert Cantu are even more conservative; neither would allow Damon to play for a full month, long after the baseball playoffs end.

The reason: the brain needs time to recover, and if an athlete suffers a

second concussion before the brain has healed, he or she is susceptible to second-impact syndrome, a potentially fatal swelling of the brain. The second blow may be unremarkable, perhaps only involving a blow to the chest that jerks the athlete's head and indirectly sends accelerating forces to the brain.

The lesson for parents, coaches, and athletic trainers involved in youth sports seems clear: different rules appear to apply to professional athletes, especially those involved in post-season play. Simply put, allowing your child to compete again in only a couple of days, as Johnny Damon has, puts your child at unacceptable risk.

Return-to-play guidelines for young athletes need to be especially conservative given recent research done as part of an NFL project to study recovery of concussions at the University of Pittsburgh Medical Center which shows that professional football players recover from concussions faster than high school players, with a majority of NFL players tested back to their pre-season score levels with a week of injury, compared to a majority of the high school players, who still had substantial deficits in reaction times and verbal memory skills seven days after suffering a concussion. Based on numerous studies showing that brain connections and growth aren't complete until a person reaches his mid-20's, researchers speculate that high school athletes' brains may be slower to recover from concussions than pro players because their brains have not fully matured.

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Article Updated: August 1, 2007
Article Created: October 10, 2003

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Return to Head Injury Home Page

Concussions: Advice For Parents Of Youth Athletes
Treating Athletes With Concussions: No Clear Consensus
Second-Impact Syndrome: What Is It?
Post-Concussion Signs & Symptoms: A Checklist
Standardized Assessment of Concussion (SAC)
Balanced Error Scoring System (BESS)
Managing Concussions In High School Sports: A Proposed Model

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