Head Bonks - don't laugh

If you hang out with enough former football players, you've probably heard them talk about having gotten their "bells rung" at least once.  Fortunately, at this point, most people take head injuries more seriously, leading to the current policy on head injuries in the NFL.  Unfortunately, too few people really understand concussions.

The following short list encompasses the answers I get when I ask adults and kids "What do you think a concussion is?"

• "It's when the brain smacks into the inside of the skull and gets bounced around and bruised."
• "When you get knocked out."
• "It's when you get hit in the head."

The first explanation is really what happens in a coup-contrecoup injury, and represents a more serious head injury; most head injuries don't feature this problem, fortunately.  The second and 3rd quotes are partial truths, and are part of the reason people, including doctors, miss concussions.

For definition purposes, a concussion occurs when a person sustains a significant impact, and then, essentially, feels funny.  Bonk/crunch ---> feel funny.  The impact can involve the head, or it can merely be a strong enough jolt to cause a snapping motion of the neck - back, forward, to the side, whatever.  The "feeling funny" refers to what doctors would call a change in mental status, and the following is a partial list of those symptoms:

• loss of consciousness
• blurry vision
• feeling foggy
• memory loss
• dizziness
• being off-balance
• speech issues
• discoordination

I have seen a lot of concussions, and here's (yet another) list of how they happened:

• Kid boarded during a hockey game
• Gymnast fell off uneven bars and landed on her backside but had her neck "bounce" hard
• Any number of football collisions
• Lacrosse cross-checking injury
• Child shoved hard by another child
• Kickball to the face
• Teen in a rush, hit side of head against door frame of car
• Home plate collision
• Fastball to the (helmeted) head
• Car accident with whiplash only.

Why are concussions so bad?  Instead of calling them concussions, let's call them "traumatic brain injuries," since that what these are - brain injuries.  I think most of us would agree that injuring your brain is bad, but how bad is it?  People with concussions and the dreaded post-concussion syndrome can suffer long-term or even permanent damage to vital brain functions like attention, judgement, balance, memory, and emotional control. 

Furthermore, some people have sleep problems, chronic headaches, and fatigue, chronic or not.  Some people even appear to suffer from ADHD/ADD-like or depression.  Google enough, and you'll see that former athletes have committed suicide after suffering from these issues.  Kids especially seem to be vulnerable to something called "second impact syndrome," which can result in either severe neurological damage or death when a person who already had a concussion suffers a similar injury before the original injury resolves.

Deep breath.

What can you do?  Read up on it; here are some good websites:

• http://www.momsteam.com/  (good overall sports parenting website, very accessible) 
• http://www.cdc.gov/concussion/HeadsUp/youth.html

Most importantly, if your children sustain big bonks and are acting funny, take them out of the game or situation and watch them carefully.  Call your doctor if you're concerned.  Have them checked out as soon as you can, in the ER right then if you're worried.  You don't need a CT scan or MRI, but you do need a good doctor who will listen to you and your concerns.

If you're really motivated, move for your town or school system to institute concussion education programs and make sure that your coaches, from youth sports all the way to high school sports, are aware of what traumatic brain injuries are.  Push for your school to have certified athletic trainers at every game.  Hopefully, with enough awareness, I won't hear the following after I advise parents to pull their kids from sports until they're feeling better...

"Yeah, doc, I hear you...you're trying to cover your butt, and I get that, but I had my bell rung a few times when I played football, and I'm just fine..."

Soccer

I coach my daughter's U6 soccer team.  The kids named us Orange Juice, because we have orange shirts.  We almost called ourselves the Orange Hats, but the funnier Orange Juice voted down Orange Hats by a vote total of 7 to 4. 

To feel my role as coach, imagine herding a bunch of insane leprechauns trying either to get the same pot of gold or to throw pulled-up grass at each other.  That pretty much describes it.  True enough, there are a number of 5 year-olds that grasp the concept of "small touches" on the ball to keep the ball in front of them, and there are even some kids who understand that getting in front of someone slows that person down.  The rest of the kids just run around and behave like 5 year-olds. 

The other day, I saw a parent on the sideline.  I already knew 5 of the families from last season; this parent is not one of the veterans of Orange Juice.  I asked her how her son was enjoying the U6 experience.  She replied that he loved it, but that she was trying to get him to be on the ball more.  I told her that he was doing great, if only because he's having fun.  It also happens to be true that he might be the best soccer player on our team, but that's not really all that important.

There's a part of all of us that wants our kids to do well at everything they do.  We want our kids to try hard; we know that practice makes better, if not perfect.  For kids, though, there are no failed athletic stints or knowledge of past semi-serious efforts that might have borne athletic scholarship fruit "if only."  For many kids, especially younger kids, trying hard means doing well.  Further, the goal is to have fun - why else would one play a sport or do anything, really?  Boring sucks.

If we can remove ourselves from the equation, and just let our kids have fun, the whole experience becomes better.  There is no "parents versus child" dynamic, no struggle for control.  The kids participate at the level they're at, and as long as no one is hitting anyone else with a baseball bat, or flicking snot at anyone else, everything is fine.

Last season, a parent walked up to my wife and told her that her daughter was having a great time with soccer.  During the game, her daughter, a child with some special needs, had run very hard to where the other kids were clustered around the ball, and started jumping up and down.  We coaches yelled, "Great job, Melinda!  Nice run!"  Her mother, apparently, had been about to say, "Melinda, kick the ball!  Don't just stand there!"  However, she realized that her daughter's goal is to run hard and jump up and down.

Should high school athletes have a similar goal?  Clearly, the answer is no.  How about 10 year-olds?  8 year-olds?  I think how you address practice and game habits depends on your children's interests, but always cheer them on.  If they feel bad about what they do, it won't matter if they're Pelé or if they like peeling oranges.  They'll quit.