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After Concussion: When Can Your Child Play?

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WebMD Magazine - Feature
Reviewed by Roy Benaroch, MD

With their young minds still developing, kids with concussions need to take time-outs -- both mentally and physically -- to fully heal, new research shows.

"After a concussion, kids need 3 to 5 days of mental shutdown to let their brain rest and recover," says Michael O'Brien, MD. He's the associate director of the Sports Concussion Clinic at Boston Children's Hospital and an author of a recent study published in Pediatrics.

A concussion is also called a traumatic brain injury (TBI), caused by a bump, blow, or jolt to the head. Whether caused by sports mishaps or other types of accidents, TBI is to blame for about 630,000 emergency room visits, more than 67,000 hospitalizations, and 6,100 deaths in children and teens each year.

Symptoms such as confusion, memory loss, fatigue, or mood swings can happen immediately or even days after the concussion.

In the study, which included 335 children and young adults ages 8 to 23, recovery times were different between kids who immediately re-engaged in thinking-intensive activities vs. those who gave their brains a break. Kids who did homework, played video games, read books, or watched TV or movies took the longest to fully recover from their symptoms -- about 100 days, on average. Kids who had mental rest recovered within 20 to 50 days.

If possible, parents should aim to keep their child's mind in low gear for at least a few days. There should be no school, homework, or reading. Kids with concussions should also try not to text, surf the Web, and listen to loud music. While unplugging your child might seem impossible, it's for all the right reasons: Any energy her brain spends on mental activity means less energy that can be dedicated to the recovery process, O'Brien explains.

After a few days, you can start to slowly introduce easy mental activities. But watch to see if concussion symptoms, like fatigue or confusion, reappear. If they do, don't push it -- take another few days of downtime.

Playing Sports After Brain Injury

Knowing when your child is ready to re-enter school and play sports again is an important part of concussion recovery, O'Brien says.

She's ready to start transitioning back to school when she can muster the mental focus required for academics without showing any concussion symptoms, for example, confusion, headache, fatigue, or memory loss.

When she does return, go slowly. Request accommodations like half-days or more time for tests. 

Say no to sports until your child can handle a full school load comfortably. Before she takes to the field, she'll also need a passing grade from her doctor, who will test her brain to make sure it's healed. 

When she gets the OK to play, take things one step at a time. Try low- and medium-intensity exercise, and then no-contact sports, to make sure the physical stress doesn't cause a setback.

If there's any reason to doubt your child is ready to return to sports -- such as lingering symptoms -- keep her off the field. A good rule of thumb: When in doubt, sit her out.

Find more articles, browse back issues, and read the current issue of "WebMD Magazine." 

Reviewed on April 16, 2014

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