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Concussions: When In Doubt, Stay Out

Parents must be their child-athlete’s staunchest advocates when it comes to recognizing and treating head injuries on Southern Nevada’s fields, courts, and rinks.

A jolt to the head or body can cause the brain to bounce or twist in the skull, creating chemical changes in the brain, sometimes stretching and damaging brain cells. Signs of concussion vary widely and can take hours or days to emerge, according to the Centers for Disease Control’s HEADS Up to Youth Sports website ( Symptoms include headache or “pressure” in the head; nausea or vomiting; balance problems; confusion and sluggishness.

“Concussions are like snowflakes. Every concussion is different. One kid may have a headache; another kid may not. One kid may be really depressed; one may be really excited,” says Jeremy Haas, chairman of the Nevada State Board of Athletic Trainers. Haas is the area sports medicine coordinator of Select Physical Therapy, which provides athletic trainer services for the Clark County School District and teams, organizations, and tournaments.

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A 2011 Nevada law (included with other resources on the Nevada Interscholastic Activities Association website, outlines the protocol to handle such injuries and requires the signature of a qualified healthcare provider for a player to return to action after sustaining a concussion.

The law has helped take coaches off the hook from being pressured by parents to play a child because it’s an important game or because of expensive fees, Haas says. CCSD exceeds the Nevada law, he adds, by requiring a player to pass a neurocognitive test and undergo five stages of graded exercises before resuming a sport. Flag and tackle football, soccer, and cheerleading are the most high-risk organized youth activities, he says.

Parents must be vigilant before play even begins to ensure medical help is available quickly. “What they need to do is go to these clubs or soccer and football programs they are working with, and start asking questions, ‘Why don’t we have an athletic trainer here? Why isn’t there an athletic trainer available? What do we do if a kid gets a concussion?’” Haas says. 

More eyes on the action and early treatment help prevent even more serious injuries, says Dr. William Rosenberg of Desert Orthopedic Center.

“The most difficult situations I see are kids who’ve had one hit to the head, are either symptomatic or didn’t disclose their symptoms, (but) are put out to play and then they get another hit to the head,” Rosenberg says. “Those are the concussions that last for months or years, or in some instances the athletes never fully recover.”

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A shortage of doctors trained in athletic-related concussions and a lack of medical resources on the club level are among the challenges facing Las Vegas, says Rosenberg, who works with the Golden Knights, Aces, and Cirque du Soleil. He is working with the Cleveland Clinic Lou Ruvo Center for Brain Health and other colleagues and stakeholders to organize a concussion symposium and develop a local network of providers in all disciplines who take care of concussions.