Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications

Abstract

Concussions are a common injury both within and outside sport and recreational settings, and they remain a serious concern for children and youth. Any young person suspected of sustaining a concussion should be medically evaluated as soon as possible, and when the injury occurs during sport, the individual must be removed from play immediately to avoid secondary injury. A brief initial period of physical and cognitive rest is followed by supervised, stepwise return-to-learn and return-to-play protocols. All individuals involved in child and youth sports and recreation must be able to recognize risk for, and signs and symptoms of, concussion. They must also ensure that any participant suspected of sustaining a concussion is properly evaluated and managed by qualified medical personnel. Evolving data and literature have strengthened both our pathophysiological understanding of concussion and guidance for clinical management, especially related to acute care, persistent symptoms, and prevention. This statement also re-examines the relationship between bodychecking in hockey and injury rates, and advocates for a change in policy in youth hockey.