How Many Concussions Are Too Many for a Young Athlete?

How Many Concussions Are Too Many for a Young Athlete?
Question: 

My 16-year old daughter has had two concussions — one while skiing, the other while biking. Now she wants to get into competitive cheerleading. Should I let her?

Answer: 

That depends on several factors. When were the concussions and how close together were they time-wise? If one of her concussions is recent — and especially if she is still experiencing post-concussive symptoms such as headache, fatigue, irritability, and sleep problems — taking on cheerleading or any other sport right now would be inadvisable. Balance can be affected and vertigo or dizziness can also be an issue following a concussion; these symptoms increase the risk of re-injury.

Two concussions within a few months would be a concern, especially if your daughter had not fully recovered from the first concussion before she sustained the second. The first concussion puts her at risk for what is called "second impact syndrome," in which the effects of the second brain injury are more magnified than they would have been had there been no first concussion. And a third concussion, should one occur with the cheerleading, would also have a great effect on the brain and increase her likelihood of having permanent problems.

As for cheerleading specifically, if your daughter is a "tossee" — the one who is tossed into the air and caught or who balances precariously on top of others — then this is particularly a concern. The "tossee" in a cheerleading squad is most at risk for falling. A "tosser" — the one who throws another person and catches her — is at lower risk of injury, but every person in the squad plays an integral role in their own and their teammates' safety.

I would recommend against participating in cheerleading until at least a year has passed since the second concussion. This is a conservative recommendation. There are no standard guidelines as to when a child or adolescent should return to sports after a concussion, though some are being developed in certain states. The guidelines that exist are developed for elite athletes who are now recognized to recover more quickly than younger athletes and are monitored more closely for the effects of a concussion.

Since the brains in children and adolescents are still growing, most experts agree that this makes the young brain more susceptible to the effects of the concussion and that it takes longer to recover.

So … "when in doubt, sit it out."

Posted on BrainLine May 6, 2011.

About the author: Jane Gillett, MD

Dr. Jane Gillett was a neurologist certified by the Royal College of Physicians and Surgeons of Canada in both pediatric and adult neurology. She created and developed the Pediatric Acquired Brain Injury Community Outreach Program, Children’s Hospital of Western Ontario. She died in 2011.

Dr. Jane Gillett

Comments (70)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Had over 15 concussions and after a while it was hard at first. Due to motocross I had most of them major with the last crash I almost died. Your forgetful and have all symptoms with not knowing what to do. It took me about a year to get over the mental side of thinking you’re stupid and it was super frustrating. They go away but take a break from getting them and till symptoms go away at some point. It will fuel your passion for the thing you love and you’ll hit back harder than you ever did with the drive to win.

I’m 13 and have had 2 concussions, one I had at school when I tried jumping over a bench and tripped and hit my head on the one behind it I cut my head open, that was when I was 10, I just had a bad BMX wreck and got a concussion and whiplash, I had small migraines and bad headaches is 2 concussions at 13 a bit much?

well. im 15 and have had over 11 concussions. at 13 i had about 7. and to this day the doctor has not cleared me cause i had 3 within 5 months and all gr. 1. i would say make a doctors appointment and if they know at all how seviere they were or symptoms. but keep in mind from here on it'll only get easier to get one. I have no rights to tell you anything cause i have no phd. but talk to a parent to make an appointment. its better to be safe then sorry. take it from me. i cant remember half of 2017.

Yeah exactly the same with about 15 or more in motocross and couldn’t remember things but got over it, the mental side was hard at first.

As a 19-year-old action sports athlete Who travels the world competing to make money. I find that concussions are scary, I am up over 10 documented concussions with about 5 to 8 more undocumented. But that’s my way of life my parents understand the burden that they have taken on and that I have taken on by committing to a field that is so dangerous. I’ve talked to many doctors and the general number that I’ve received is three concussions and you should stop, obviously a healthcare professional would struggle to pinpoint an actual number due to the nature of concussions. With concussions affecting each person differently and cushions being able to be very mild or very severe it’s hard to draw a line in the sand where you should quit or when you should keep going. I’ve gone to far and I understand that there’s no fixing the damage that will eventually catch up to me in 10 to 15 years. But there is no problem with not doing a sport because you’re afraid of concussions that is completely reasonable and a decision that could be extremely difficult. If there’s even any hesitation on whether you should let your daughter go into a new sport then the answer is probably no you shouldn’t let her. I think that if there’s any doubt in a parents mind about how he concussion will affect their child in the long run they should pull their child out of whatever increases the risk of a concussion. Concussions are no joke and you may not see the damage for a long time. It could be all fun and games now but by the time they’re 30 they couldn’t even remember who they are. I am not a doctor but as somebody that has had a lot of concussions and is still very active in action sports this is my opinion.

im only 14 years old and ive had 13 concussions 10 of them major, idk what to do, im always dizzy, nothing works to get rid of headaches, am i going insane?

no you're not going insane, you have brain damage.

Same here I have just had my 14th concussion and that's only in the past two years and I mean I've gotten over all the migraines and dizziness now it's just I'm starting to get the aggression and with the depression and mood swings I don't know if that has anything to do with it but it's just it's odd I don't know what to do

I've only had 3 concussions and I'm 16, going into grade 11. My mom is forcing me to quit hockey but I still want to play. I'm trying to convince her to let me play one more year, but I also feel like she's right about making me stop. Any advice?

i’m 14 and i’ve had two concussions at the same time from volleyball but i didn’t get treated until a week after it all happened. there’s a chance that i may have another one right now and it’s all happened in 3 moths i don’t know what i should do

Hello
I am 30 years old. I have had 37 concussions since 2001. 90% of the 37 concussions were Football related. I played Junior High, High school and 4 years Semi pro Amateur Football. I played on the defensive line. I was a DT. The other remaining 10% of concussions were do to falls and other activities. Out of the 37 concussions. I suffered 4 concussions that ended up with me going helmet to helmet with another player. Those 4 concussions knocked me unconcious. In 2012 I played my last football game after being knocked unconscious and not being able to pass concussion protocol even weeks later. I was told I was done. We are now in 2020 and I forget simple things and put my shoes in the freezer or microwave. Amongst other things. I have ringing in my ears. My eyesight constantly changes or just fades in and out. My balance is still off to this day.

I'm 13 and I've had 7 concussions 3 major and 5 minor and i have ADHD what is my life expectancy? I'm scared!

Hey man talk to your parents if your worried when I was playing hockey I had gotten like 13 or 14 concussions and the effects aren’t horrible but they do effect you go see someone about it like a doctor or something it’s your mind you gotta take care of it jus like anything else in ur life

Hello, I’m 16 years old and in the heart of my high school soccer season. I’m currently suffering from a concussion and have had 3 in the past 2 years (all evenly spaced out), and one back when I was 11. I’ve read that three concussions is the number when you should stop participating in sports, but I am in mid season and want to at least finish out this year with my team. Would it be safe to try and play out the rest of this season or is it too dangerous to continue, please let me know. Thanks.

Im 15 and i’ve had 2 minor concussions, each heeling within 2 weeks maybe 3 tops. My first one was from ice skating in gym when I was 12 and the second one was just a couple months ago playing softball, i banged my head on the ground diving for the ball. I would like to start playing sports more competitivly however the issues stands that three concussions is a lot. I really don’t know what i should do. i would train throughout the school year then start playing again never summer give the appropriate 1 year gap before restarting vigorous sports. But I really don’t know if it’s even a good idea... please help me!

I’m fourteen and I’ve had 3 concussions in the past 8 months. They’ve all been from competitive dancing which I’ve been doing since the age of 3. I’m still dancing but don’t know if I should continue to do it so rigorously. Any thoughts?

I’ll be 22 July 2. I’ve had 6 concussions. 3 major,3 minor, with one of them being borderline major. I played football from the time I was 4 until freshman year. I was full back, middle linebacker. 1/2 was major. One was minor. I also raced motocross. 3 years ago I was being a normal 19 year old, not thinking before I acted. Me and my best friend got drunk and I got on my bike. I hit a rock about to size of
My front rim. It threw me over and the bike landed on me. Also a major. I got my third major the end of last summer while riding jet ski on the lake another person on a jet ski hit me head on before I could do anything about it. Busted the front of the jet ski to the point it sank. My last major. Since then I’ve had
2 minors. Fighting,boxing. I have 2 children. And a wife. I’m young though. I totally forget literally everything. I get severe headaches and extreme fatigue, ringing in my ears, loss of eye sight randomly for 20-30sec and I’m depressed when In all reality I have no reason to be. I am scared of the thought of having brain problems for the rest of my life. But I’m just not the same after the last major. PLEASE SOMEONE HELP. When should I go to the doctor, not for concussions I’ve done that but for the injuries it’s caused my brain. I want to remember things I do with my wife and kids. But I can’t. I forget everything it doesn’t matter what it is. I’m sorry for the long comment I just need help. I need someone’s input that’s dealt with this

That's tough

I am going to start by saying I am not a doctor or trained professional.

My name is Sophie I'm 24 years old. I was in every sport possible soccer track football wrestling swimteam. And I was never taught how extremely important the thing that does the thinking really is. From the time I was little I've been clumsy I'm a Faller I like the ground apparently. And doing backstroke on autopilot means you forget to feel for the wall with your hand sometimes multiple times in a session slamming the top of your head into a cement and tile wall at full speed.
In 2014 I was diagnosed with Complex Regional Pain syndrome. Which has annoyances of it own but beginning of 2016 I was in a wreck totalled my car completely. Shattered my driver's side window with my head. I don't remember any of it. Just waking up being pulled out and refusing to go to the hospital because of the bills.
2019 I hate myself for not getting care. Ill sleep 2 hours a night for 3 weeks before I crash and sleep for 18-24 hours. Mini-coma anyone?
My eyes are deteriorating faster now and I need a new prescription every 6 months.
My ears, I can't listen to music any more and even voices can be painful.
The depression, anxiety, hopelessness, rule my life, my inability to hold a job, it all ties in together.
Your brain is your life
If it's mush your mush
If you are wondering when it's time to see a doctor about a new, current or previous concussion, the answer is now. Yesterday even.
If your a sports kid reading this trust me I get it competition is life and mine took me to the Navy as a rescue swimmer.
Until I started having headachs go to migraines to turn into seizures I'd never had before from over stimulation.
Journal out your symptoms every week if you can and show it to your doc. If your having memory trouble. When it comes time to talk to the doc, you don't want to be sitting there with drool coming out your mouth trying to think of the past 3 months and how your symptoms have changed and what you were doing at the time they happened.

If your wondering when it's time to get care.
It's time.

You need to go see a neurologist. The symptoms you are having, along with your history suggests the you may be experiencing some brain-related syndrome, like CTE. Better to get a professional opinion for you and your family’s sake.

Go right away Wtf you could have blood clots in your brain. Do you want to die young???

I am 14 when I was 9 I had 1 major concussion and that’s all. I really want to continue playing football. Would that be ok to do or no?

I'm 19. I've had three concussions still recovering g my last one. Two we're unrelated -- a fight and another ice skating but I just received another from boxing. I love the sport and wish to stay in it but the doc tells me I should quit but other ppl tell me I'm fine until I get another one then I should quit. Any boxers who got any tips to stay in the sport or if they do after a concussion?

It's simple, cover your not only your faCe but your head. You got to duck, bob and weve. It's a simple 123 combination. (Jab with right hand protecting your face, cross while left hand protecting your face, duck down while giving a a hook while covering with right hand. . . or. Duck down punch in stomach With left hand covering your face with right hand or give an ((upper cut with right hand covering your face with the left)) its all about combinations. Most importantly get a lot of sleep that you can get and don't strain your neck or do too many things that could be extraneous to you... Only you know your body. Don't listen to other people, listen to your doctor. You need to exercise at least 30 mins. a day moderately and go at your own pace until you can do heavy exercise. Learn how to fall. Take painkillers, ice, heating pads, stretch, and even physical therapy if you have to. . .However you only have one brain, you cannot get another one. I too do many sports ans wrestling and MMA etc.. Are apart of it. BE CAREFUL. I was lucky, it took me over 4 months to recover from my first concussion then I got two more shortly after that this year. One was from wrestling the others were from fighting. Even though I won all those fights and matches, in the long run it wasn't worth it because I am still suffering and slowly recovering. Not only did I get concussions I also got a neck/ back injury that resulted into a neck shoulder muscle spasm. Don't be dumb because you only have one brain. Its irreplacible.

Hi im 13 and i have had 3 concussions , all minor but one of them close to severe all soccer related. If i were to get another concussion, would it be safe to keep playing after i recover?

Nope. Have you not taking the impact test or learned about the brain etc??? That's a rhetorical question. Seriously, you are very young and your brain os still developing. So many things that you do and go through affects your body. And not just one but three injuries will mess your brain up and make you think and act totally different that you normally did before injuries. Trust me, I've had horrible concussions that led to neck injuries and muscle spasm etc. All of which that comes with worseing my PTSD, asthma, PCOS, sever: anxiety, stress, and depression. Take an advantage of sleep and rest because you're not obligated to do soccer because it's not a career. Wait at least till your freshman year of high school to go back into Soccer again. Most importantly, learn how to fall amd protect your head!

hi i am 14 years old i’ve had 1 major concussion and 2 minor i love hockey so much and have a lot of skill in it should i still play?

Hi I'm 16 and I've had 4 concussions one just very recently the rest occurring at least a year apart each 2 years prior. I am concerned for my health however I would like to continue pursuing my passions skateboarding, snowboarding, parkour. I know these aren't the safest things to have passions for however it is what I love to do the most. It may be important to mention that I have never had memory loss from any of these concussions however, I have gotten a little wonky directly after. Any recommendations as to what I should do? Any opinions help.

I’m 17 I had a minor concussion when I was 15 and kept playing ice hockey though it. I took another 3 bad hits and was out for two years with post concussion syndrome. My parents advised me to stop playing, but I couldn’t quit and I’m still grinding ice hockey to this day. Will I have symptoms for the rest of my life? Probably. Was it worth it? Probably not. But at the end of the day I’ll be able to say I never gave up on my passion. You have to figure out how much skate boarding is worth to you. How much are you willing to sacrifice for it? There’s no right or wrong answer.

I’ve had 10 concussions most of them have been major and 9 of them accured before I was 15 and the other one last year, I am 23 now. I’ve also had 10 gran mal seizures. Over the last year it’s been getting worse, I get sudden dizziness and anxiety and sometimes my ears will just start ringing really loud out of nowhere. Have any of you had these symptoms?

I have had 17 and I’m 13 most of them occurring when I was 7-8 because of motocross

you should go to the doctor bruv

I’ve had nine concussions three severe close ones required facial surgery 1 Grande Mal Seizure I was shaken at the hospital by Dr.’s trying to get me conscious I was out for 20 minutes 5minutes full stiff jarring seizure. I get daily headaches, migraines every month that last 4 to 10 days. I can’t hold onto a job longer then 11 weeks they fire me due to slow cognitively and I can’t remember all the steps with their software used at work to do my job, I feel stupid and worthless. It’s devastating. Everything getting worse, and now my left hand is having electrical spasms, concerning! I have brain damage! I don’t know what to do?????

Im not giving medical advice but for me and my injuries i noticed sport HBOT chamber therapy help a lot takes a while like mabye 10 seccions to see good results but i believe it helps in my personal opinion but always check with the doc before doing somthing like that

Apply for disability and go see your primary care doctor (physician) tell him or her everything you're going through. You may need to do physical therapy and stop any bad habbits like smoking or drinking if you are doing so... And bad eating and sleeping habbits and take painkillers or other remedies. Drink plenty of water and get a lot of sleep. Be active at leaste for 30 mins. A day moderately ... Apply ice and heating pads to affecting areas, stretch, and breath slowly in from your mouth and out from nose when having anxiety..But be careful because opium is very highly addictive.

I'm 11 and I've had 1 major concussion and I'm wondering should I play football next year

Football is really dangerous, especially for children. If you keep sustaining blows to your head in football, you will be at a higher risk of dying early and receiving mental illnesses.

This is my 10th concussion. 2 from work 6 from sports and the other 2 are to personal. Doctors claim that none of this is normal cause they dont understand how normal I'm feeling cause they said I'm not suppose to be normal. I even get this saying from doctors "how am I not dead yet". My question is how am i feeling so lucky to be alive and what's keeping me here when I could've easily died?

Hi im 14 and I’ve had 8 concussions 3 major 2 minor and I play basketball and I’m going football should I worry about brain damage?

Yes you should, the more concussions you have, the easier you receive them

The fact that you are worried and sought out an opinion should tell you that it isn't a good idea. Please don't risk your next 60-70 years for a couple years of football.

YES. Dude, I am you, 20 years down the road. You have had 3 major and 2 minor concussions THAT YOU KNOW OF. You know what I did today? Walked to the grocery store in the rain....again. I cannot drive. After multiple concussions before football and then a slew after I developed a rare childhood epilepsy in my first year of university. No girls want to date me because they have to drive my ass around. No matter what job you work not having a license is an issue. I take tons of meds every day. I cannot drink alcohol because of the interaction with my meds. I periodically get headaches and miss work. Then there's the seizures. I wouldn't wish them upon my worst enemy. Memory loss, depression, fatigue. My marks in biology, chemistry and physics? 95, 92 and 93. Now I can't read a page of a text book without forgetting what I just read. I can't even get a job in the military. I get called brilliant pretty much every week at my volunteer positions.....and I live in a basement.

Hi I'm 16 years old and I have had 6 concussions lately I have been very angry and agitated is this something to worry about? I haven't had a concussion in about a year. I don't know if its just teenage fazes or if its something to worry about.

Well it is normal for behavior change but 6 concussions does have a worse impact than 1 or 2. . . especially if its in the same year. Talk to your doctor. Its not a teenage phase. I've had 3 this year of 2019 ... Theres my first one then the second was about 4 moths apart then my second one and my third one shortly less after that.. It is something to worry about but it'll take time to heal.

im 17 and have had 4 concussions the doctor said that these are normal signs from getting concussions

I am 20 years old and I play college field hockey. I am also a goalie. I just received my fourth concussion, spanning since my sophomore year of high school, and it has been a year since my last one. Is it time to stop playing?

i guess a big part also in mine were, i have never been knocked out and i also finished every game that i got the concussions in even tho they were major i just never noticed i had the concussion until the next day waking up and being in agony and always feeling cold and just no balance what so ever i couldnt take one step infront of the other without falling.

forgot to say 3 of those were major for the second one that i got in the span of 1 month i couldnt even stand up straight in church for new years eve but yet i have no real problems going on in my head im not depressed nothing like that i just wanna live life to fullest and play hockey because i feel like if i quit hockey thats when the depression would kick in and im sure you love field hockey as much as i like ice hockey

nah bro keep on keepin on id say keep playing if its what you love but if not then quit. last hockey season(midget aaa) i had 2 concussions in the span of a month came back and finished the season and then my second game in this year i got another concussion also simply got one from smashing a beer over my head for god sakes. im currently still planning on playing the rest of my season but if i get another concussion im quitting. i simply like hockey too much to just quit without seeing what happens next and its my last year in minor hockey. this last one i had was just a slight concussion the doctor just said youve bruised your brain again. now it depends if you yourself are willing to take that risk im currently 17 years old and have had 4 concussions that i know of and am willing to get another but thats just me.

I know this post is old but this is for future people I am 18 years old I have had 6 major concussion over some years and those big ones have gotten to me I have chronic depression my doctor is afraid that I will get a sub dural hematoma, and if I get another major concussion I have 3 highly probable our come and those are be in a vegetable state for life, go in to a deep coma, or just flat out die. Head injuries are nothing to joke around with don’t be like me either I know for some people it is hard to talk about what’s wrong but you need to talk for your own good I am at the point were I don’t even know what’s wrong with my own body.

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