How Many Concussions Are Too Many for a Young Athlete?


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?


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.

Jane Gillett

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.

Comments (13)

Hi, Im 17 years old and I've probably had 14 or more concussions in hockey. This past year I have had 4. Is it time for me to stop playing hockey? Or is it safe to continue.

It would be advisable to stop playing hockey for a while. If you are experiencing any symptoms of concussion, you should get checked by a doctor who specializes in head injury and concussion.
I would recommend a year off of hockey (or longer if necessary) unless you feel you are ready.
Make sure to check for symptoms such as headaches, nausea, balance problems, dizziness, fatigue, sensitivity to noise or light, loss of appetite, and insomnia. There are more symptoms, but those are the more noticeable ones.

Don't ask people online! Get into a DR. APPT. With a neurologist! Your life + future are more important than hockey! I have never heard of anyone having so so many concussions! Please get professional advice!
I'm 18 and I have 12 concussions and I'm still doing sports would it be a good idea to stop doing sports?
As a hockey trainer, and a hockey Dad, I would say 4 concussions over one season is a high number. If you are playing competitively, I would seek out specialist advise to your susceptibility. The reality is, every time you are concussed, you are injuring your brain. Let me ask you this, if you suffered recurring sprains in your knee, would you continue to play? If you are playing recreational hockey, I would suggest taking a year off to fully recover before returning.
The young men stating such a high number of concussions literally need their heads examined by a concussion specialist. Our son is 14 and plays football, basketball and baseball and received his fourth concussion just today during a game and will see the specialist tomorrow and we will follow his recommendation. Granted their is always recovery time and it will be followed to the letter. Recovery and rest are essential in order that he may rejoin his team. Each year there is a baseline done by the district to evaluate potential concussions. I suggest anyone who has kids playing contact sports, have one done.
I'm 15 and have had 6 concussions, one every year from skiing. In the same night recently I got a concussion, went back out, and managed a massive blow to the head. Should I stop skiing?
I’ve had 4 concussions in my life 3 while playing hockey and I’m almost 19 years old haven’t been knocked out on any of them. I got my first one 7 years ago and never had 2 in the same year and had about 1 1/2 years between a couple of them. I was an average student throughout high school. I just get post concussion syndrome and anxiety gets high. I have taken impact test after my 4 concussion and the scores came back of someone who has never had any sort of trauma to there brain. Just deciding when I call it quits on my hockey career so I have a safe future?
I am 13 years old and have 6 concussions
yall should stop playing sports if you have more then 10 concussions\
Hi, I'm 13 and I've had 3 concussions. All three while playing basketball. I got one when I was 12, and the second two in the same year when I was 13. Now if I get a hit to the head I get dizzy, and a headache. Everything gets really bright and looking at my phone is something I can't do. Even a light tap to the head can cause these problems. I don't want to quit sports but if I need to I will. Not sure what to do...

I am a mother of 3 teenage boys that all play a lot of sports. I think if you have these concussion symptoms triggered so easily you should stop playing because your brain has not fully recovered. definitely go and see your family doctor and get expert advice.

Yes this is what has happened to me I don't know what to do.

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