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Concussions in Kids

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What is a Concussion and What to do Next

A concussion is a Mild Traumatic Brain Injury that occurs with an impact or forceful movement to the head/body, causing a rapid motion of the brain in the skull. It can happen to children of any age as well as adults. Note: it’s not just blows to the head that can cause a concussion. Impact to the body can also transmit force to the neck and head, resulting in a concussion.

If your child has had an injury and you suspect a concussion, take them to the emergency room immediately if any of the following symptoms occur: What are the signs and symptoms of a concussion in children/teens?

Each person is different and may experience one, some or many of the below symptoms. These may vary from day to day or could be consistent. 
  •     Very Drowsy
  •      Vomiting
  •      Memory Deficits
  •      Seizure
  •      Blood from Eyes/Ears
  •      Bruising/ Black Eyes
  •      Severe Balance Issues
  •      Severe Injury
  •      Slurred Speech
  • Numbness in Arms or legs
 Emotional and Behavioural:

  • Irritability
  • Nervous/anxious/angry
  • Frustrated
  • Sadness

Physical symptoms:

  • Headache
  • Nausea/vomiting
  • Dizziness
  • Sensitivity to noise/light
  • Blurry vision
  • Decreased balance
 Mental symptoms:

  • Fogginess/tired
  • Feeling slowed down
  • Trouble remembering
  • Trouble concentrating

Sleep:

  • Trouble falling asleep
  • Trouble staying asleep
  • Sleeping too much
*Only 10% of concussions cause a loss in consciousness so this is not a reliable sign*

**Signs and symptoms of a concussion can be delayed by several hours or even several days! When it comes to kids and sports – if you’re not sure if a concussion has occurred – it’s best to rest for 48 hours after a blow to the body/head before returning to play. “When in doubt, sit them out.”

 

What are signs and symptoms of a concussion in toddlers and infants?

Infants and toddlers with a suspected concussion, or those experiencing behaviours that are abnormal/concerning for them, should seek immediate medical attention.  An infant or toddler with a concussion can present with some or all of these symptoms:

  • Crankiness/irritability that is not typical
  • Cannot be comforted or crying excessively
  • Changes in eating, sleeping or playing patterns
  • Worsened balance/walking
  • Decreased interest in toys/play
  • Increased fatigue/tiring easily
  • Decrease in skills (language, social, emotional or physical) 

What to do if your child has a concussion

Immediately:

  • Make them stop what they are doing
  • Stay with them to monitor them
  • Seek medical attention to be assessed

During the first 48 hours:

  • Allow your child to rest for a maximum of 2 days. They will need physical and cognitive rest to help their brain heal. 
  • Limit screen time and avoid activities that increase/cause symptoms. 
  • Schedule an appointment with a paediatric, concussion-trained physiotherapist to get started on a recovery plan.

After 48 hours: 

  • Limit physical exertion to activities that do not increase your child’s heart rate too high/cause them to break a sweat. 
    • Examples of things to avoid: Work outs, sports, running, biking, rough play, etc.
  • Cognitive activity should be slowly and gradually re-introduced as symptoms allow, including activities that require concentration and learning as well as exposure to loud noises. 

How long do symptoms last?

  • Most concussion symptoms resolve in 1-4 weeks. During this time we recommend that kids gradually return to school and sports with a return to play protocol, under the guidance of a trained professional.
  • Returning to full activity/sports too soon may result in more severe symptoms or long term problems. It can also put your child at risk of sustaining another concussion with more severe symptoms and a longer recovery period.

How do you treat a concussion?

Physiotherapy can help to assess and address concussion symptoms. Treatment can involve:

  • Neck dysfunction/whiplash 
  • Vestibular system – dizziness and nausea symptoms
  • Visual symptoms
  • Graded and monitored return to school and work with communication to teachers, coaches and more
  • Education on symptom management and how to successfully return to school and sports.
  • Comparing where your child is at to their Concussion Baseline Test, if they have one, and ensuring they get back fully to their baseline levels.

What’s different about Playworks Physio Concussion Treatment?

At PlayWorks Physio, our therapists have up to date concussion training and we individualize each patient’s treatment to their specific concerns and symptoms. We take the time to find out what your child’s interests are and use games and play to motivate them with their exercises! From high level athletes to toddlers, each child’s plan is catered to their level. 

Have a child with a suspected concussion? Click here to book an appointment or call us to see how we can help to identify if a concussion is present and provide treatment as necessary – 604-492-3888.

 

Written by: Kate Heays & Lindsay Eriksson

 

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5 Tips For Choosing Shoes For Your Toddler

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5 tips for choosing shoes for your toddler

 

Choosing shoes for your toddler can be overwhelming! There are so many brands and styles to choose from. The shoes you put your toddler in can impact their foot development, arch development and overall comfort. Here are 5 important tips to consider the next time you are choosing shoes for your little one:

 

  1. A wide toe box. You want to ensure that the front part of the shoe (the toe box) is wide enough to fully allow your child’s foot to splay/spread out when they are walking. This is important for their balance and both the structural and muscular development of their feet.
  2. A flexible sole. You should be able to easily bend the shoe when you are pushing from the toe and the heel. This will allow their feet to move more naturally while they are walking and promote the development of their arches by allowing their intrinsic foot muscles to engage.
  3. Firm heel cup. The heel cup should be firm – if you pinch the heel of the shoe, it should maintain shape. This will provide adequate support for your child’s feet.
  4. The right size. It’s important to have shoes that fit your child properly, resist the urge to buy shoes that are too big!  The “flex point” of the shoe should line up with where their foot bends when walking. If a shoe is too big, then these two spots will not align. Their feet will be less supported in a larger shoe and can also lead to more tripping and ankle injuries.
  5. Secured. Having shoes with velcro or laces are ideal to make sure they fit snugly on your child’s feet. This will prevent “toe gripping” and decrease tripping. Toe gripping happens when shoes are too big or aren’t secured onto the foot well enough. It can lead to instability and over time lead to foot or leg pain.

 

Proper footwear is so important, especially in the early years! If you have any questions please reach out, we are always happy to help! 

 

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Are Flat Feet Normal in Kids?

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Did you know that almost everyone is born with flat and flexible feet? In their first year, babies’ feet grow extremely fast – about 2.5cm! As children get older and start walking, their feet are still flat because the bones, muscles and ligaments are not yet fully developed.

 

Foot development

The main arch of the foot, the medial longitudinal arch, begins to form at 3-4 years of age. This arch continues to develop throughout the first 10 years of life and many studies state that the mature foot posture is not obtained until 7-10 years of age (Uden et al., 2017). This means that we should expect our children’s feet to be flat during their first 3-4 years and to then start developing an arch over the next 7 or so years.

 

Factors that can affect foot development

  • Poor fitting shoes: too small, too big, too rigid
  • Not enough barefoot time at home

 

What about those Flat Feet?

Flat feet aren’t always problematic. As you can see from above, younger kids tend to have naturally flatter feet and therefore treatment is not always necessary. If your child goes up on their tiptoes you should be able to see their arch form. This is considered “flexible flat feet”. These should not be painful. Ultimately painful flat feet in kids are a problem and non-painful, flat feet in children (or adults!) are not a problem and do not need to be treated unless they are accompanied by any of the points listed below.

 

Here are some reasons why we see kids at PlayWorks Physio for flat feet:

  • Their walking pattern is different. For example, if they do not push off from their big toe, instead they use the inside of the foot
  • Complaints of foot, ankle or knee pain
  • Bunion development on the inside of the foot
  • Frequent rolling of their ankles
  • Complaints of their feet getting tired or sore after activity
  • Excessive pronation (collapsing inwards) of feet

 

Things you can do to encourage proper foot development in your kids

  • Find properly fitting shoes. Look for shoes with a supportive heel cup and flexible sole. CLICK HERE  to learn how to pick the best shoes for your child.
  • Have your child barefoot when safe/appropriate. This helps develop the muscles, ligaments and tendons of their feet and will contribute to arch development.
  • Play around with walking on different types of surfaces. For example: grass, hills, trails, gravel, sand etc.

 

If you have any questions about your child’s foot development, email us at hello@playworksphysio.com

 

Written by: The PlayWorks Team

 

References: Uden et al. Journal of Foot and Ankle Research (2017) 10:37

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