Concussions & Kids In Sports

It’s that time of year. Kids are in the cul de sac with hockey sticks. They’re sweating out summer at a variety of sports camps. Coaches are ordering jerseys, equipment and extra laps in anticipation of fall play. Fathers are throwing footballs after days in the office, and mothers like Sherry Middien of Spring Hill, Kan., are wringing their hands with worry.

“I have an agreement with my son that if he takes a hard hit now, he looks up into the stands, finds me and gives me a thumbs up if he’s okay.”

Dr. Lori Boyajian-O’Neill of Overland Park Regional Medical Center administers ImPACT testing with a student athlete.

Middien’s youngest son, Jordan, an athlete at Spring Hill High School, has sustained two concussions in the past few years — one from wrestling and one from football.

Middien and her husband Charlie are keenly aware of the risks associated with athletics. They have an older son who played sports, and Charlie is the elected football chairman for the Football and Cheerleading Clubs of Johnson County (FCCJC).

They are also friends with the family of Nathan Stiles, a Spring Hill football player who passed away following a hit in a game that caused a re-bleed from a previous injury. Stiles’ death prompted discussion about second-impact syndrome for athletes across the country.

“It’s amazing how we stand up and support one another,” Middien says. “Jordan’s not scared, but he knows what it feels like to get a concussion, he knows what they can do, and he knows to discuss it with us.”

Jordan also knows to discuss his injuries with Dr. Lori Boyajian-O’Neill at Overland Park Regional Medical Center. Dr. Boyajian-O’Neill is a renowned sports and family medicine physician, a published author and team physician for USA Volleyball. She specializes in caring for athletes and co-founded The Center for Concussion Management at Centerpoint Medical Center in Independence, Mo.

What is a Concussion?

According to Overland Park Regional Medical Center, a concussion is a traumatic injury caused when the brain violently moves within the skull, injuring brain cells (neurons). The ability of the injured neurons to communicate with each other, use glucose for fuel and regulate calcium, potassium and sodium movement is impaired. The local blood supply also is diminished. Until there is a return to normal function, there will be continued symptoms and neurocognitive impairment.

Signs of Concussion

Be on the lookout for these signs of a concussion if you, your child or someone else has experienced a hard hit or head bump during a game, activity or practice, say experts at Overland Park Regional Medical Center. If you suspect a concussion, seek medical attention immediately.

Observed Symptoms:
· Appearing dazed and stunned
· Confusion about assignment or position
· Forgetfulness or loss of memory recall
· Loss of consciousness (brief or longer)
· Behavior or personality changes
· Clumsy movements and slow response time

Athlete-Reported Symptoms:
· Headache or head pressure
· Nausea or vomiting
· Loss of balance or dizziness
· Double or blurry vision
· Sensitivity to light or noise
· Feeling sluggish, hazy or groggy
· Loss of concentration or memory
· Confusion

Possible Concussion? Take Action.

If you suspect that a concussion has occurred, Overland Park Regional Medical Center suggests the following steps:

· Immediately remove yourself, your child or another player from play.
· Seek evaluation by a healthcare professional with concussion management experience.
· Call the Emergency Department at Overland Park Regional Medical Center at (913) 541-6866, and come in for an assessment. Don’t eat or drink until after arrival.
· Follow up with a primary care physician, pediatrician or concussion specialist.
· Don’t play again until cleared by a primary care physician or pediatrician.

Recently, she brought her expertise to Overland Park Regional in an effort to serve Johnson County athletes with sports-related concussions, like Jordan Middien.

“She’s stern to make sure I’m healing fully,” says Jordan. “She knows I’m on the phone with my girlfriend and texting, but she tells me to get to bed by 9 p.m. and limit those things.”

Her direct approach and prescription for rest works, says Sherry, who believes that Boyajian-O’Neill is an advocate for parents who cares about her patients and is living her passion. Without her help, she isn’t sure that Jordan would be fully recovered and able to play sports again without serious consequences.

Boyajian-O’Neill and her concussion management team are devoted to educating people about sports-related injuries. They work with athletic clubs, coaches, school districts, church groups, neighborhood associations and teams of all sizes across the metro to teach people how to recognize a concussion and get help.

“Brain injuries are more serious than broken bones because you can’t see the impact of a concussion,” says Boyajian-O’Neill, who can often spot a patient with a concussion by the way his or her ball cap is pulled down because of sensitivity to light following injury. “Symptoms aren’t the same for every child, and sometimes a child is asymptomatic with a concussion, which gives me goose bumps.”

The patients and parents on Boyajian-O’Neill’s doorstep are all different. Some have sustained injuries due to contact sports such as football, but others are related to soccer, lacrosse, cheerleading and simple play outdoors.

Boyajian-O’Neill says it’s her job to evaluate and test each person according to his or her individual needs. But she wishes athletes would get tested prior to injury using advanced assessment techniques from neurocognitive tests that measure the brain’s abilities, such as memory and reaction time.

Boyajian-O’Neill and her team evaluate patients using ImPACT, a neurocognitive test developed by the University of Pittsburgh Neurosciences Center that is also used by MLB, NHL, NBA, MLS and NFL. ImPACT assesses the brain prior to injury to provide physicians with an individual baseline. Baseline ImPACT scores can be compared to scores following injury to help determine the best diagnosis and recovery.

“ImPACT testing is a tool that helps when we make return-to-play decisions,” says Boyajian-O’Neill.

The tests are available to any child age 10 and up, and testing is recommended every two years. Each non-invasive test takes about 45 minutes, and baseline testing is available for groups and teams at various rates that are not covered by insurance.

Boyajian-O’Neill says that more people are becoming aware of ImPACT testing, just as more people are becoming aware of the severity of sports-related concussions and the risks associated with returning to play too soon.

“Athletes are grateful for these tests and how they’re helping them sit out to fully recover,” says Boyajian-O’Neill. “Right now we’re up against ‘no pain, no gain’ and the ‘I got my bell rung’ generations, but with better research and better knowledge, we’re learning more about the long-term effects of concussions.”

For Jordan, all it took was a few hard hits and a few hard-to-swallow truths from Boyajian-O’Neill to understand what his brain was up against if he didn’t sit on the sidelines. Sadly, the death of Nathan Stiles is also a reality check for Jordan. He knows that when brain injuries don’t have time to heal, another hit could mean missing out on much more than games.

As an active guy, Jordan admits that rest didn’t come easy, but he also says that it was worth it.

“I’m feeling good now and ready for football, wrestling and maybe baseball,” says Jordan. “My teammates can tell a difference in me, and now I tell them to take getting hit seriously.”

Sherry was happy to hear that Jordan was sharing his wisdom with other athletes, but she says her hands may still wring a bit when she takes a seat in the stands this fall. Luckily, she knows just the doctor to call if the lights go out.

For more information, contact Dr. Lori Boyajian-O’Neill at Overland Park Regional Medical Center at (913) 541-5500.

To make an appointment for testing or for questions concerning an injury, call (913) 541-3365 Monday through Friday, 8 a.m. to 5 p.m.

For more information about ImPACT™ testing, visit

photos: Brooke Vandever