Your child receives services from board-certified pediatric and adolescent physical therapists. They work closely with sports medicine doctors and orthopedic surgeons to tailor services to your child’s needs. We offer sophisticated options, including the Graston technique to loosen stiff tissue, balance re-training for concussions and hand therapy.

Pediatric orthopedic surgeons at Joe DiMaggio Children’s Hospital deliver outstanding care and outcomes. Our commitment to excellence has earned our program top honors, including recognition from U.S. News & World Report. Care for complex cases may include repairing multiple injured knee ligaments and delicate hand and upper extremity issues.

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move quickly back and forth. This fast movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging the brain cells.

If a child, student, or athlete experiences a blow to the head or body and reports any of the following symptoms, they may have a concussion:

• Balance problems or dizziness
• Concentration or memory problems
• Confusion
• Double or blurry vision
• Headache or "pressure" in head
• Loss of consciousness 
• Nausea or vomiting
• Ringing ears
• Sensitivity to light
• Sensitivity to noise
• Sluggish, hazy, foggy, or groggy feeling
• Not “feeling right” or “feeling down”

To schedule an appointment at our Concussion Clinic, call 954-538-5566.

If you are a coach, parent, or school staff, the following signs may indicate a child has a concussion:

• Appears dazed or stunned.
• Answers questions slowly or repeats questions.
• Can't recall events prior to or after a hit or fall.
• Forgets instructions, is confused about assignments, position, game, score, or opponent.
• Moves clumsily.
• Loss of consciousness (even briefly).
• Shows mood, behavior, or personality changes.

To schedule an appointment at our Concussion Clinic, call 954-538-5566.

When in doubt, sit them out!

1. Remove Athlete/Student from Play Immediately: They must be removed from play, including sports practices/games, PE class, and physical activity at recess, on the same day the injury occurred.
2. Seek Medical Attention Right Away: Only a health care provider can assess the injury and determine when it is safe to return to activities.
3. Inform Parents/Coaches
   • Coaches: Inform the athlete's parents about the possible concussion.
   • Parents: Tell your child's coach about any previous concussions.
4. Do NOT Return to Play Too Soon: The brain needs time to heal. A repeat concussion while the brain is healing can be very serious, affecting the athlete for a lifetime, and can even be fatal.
5. Obtain Written Instructions: Coaches must ask for written instructions from the healthcare provider for the return-to-play process.

To schedule an appointment at our Concussion Clinic, call 954-538-5566.

If your child or athlete has a bump, blow, or jolt to the head or body and exhibits any of the following signs, call 911 or take them to the emergency department right away, as these could indicate a dangerous collection of blood on the brain:

• One pupil is larger than the other.
• Drowsiness or inability to wake up.
• A headache that gets worse and does not go away.
• Repeated vomiting or nausea.
• Slurred speech, weakness, numbness, or decreased coordination.
• Convulsions or seizures.
• Increasing confusion, restlessness, agitation, or unusual behavior.
• Loss of consciousness (passed out/knocked out).

To schedule an appointment at our Concussion Clinic, call 954-538-5566.

Supporting a student recovering from a concussion requires a collaborative approach among parents, school professionals (e.g., teachers, coaches, school nurse, speech-language pathologist, counselor), and health care providers, as they may need accommodations during recovery.

Students recovering from a concussion may need temporary support and accommodations, which can be gradually removed as symptoms decrease:

• Take rest breaks as needed.
• Spend fewer hours at school.
• Be given more time to take tests or complete assignments.
• Receive help with schoolwork.
• Reduce time spent reading, writing, or on the computer.
• School Staff should watch for increased problems with attention, memory, and changes in behavior (e.g., irritability, impulsive behavior).

To schedule an appointment at our Concussion Clinic, call 954-538-5566.

An athlete’s return to school and sports should be a gradual process that is approved and carefully managed and monitored by a health care provider and could take days, weeks, or months. When available, coaches should work closely with the team’s certified athletic trainer. The athlete should only advance to the next step if they remain symptom-free at the current step.

Below are five gradual steps that coaches, along with a health care provider, should follow to help safely return an athlete to play over days, weeks, or months.

BASELINE: Athlete is back to their regular school activities, is no longer experiencing symptoms from the injury when doing normal activities, and has a green light from their health care provider to begin the return to play process. An athlete should only move to the next step if they do not have any new symptoms at the current step.

STEP 1: Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weightlifting at this point.

STEP 2: Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting (less time and/or less weight than a typical routine).

STEP 3: Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).

STEP 4: An athlete may return to practice and full contact (if appropriate for the sport) in controlled practice.

STEP 5: An athlete may return to competition.

Remember

If an athlete's concussion symptoms return or new symptoms appear, they should stop the activity and contact their health care provider. They can resume at the previous symptom-free step after getting the provider's approval. Also, talk with an athlete’s parents if you notice their concussion symptoms come back after they return to play.

To schedule an appointment at our Concussion Clinic, call 954-538-5566.

Sports are a great way for children and teens to stay healthy and can help them do well in school. As a youth sports coach, your actions create the culture for safety and can help lower an athlete’s chance of getting a concussion or other serious injury. Aggressive and/or unsportsmanlike behavior among athletes can increase their chances of getting a concussion or other serious injury. Here are some ways you can help keep your athletes safe.

Talk with athletes about the importance of reporting a concussion.

• Talk with athletes about any concerns they might have about reporting their concussion symptoms.
• Make sure to tell them that safety comes first and you expect them to tell you and their parent(s) if they think they have a concussion.

Create a culture of safety at games and practices.

• Teach athletes ways to lower the chances of getting a concussion.
• Enforce the rules of the sport for fair play, safety, and sportsmanship.
• Tell athletes that you expect good sportsmanship at all times, both on and off the playing field.

Ensure athletes avoid unsafe actions.

• Striking another athlete in the head.
• Using their head or helmet to contact another athlete.
• Making illegal contacts or checking, tackling, or colliding with an unprotected opponent.
• Trying to injure or put another athlete at risk for injury.

Keep up-to-date on concussion information.

• Review your state, league, and/or organization’s concussion guidelines and protocols.
• Take a training course on concussion, like the CDC's HEADS UP concussion training at no cost.
• Download CDC’s HEADS UP app and a list of concussion signs and symptoms that you can keep on hand.

Check out the equipment and sports facilities.

• Make sure all athletes wear a helmet that fits well and is in good condition when appropriate for the sport or activity.
• There is no “concussion-proof” helmet, so it is important to enforce safety rules that protect athletes from hits to the head and when a helmet falls off during a play.
• Work with the game or event administrator to remove tripping hazards and ensure that equipment, such as goalposts, has padding that is in good condition.

Keep emergency contact information handy.

• Proper hydration should start at least 48 to 72 hours before competition.
• Athletes should drink 16 to 24 ounces of water or an electrolyte sports drink two to three hours before competition.
• Athletes should eat a healthy meal that is rich in carbohydrates and sodium two to three hours before competition.
• Avoid eating high-protein foods or taking supplements.
• Athletes should drink 8 to 12 ounces of water or a sports drink (electrolyte) at least 20 minutes before competition.
• During competition, athletes should drink diluted sports drinks for quicker absorption of electrolytes.
• Drinks that are caffeinated, carbonated, or high in sugar should be stopped at least one hour prior to competition.
• Record athletes’ weight before and after practices and games.
• It’s recommended that athletes drink 16 ounces of water or an electrolyte sports drink for every pound lost.

Are You Drinking Enough Water?

To assess your hydration level, compare the color of your urine to the colors on the chart to determine if you are drinking enough water. Athletes should drink water throughout the day, not just when they are thirsty.

• 1-3: Hydrated (pale yellow, odorless)
• 4: Lightly dehydrated (slightly darker yellow, drink 1 c of water)
• 5: Dehydrated (medium-dark yellow, drink 3 c of water)
• 6-7: Very/Severely dehydrated (dark, strong-smelling, drink 1 liter of water)

With normal kidney function, the color of urine can serve as an easy visual indicator of an individual’s hydration level.

• The darker the color of urine, the more likely the person is dehydrated.
• Keep in mind that some vitamins and supplements may darken the color of urine.
• Dehydration is often a key contributor to heat-related illnesses.

These are general guidelines and should not be considered medical advice. Some of these signs or symptoms may indicate serious health problems. For any questions or concerns, consult a health care professional for advice.

Heat Cramps

• Intense muscular pain, typically in the calf, hamstrings, or abdomen
• Persistent muscle contraction that won’t stop

Heat Exhaustion

• Diarrhea
• Dizziness
• Fainting
• Loss of coordination
• Nausea
• Profuse sweating or pale skin
• Vomiting

Heat Stroke

• Altered consciousness
• Dizziness or weakness
• Hot dry skin
• Nausea, diarrhea, or vomiting
• Seizures, confusion