Youth athletes, parents, coaches and trainers need to change the culture around reporting concussions, a U.S. panel of experts says.

The U.S. Institute of Medicine reviewed evidence on concussions in athletes aged five to 21 and released its findings on Wednesday in Washington.

Girl on Boy's Hockey Team

Helmets protect against skull fractures but there isn't solid evidence for concussions, experts say. (Greg Lindstrom/Concorn Monitor/Associated Press)

The committee chairman, Dr. Robert Graham, urged parents, schools, athletic departments, and the public to treat concussions seriously so young athletes don't hide their symptoms.

"Concussion is an injury that needs to be taken seriously. If an athlete has a torn ACL [ligament] on the field, you don't expect him to tape it up and play," said Graham, who directs the Aligning Forces for Quality national program office at George Washington University.

Concussions are brain injuries from rattling of the brain inside the skull. Most young athletes recover from a concussion within two weeks of the injury, but in 10 per cent to 20 per cent of cases, concussion symptoms persist, the review showed.

Athletes who return to play before their brain has fully healed may place themselves at increased risk for prolonged recovery or more serious consequences if they sustain a second brain injury.

Concussions in children watch list

  • Listlessness, easy to tire.
  • Irritability, crankiness.
  • A change in eating or sleeping patterns.
  • A lack of interest in favourite toys.
  • A loss of balance or unsteady walking.

Graham said youth themselves can help change the culture by making decisions about the style of play, type of sport, how they protect themselves and encouraging teammates to look out for each other.

But the report's authors found a gap in information about concussion rates in younger players before high school, and recommended a national system to better track sports-related concussions.

The panel's suggestions for parents included:

  • Learn the warnings signs of concussion and pay attention if a child is acting differently.
  • Encourage a child to tell you if you have symptoms after getting hit in game and emphasize the need to sit out and get checked by a qualified health professional who understands concussion.
  • Check that coaches and leagues have a return to play protocol and follow it.

The panel found little evidence that current helmet designs and face masks prevent concussions, even though some equipment makers make such claims. They stressed helmets are important for doing their job of preventing skull fractures and face injuries but there isn't yet data to evaluate how they might protect against rotational impacts that contribute to concussions.

Concussion rates appear higher for youths with a history of prior concussions and among female athletes, although its unclear whether girls may be more likely to report the injury than boys. 

With files from The Associated Press