Ask the Pediatrician

Q1: I have heard a lot about concussions lately. I want my child to participate in sports but now I am very concerned about permanent brain injury. What do I really need to know about concussions?

The term “concussion” can be very concerning for parents, but thankfully very few of them lead to any longer-term problems. On the other hand, it is important to take them seriously. Here are a few general suggestions to consider if your child has sustained a concussion.

Concussion simply implies an injury to brain that is significant enough to cause symptoms after the injury. This can result from a direct hit to the head—from a sporting activity, a fall off a scooter or bike, or even just tripping and hitting the ground. It can also result from an indirect jarring of your child’s brain from an injury elsewhere on his or her body. A child or teen does not need to lose consciousness—dizziness, headache, confusion, blurred or double vision, and loss of memory all signal that a fair amount of force has been delivered to the brain. There does not need to be any physical changes to the brain to be diagnosed with a concussion. It is a “functional” injury related to the neurons (brain cells), which are temporarily not working normally.

One of the biggest advances in the treatment of concussion in the last decade is the determination that the brain must have sufficient time to heal following an injury. This is very different than the previous concept that a quick return to “the game” is perfectly fine. The current recommended steps for “concussion rehabilitation” after a sports-related injury follow these sequential steps:

1. No activity – complete physical and cognitive rest 

2. Light aerobic activity – walking, swimming, stationary bicycle, etc.

3. Sports-specific exercise with no head impact

4. Non-contact training drills

5. Full-contact practice

6. Return to play

Moving from one step to another requires that there are no concussion-related symptoms experienced at that earlier stage of healing before moving upward.

As always, if you believe your child has sustained a concussion, please consult your medical professional.

Q2: With summer coming, I would like my kids to have some sort of camp experience. What should I think about when it comes to camps, and how can I help my child have the best experience possible?

Camps can be a great opportunity for children and teens to experience an entirely different physical environment than what they are used to, from a very primitive setting in the Boundary Waters, to canoeing on one of Minnesota’s 10,000 lakes, to traveling outstate for backpacking in the mountains. At the other end of the spectrum are music, art, debate, theater, and language camps. In addition to the traditional “sport camps,” there are sport-specific camps that can significantly enhance your child’s skills and abilities.

One way to begin considering the best camp for your child is to include him or her in the decision-making process. What type of camp would they like to attend? Then consider if you want a day-based camp—which will generally be more local—or will this be an overnight or extended experience? Camps for teenagers can commonly go for two- to four-week sessions. If this is your child’s first extended time away from home, preparing them in advance by talking through the experience and building up the opportunity will generally be helpful to ease their transition away from home.

Many camps require a number of forms to be completed, including necessary medical information. Your child’s immunizations should be up to date, both for their sake and the sake of the other campers. Making sure the staff is fully aware of any health issues and/or needed medications that your child has is essential. Campers will need to have an adequate supply of routine and urgent medications (like an albuterol inhaler for wheezing)—which can sometimes be overlooked by parents. Knowing what health care resources will be available onsite in case of an urgent need is very important and reassuring to parents as well.

There are a large number of resources and websites that can help you get started in this process with practically an endless number of choices for families. Many colleges and universities will have academically-oriented programs available for younger students. Churches and faith-based organizations typically have many options, including “family camps.” A few websites include:;; and

If you get this issue in time to attend, Minnesota Parent holds an annual camp fair at Como Park Zoo and Conservatory. This year it is on February 23 between 10:00 a.m. and 2:00 p.m. Go to for more information.

This column is intended to provide general information only and not medical advice. Contact your health care provider with questions about your child. Dr. Peter Dehnel is a board-certified pediatrician and medical director with Blue Cross Blue Shield of Minnesota. Send questions to