Lindsey Tanner, AP

Emergency room visits for school-age athletes with concussions has skyrocketed in recent years, suggesting the intensity of kids' sports has increased along with awareness of head injuries. The findings, in a study of national data, doesn’t necessarily mean that concussions are on the rise. However, many children aren't taken for medical treatment, so the numbers are likely only a snapshot of a much bigger problem, doctors say.

“It definitely is a disturbing trend,” said lead author Dr. Lisa Bakhos, an ER physician in Neptune, N.J.

The study examined concussions in organized youth sports involving ages 8 to 19. ER visits for 14 to 19-year-olds more than tripled, from about 7,000 in 1997 to nearly 22,000 in 2007. Among ages 8 to 13, visits doubled, from 3,800 to almost 8,000.

While awareness has increased, many parents, coaches and players still don't understand how serious concussions can be, Bakhos said. Many often seem less concerned with the injury than with how soon kids can return to sports. “They want to know if they can play tomorrow, and you're just like, 'No!'”, she said. “It's not just as simple as get up, shake it off and you'll be fine. If they're not treated properly, with rest, then they can have long-term problems,” Bakhos said. Those include learning difficulties, memory problems and chronic headaches.

The study appears in Pediatrics, published online, along with a report about sports-related concussions from the American Academy of Pediatrics' sports medicine council. Symptoms aren't always obvious, there usually is no loss of consciousness, and a concussion doesn't show up on an imaging scan unless there is bruising or bleeding.

“If you go back in too early, that can be devastating,” said Dr. Kevin Walter, co-author of the report and a concussions specialist at Children's Hospital of Wisconsin in Milwaukee. Resuming sports too soon risks another concussion that could be deadly or cause permanent brain damage, he said. Researchers believe young athletes may be more vulnerable than adults to lasting damage from these head injuries because their brains are still developing.