Wintertime provides several opportunities for outdoor fun with friends and family, with sledding and snow tubing being some of the most common activities. While these activities can be fun and provide an opportunity for physical activity in the cold winter months, they can sometimes lead to serious injuries, including concussions.\nAccording to the American Academy of Pediatrics, 30 percent of children hospitalized following a sledding injury suffered significant head injuries, and 10 percent of these children had a permanent disability. More than 20,000 annual emergency room visits are a direct result of sledding injuries in patients 19 years of age or younger according to the National Electronic Injury Surveillance System database.\nConcussions and other head and neck injuries are of particular concern during winter sports such as sled riding and snow tubing, according to Alicia Sufrinko, Ph.D. You can reach very high speeds and, unfortunately, sometimes you crash into something or with someone else.\nWhen your head or body takes a hit, it can cause your brain to shift or shake around inside your skull, similar to a yolk inside an eggshell. This impact can injure your brain and cause a concussion.\nDon\u2019t let injuries get in the way of winter fun. Try these tips to reduce the likelihood of sustaining a concussion and other injuries:\n\u2022 Use a proper sled. Never use a sled substitute such as a lunch tray or cardboard box because they can be pierced by objects on the ground.\n\u2022 Dress appropriately. Frostbite and hypothermia are real concerns during any winter sport. Be sure to wear sensible winter outerwear while sledding or snow tubing.\n\u2022 Always wear a helmet. Be sure to wear a helmet as a safety measure to protect against head injuries like skull fractures.\n\u2022 Choose the right terrain. Choose a hill that is specifically designated or designed for sledding and has a long, flat area at the bottom so you can glide to a stop. The hill should be clear of trees, bumps, rocks, poles, and other obstacles.\n\u2022 Go sledding during the daytime, when visibility is better. If you go sledding at night, make sure the hillside is well-lit so you can see potential hazards.\n\u2022 Designate a go-to adult. In the event someone gets injured, you\u2019ll want an adult on hand to administer first aid and, if necessary, take the injured sled rider to the emergency room.\n\u2022 Sit face-forward on your sled or tube. Never sled down a hill backwards or while standing, and don\u2019t go down the hill head-first, as this greatly increases the risk of a head injury.\n\u2022 Young children (five years of age and younger) should sled with an adult, and children younger than 12 should be actively watched at all times.\n\u2022 Go down the hill one at a time and with only one person per sled (except for adults with young children).\n\u2022 Never build an artificial jump or obstacle on a sledding hill.\n\u2022 Keep your arms and legs within the sled at all times. If you fall off the sled, move out of the way. If you find yourself on a sled that won\u2019t stop, roll off and get away from it.\n\u2022 Walk up the side of the hill. Leave the middle open for other sled riders and snow tubers.\n\u2022 Never ride a sled that is being pulled by a moving vehicle.\nWhile it\u2019s unlikely that you\u2019ll be injured while sledding or snow tubing, the possibility does exist. Remember, concussions are treatable when managed properly. If a concussion is suspected, it\u2019s important to seek medical attention from a health care provider trained in concussion.\nTo learn more about the UPMC Sports Medicine Concussion Program\u2019s treatment approach for concussions, visit www.rethinkconcussions.com. To schedule an appointment with one of our experts, call 1-855-93-SPORT (77678).