Concussions and our Young Athletes

08/09/2016

Healthy Living - August 9, 2016
JP Stowe, ATC
JP-Stowe.jpg
Concussions have created huge headlines over the past few years for not only many professional sports leagues, but also youth leagues and high school athletics. There are between 1.6 and 3.8 million concussions in the U.S. every single year, 66 percent of which occur during game play. How can we as parents, coaches, administrators and medical providers help athletes avoid playing while concussed? One of the best ways is by educating our young athletes, parents, and coaches about concussions and the health risks it may cause by playing while symptomatic.

A concussion is a traumatic brain injury that affects the way the brain functions. When there is a blow great enough to the head or body it can cause the brain to jiggle around inside of the skull. This in turn, causes a biochemical imbalance which triggers many of the symptoms that can take seconds or even days to appear in a concussed athlete. No two concussions are alike and not all athletes will have the same symptoms after suffering a concussion. Typical concussion symptoms are headache, dizziness, blurry vision, nausea, ringing in the ears, confusion, sensitivity to light and noise, and memory and concentration problems. As you can see most of these typical concussion symptoms are subjective, which makes healthcare professionals heavily rely on the athlete for answers. Sometimes this makes diagnosing a concussion difficult or delayed.

Educating athletes to let a coach, parent, athletic trainer or administrator know when they or a teammate are having symptoms after a possible concussion is very important. Early recognition equals early diagnosis and better long term outcomes. For example, Pittsburg Steelers starting quarterback Ben Roethlisberger pulled himself from a game against the Seattle Seahawks last year after taking a big hit from one of the linebackers. He was having concussion-like symptoms after the hit and later stated on Pittsburg’s 93.7 The Fan, “I didn’t feel right; it doesn’t make you less of a man or a football player to come out of the game.” He then went on to say, “I have played through many injuries but the brain is not an injury you want to play with.” This is what we need to stress to athletes, that this type of injury is not something you can downplay or “tough it out”. Playing while concussed puts athletes at a much higher risk for second impact syndrome. This is when a second concussion occurs while the brain has yet to heal from the first concussion. Causing severe and acute brain swelling and leaving the athlete to suffer with long term debilitating health problems, the effects are irreversible.

Currently, all 50 states have enacted concussion return to play laws. Maine State Law LD 1873, in effect since May of 2012, basically states the following:
  • All schools must adopt a concussion management plan
  • Any athlete that exhibits any signs and symptoms of a concussion MUST be taken out of play and evaluated by a healthcare professional trained in concussion management
  • The athlete cannot return to play until they have been cleared by a medical professional trained in concussion management and must complete a progressive return to play protocol
Common Concussion Myths Dispelled
  1. In order to have a concussion you must lose consciousness. False! Loss of consciousness only occurs in 10% of cases.
  2. My football helmet will prevent me from getting a concussion. False! Helmets will only prevent skull and facial injuries, not concussions.
  3. I need to wake my child every hour at night after a concussion. False! Sleep and rest is the most important recovery tool after a concussion. Let them sleep!
  4. A CT Scan and MRI will tell me if I have a concussion. False! CT’s and MRI’s are great for finding skull fractures and brain bleeds, but will not help in diagnosing a concussion. It is not a structural injury.
Key takeaways about concussions:
  • When in doubt, sit them out! Immediately remove any athlete from play who exhibits any signs or symptoms
  • Get the athlete evaluated immediately by their certified athletic trainer or a primary care provider
  • Do not let them “tough it out” or “suck it up” by playing with symptoms
  • Get accommodations for school work by working with your treating provider and guidance counselors
  • The athlete should fully return to school and be asymptomatic before starting a return to sports
  • The return to play should be a progression over 4-5 days and overseen by an athletic trainer
References:
  1. Brady, J. "Ben Roethlisberger Suffered Concussion during Seahawks Game."SBNation.com. N.p., 01 Dec. 2015. Web. 08 Aug. 2016.
  2. "Second Impact Syndrome - Brain and Spinal." Brain and Spinal Cord. N.p., n.d. Web. 08 Aug. 2016.
  3. Maine Legislature. Committee on Education and Cultural Affairs. An Act To Direct the Commissioner of Education To Adopt a Model Policy Regarding Management of Head Injuries in School Activities and Athletics. 125th Legislature. 2nd session.
  4. http://www.cdc.gov/headsup/index.html