Concussions

 

What is a sports concussion?

                A sports concussion is a change in awareness, behavior, and/or physical sensations due to a direct blow to the head or elsewhere on the body that transmits a force to the head.  A player does not need to be knocked out to have a concussion.

                The signs and symptoms of a concussion vary widely.  An athlete with a concussion may complain of confusion, difficulty remembering events, or difficulty forming new memories.  Typical symptoms may include headaches, balance problems, nausea, blurry vision, irritability or emotional changes, and/or feeling “foggy-headed” or “slowed-down.” When examined by the medical staff, the athlete is easily distracted and may be slow to answer questions or follow directions.  He may be glassy-eyed, have slurred speech, and poor balance or coordination.

Are there different types of concussions?

                Concussions may be categorized as simple or complex.  In a simple concussion, an athlete’s signs and symptoms will progressively resolve over 7-10 days without complication.  A complex concussion has occurred when an athlete has persistent symptoms.  Athletes with multiple concussions, seizures after the injury, or loss of consciousness for longer than 1 minute may also fall into the complex category.

How do you treat a concussion?

                Similar to other sports injuries, athletes with concussions should complete a rehab program.  The rehab program contains 6 steps:

STEP 1:  No activity, complete rest. Once symptoms are gone, proceed to step 2. (Continue to progress to the next step IF THERE ARE NO SYMPTOMS. If symptoms return, drop back to a step where there are no symptoms, and try to progress again.)

STEP 2:  Light exercise (walking, stationary bike)

STEP 3:  Sport specific activity (running, jumping, kicking, etc.)

STEP 4:  Non-contact drills. 

STEP 5:  Full contact training, once cleared by a medical doctor.

STEP 6:  Return to competition. 

 

An athlete should not return to play if he or she still has symptoms.

 

The time it takes to progress through the rehab program will vary from concussion to concussion and athlete to athlete.

Are there any special tests to check for concussions?

                Over the past decade, there has been much interest in developing tests to help diagnose concussions.  Traditionally, medical teams have used pencil and paper exams that test several aspects of an athlete’s brain function.  More recently, researchers have been developing computerized programs to help with the diagnosis and management of concussions.  The medical team may also use special balance testing to assess the athlete’s resolution of symptoms.  Special x-rays, CT scans, and MRIs are not necessary when dealing with simple concussions.  These studies may be helpful with complex concussions or more severe brain injuries. 

What are the dangers of an athlete returning too soon?

                Due to slower reaction times and thought processes, returning an athlete too soon will put them at risk for other injuries.   When an athlete still has symptoms, the brain may be vulnerable to more severe or permanent injury.  Some experts have suggested that if an athlete sustains a second concussion during this vulnerable time, brain swelling, blood vessel damage, or even death may occur.  Newer studies do not support this claim.

Are there any long-term complications from concussions?

                Most athletes that sustain simple or even complex concussions will have complete resolution of symptoms with time.  Post-concussion syndrome (PCS) consists of prolonged symptoms lasting from weeks to months.  Although not common, PCS has ended the careers of a few well-known professional athletes.  “Punch Drunk Syndrome”, also known as dementia pugilistica, is early loss of brain function due to repeated head trauma.  This type of dementia has been described in professional boxers.

What can athletes do to prevent concussions?

                Wearing the appropriate protective equipment can minimize the risk of a concussion; however, there are no sure-fire ways to prevent concussions.  Special helmets, mouth-guards, and neck collars may all reduce concussion risks.  Padded equipment and appropriate playing surfaces are also beneficial.  Referees play one of the most important roles in preventing concussions- rule enforcement is critical in protecting athletes.