Concussions in athletes - more than just a bell-ringing!

Legendary quarterback Brett Favre recently made news headlines, but not for his athletic prowess. He revealed that he has had memory issues related to multiple concussions on the football field. And he is just one of many players, of various sports and at all levels – professional, college and high school – who have gotten their "bell rung" and suffered the consequences.

What exactly is a concussion? It is a brain injury resulting from a blow to the head. It may or may not cause loss of consciousness, but it always causes some degree of impairment in brain function. In milder cases, that impairment only lasts a matter of minutes. In more serious cases, it may last hours, days or weeks. It could even become permanent.

As our understanding of concussion has improved, our approach to diagnosing and treating head injuries has changed. Primary care providers, neurologists, sports medicine specialists, athletic trainers and coaches are now coming together to protect athletes from the dangers of concussions.

How can you tell if someone has a concussion?

Someone with a concussion may tell you that they have:

  • headache
  • blurred vision or double vision
  • nausea
  • loss of memory about the injury (or the time before or after the injury)
  • trouble concentrating
  • dizziness
  • feeling drowsy or hazy

You may observe that the individual has:

  • lost consciousness (although most people with a concussion remain conscious)
  • trouble with balance or coordination
  • difficulty remembering (the date, the opponent or the play which caused the injury)
  • vomiting
  • trouble speaking clearly or making sense
  • a dazed or confused look, such as a blank stare
  • a slowed response time to questions

This moving ESPN video shows just how devastating a concussion can be ...

 

Who is at risk for a concussion?

First, more than just football players are at risk. Concussion risk is also high in rugby, hockey and soccer. Second, it's not just boys. In fact, the risk is greater for girls than boys in soccer and basketball. Third, if you have had one concussion, you're more likely to have another, especially in the first 10 days. Helmets reduce the risk of concussion, but nothing can eliminate the risk.

What should you do if you suspect a concussion in your athlete?

If the player is down on the field and a head injury is suspected, do not move the head or neck (head and neck injuries often go together, and a neck injury can lead to paralysis or death). Summon medical help, and in the meantime, check to make sure the airway is open and that there are signs of breathing and circulation.

If the player is up and walking, then the athlete should be removed from play. Immediately. The athlete should not return to play until cleared by a licensed healthcare professional with experience treating concussions.

What will the doctor do?

Family physicians, pediatricians, emergency physicians, sports medicine doctors and neurologists may all have training in evaluating concussions. They will ask the player questions and examine brain function (by testing things like memory, concentration, coordination, balance, emotional state, strength and sensation). They may take neck X-rays or a CT scan of the brain, although these tests are not usually required. They may ask the athlete to rate his or her symptoms on a checklist or undergo more detailed neuropsychological testing.

The healthcare provider will not let the athlete return to play until the concussion is resolved, and the player is completely free of symptoms off medication. The younger the athlete, the longer it takes for symptoms of concussion to go away, therefore the younger athlete (high school age or below) will often take longer to return to play than a college or professional athlete. Sometimes the healthcare provider will recommend a graded return to play; for example, the athlete may be permitted to run or condition for a period of time, without any contact, to transition to full play.

Where can I get more information?

The Centers for Disease Control has some great resources on their website. The American Academy of Neurology has a Sports Concussion Toolkit for parents, coaches, trainers and healthcare providers on their website – they even have a "Concussion Quick Check" application that you can download for your smartphone. Their new concussion guidelines were instrumental in the writing of this article.

Remember, concussions are serious – they represent an injury to the brain. Learn to recognize a concussion, remove the athlete from play, and seek medical attention. Parkview Physicians Group and our colleagues at SportONE have trained professionals who can evaluate and treat your athlete's concussion and return him or her safely to play.

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