As fall sports kick off in our region, hot topics within sports medicine begin to resurface. One of the most discussed and studied subjects over the last decade is that of concussions. So, what do you need to know about them?
A concussion is a mild traumatic brain injury that occurs when the brain makes contact with the inner surface of the skull. This trauma causes a disruption in the neurological function of the brain. This can be a result of a direct blow to the head or other external forces such as whip lash. As an example, imagine the yolk within an eggshell. If you shake that egg, the yolk will slosh back and forth causing contact with the inner surface of the shell. This is similar to force that the brain experiences within the skull.
Concussions and their symptoms vary based on the mechanism of injury and the area of the brain affected. Common symptoms include but are not limited to:
– Disorientation/ confusion
– Decreased balance
– Memory Loss
– Visual disturbances
– Slurred speech
– Sensitivity to light
It is essential to remember that just because an athlete does not lose consciousness, does not mean that they are clear of a concussion.
What should you do?
Your athlete should be examined by a health care professional that is trained in the recognition and management of concussions. Fortunately, all three secondary schools in Mason County have Athletic Trainers on staff that are highly trained in this and are available to both middle school and high school athletes. You may also choose to schedule an appointment with the athlete’s primary care physician for an evaluation. In either case, the athlete will undergo an assessment that evaluates their symptoms and other signs of neurological dysfunction. They may also undergo a computer based neurocognitive test that can assist in evaluating their memory and reaction time.
It is important to note that diagnostic imaging such as an MRI or CT scan are used to rule out brain bleeds and swelling. Therefore, a negative result from one of these scans does not necessarily mean your athlete is clear of a concussion.
How are concussions treated?
Treatment is based on the signs and symptoms that the athlete is experiencing. The current best practice in initial treatment of concussions is mental and physical rest. Current studies also encourage regular sleep and modified schoolwork to aid in recovery.
Once the student athlete has been asymptomatic for 24 hours, they will start a “Return to Play” protocol. This phases them back into physical activity over the course of several days. If symptoms reoccur, they must wait to be asymptomatic again for 24 hours before repeating that phase.
A Return to Play Protocol progression is as follows:
1.) Physical and Mental Rest until 24 hours Asymptomatic
2.) Light aerobic exercise
3.) Sport Specific Exercise
4.) Non-contact training drills
5.) Full participation practice (following clearance from health care provider)
6.) Return to Play
In addition to being best practice, it is actually a law in West Virginia that athletes who sustain a concussion must undergo this protocol before being cleared to return to their sport.
Can we prevent concussions?
Despite what many protective equipment companies try to market, there is currently no device that will 100% prevent a concussion. So, it is imperative that athletes in contact sports train properly in technique to help reduce the likelihood of a concussion.
Overall, the best means of prevention is awareness and knowledge of the risks of concussions and their appropriate treatment.
This piece submitted by Pleasant Valley Hospital.
Gabe Roush, LAT, ATC, is Pleasant Valley Hospital’s Sports Medicine Manager.