Concussions – The Least Understood Sports Injury

A severely sprained wrist or a broken bone quickly earn a player a visit to a doctor for treatment. Yet the treatment of a concussion, a potentially much more severe injury, is often handled by a coach or parent without any medical knowledge. Much of this lies with the fact that sports related concussions are not uncommon and most players who suffer concussions are capable of resuming play within a few minutes of experiencing them. Pressure from coaches, parents or even from the player himself may dictate a quick return to the game.

But, new research is starting to show that just because players can resume playing after a concussion, doesn’t mean they should.

What is a Concussion?
A concussion is an impact to the brain caused either by a blow to the head or the rapid movement of the head resulting in the brain hitting the inside of the skull. Symptoms of a concussion can include:

  • Headache
  • Vision disturbance
  • Dizziness
  • Loss of balance
  • Confusion
  • Memory loss (called amnesia)
  • Ringing ears
  • Difficulty concentrating
  • Nausea

A severe concussion can include the following symptoms and are cause for a quick trip to the emergency room:

  • Stiff neck
  • Difficulty walking, speaking or using your arms
  • Severe headache
  • Repeated vomiting
  • Confusion that gets worse
  • Convulsions
  • Unusual sleepiness1

Treatment
Fortunately, most mild concussions leave no lasting impact on a player and are treated with rest and headache remedies. However, repeated mild concussions or a single severe concussion may cause brain swelling and/or bleeding and threaten the life of the player.

Risks of Returning to Play
Dr. Michael Collins, a neuropsychologist and assistant director of the University of Pittsburgh Center for Sports Medicine’s Concussion Program conducted a study of high school athletes and found that “prior concussions may indeed lower the threshold for subsequent concussion injury and increase symptom severity in even seemingly mild subsequent concussions”.

A 17-year-old high school football player was tackled on the last day of the first half of a varsity game and struck his head on the ground. During half-time intermission, he told a teammate that he felt ill and had a headache; he did not tell his coach. He played again during the third quarter and received several routine blows to his helmet during blocks and tackles. He then collapsed on the field and was taken to a local hospital in a coma where he died a few days later.2 Accounts such as this are not limited to football. Almost every sport has a similar story.

Dr. David Kushner at the University of Miami School of Medicine recommends that athletes who have symptoms of concussion lasting more than 15 minutes or who have post-traumatic amnesia should not be permitted to resume sports participation for at least one week. No athlete should be permitted to return to play while signs or symptoms of a concussion are present. He also recommends an emergency department evaluation for any athlete who suffers loss of consciousness.3

1http://familydoctor.org/458.xml
2http://www.headinjury.com/sports.htm
3http://www.aafp.org/afp/20010915/1007.html

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