The start of the new school year also marks the beginning of the fall sports season. It’s an exciting time for young athletes to get back onto the playing field with their friends. It can also be an anxious time for their parents, because these fall sports, such as football and soccer, are among those with the highest rates of concussions. Concussions have been on the rise over the past decade, although the increase is partly due to greater awareness about concussions, resulting in more concussions being diagnosed that might have previously gone undetected.
A concussion typically is the result of a direct blow to the head, but a concussion can also occur from a whiplash type of injury after getting hit in another part of the body. This force can lead to a bruising of the brain that affects the functioning of the brain. This bruising occurs at the microscopic level of the axons and can’t be seen with regular radiographic imaging, such as a CT scan or MRI of the head.
The brain has to work harder during this type of injury just to meet normal demands. At the time of the injury, the athlete does not need to have passed out in order to be diagnosed with a concussion. In fact, most concussions occur without the athlete passing out.
There are many symptoms associated with a concussion injury, which can make identifying one difficult at times. The most common symptoms are headaches, dizziness and a sense of “fogginess,” which has been described as feeling like you’re watching a standard TV instead of an HD TV. The headaches can be similar to migraines, causing pressure in the head, as well as nausea and sensitivity to light and sound. Concussions commonly affect a part of the brain that controls our balance. Other symptoms might include fatigue, irritability and wanting to sleep more than usual.
When there is concern that a concussion injury may have occurred, the athlete should be removed from play immediately and evaluated by the team’s athletic trainer or health care provider. If there is not anyone to evaluate the injury, then the athlete should not be allowed to return to play and should be seen seen by a health care provider.
There are risk factors that may cause someone to be at a greater chance of having a concussion. If an athlete has a history of a previous concussion, a lesser force can cause a concussion. Some athletes are at greater risk because the position they play makes them more likely to receive blows to the head. Females, anyone under 18, and people with a history of migraines or learning disabilities such as ADD/ADHD are at greater risk for concussions.
The main treatment for concussions is rest — physical and mental. The injured brain is already working harder to meet normal demands, and sometimes increased concentration, such as with school work or playing on the computer, can make the symptoms worse. Other activities that can tax the brain include texting, video games, watching TV and reading. Students may need to stay home for several days in order to get proper mental rest. The student’s doctor may provide school accommodations during the recovery period if necessary, such as no homework or tests until recovered. It is important that the athlete gets proper sleep during the recovery. It is not necessary to wake up the athlete throughout the night to check on symptoms.
A majority of concussions resolve in 7–10 days, but some can last several weeks. A doctor may recommend some medications to help with symptoms, but currently there are no medications that speed up the recovery of a concussion. Only physical and mental rest will help the athlete recover. Some doctors use a computer test to help determine when it is safe to return to play, but it is not required. Once the doctor has determined that the concussion has resolved, the athlete will go through a five-stage return-to-play protocol that is usually guided by an athletic trainer.
There is no equipment that can prevent a concussion. Helmets protect athletes from skull fractures, and mouthpieces protect from dental injuries, but neither will prevent a concussion. Using proper technique, such as tackling with the head up in football, is one way to try to prevent concussions. Most importantly, proper education for health care providers, coaches, parents and student-athletes is needed to be aware of the signs and symptoms of concussions.
Concussions are an important concern for parents with children in sports, but they are not the only concern. Injury prevention, fitness planning and treatment for common sports injuries often worry parents. These concerns are the subject of an upcoming children’s sports medicine workshop brought to you by doctors Kelly Billig-Figura, M.D. and Ray Carter, M.D. from the upcoming Christiana Care Concord Health Center primary care practice.
This “Keep them in the game” workshop will be held on Tuesday, Sept. 10, 7 to 8:30 p.m., at the Brandywine River Museum.
The session is part of a free monthly lecture series offered by the soon to be opened Christiana Care Concord Health Center at the Brandywine River Museum. Upcoming topics will address sexual health for couples and cancer care.