How to look for the warning signs of sports-related concussion

Concussions and football are a hot topic these days, but unfortunately head injuries can also occur in other sports. Here’s what to look for if your child suffers a blow during a game or practice, from Any Given Monday: Sports Injuries and How to Prevent Them, for Athletes, Parents, and Coaches – Based on My Life in Sports Medicine.

Concussion sometimes goes by the more descriptive name of mild traumatic brain injury (MTBI), but it is hard to describe exactly how the injury occurs. Unlike a damaged joint or torn ligament, there is not one clear point of injury; instead, the best way to imagine a concussion is to picture the soft matter of the brain being slammed against the hard bones of the skull—almost like shaking Jell-O in a Tupperware container. When an individual suffers any kind of trauma to the head, such as hard contact with the ground after a fall or a tackle, or being hit in the head with a ball or other piece of equipment, there is a risk that the brain may have suffered trauma that could disrupt normal function.

Warning signs of a concussion are sometimes very easy to spot, such as a loss of consciousness or uneven pupil size. However, these telltale markers need not be present for a concussion to have occurred. In fact, some of the other symptoms are far more common. Following any kind of blow or fall involving the head, the affected athlete should be evaluated for these signs of concussion:

• Nausea
• Headache
• Dizziness
• Blurred vision
• Double vision
• Confusion or disorientation
• Slowed reaction time
• Problems with balance
• Sleepiness or feeling in a fog
• Difficulty concentrating
• Memory problems
• Sensitivity to light or noise

No athlete should be allowed to reenter the game or practice until he or she has been evaluated and cleared to do so by a qualified health professional.

During the first twenty-four to forty-eight hours following a concussion, it is important that the athlete be put under minimal physical and mental stress. This obviously means that he or she should not return to the game or practice, but there are other prohibitions as well. For example, the athlete should not attempt to read or study, nor should he or she type or work on a computer. Movies, video games, and even text messaging should all be avoided until the brain has had a chance to recover. Additionally, heavy or spicy foods, alcohol consumption, and the use of nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen should all be avoided for fear of worsening bleeding. Injured athletes should avoid driving or operating any other type of machinery. It is safe for the affected person to be given acetaminophen for the pain, to have ice packs applied to the head and neck, to sleep, and to eat light meals. Also, some emerging science shows that 1 gram daily for thirty days of docosahexaenoic acid (DHA) omega-3 may assist the brain in righting itself. The student’s teachers should be made aware of what has occurred so that alternative arrangements for tests and assignments may be made if necessary.

Parents should be aware that the effects of a concussion can last up to three weeks. If a concussion is suspected, be on the lookout for any changes in normal behavior such as restlessness, lethargy, disturbed sleep patterns, tearfulness or depression, or other emotional responses that seem inappropriate to the situation. These can all be indicators that the brain has suffered injury and is still trying to repair itself.

All concussions, no matter how mild, are serious and must be treated like the medical emergency that they are. In other words, there is no such thing in concussion lingo as a “ding” anymore. More and more studies are showing the damaging effects of multiple concussions on the long term mental and physical health of athletes. Recent findings indicate that professional football players with three or more confirmed concussions have a higher risk of neurophysiologic changes in the future. For a player who is suspected of having suffered a concussion face a higher risk for a repeat injury if he returns to the game without being examined, an immediate response to a suspected concussion is essential. The team’s medical professional may choose to evaluate a player pulled from the game with a suspected concussion, but a CT scan may be recommended for an athlete whose symptoms are especially troubling or severe.

Many states have what are called return-to-play laws designed to protect young athletes who have been diagnosed with a concussion or are suspected of having a concussion. These policies restrict when players can return to play following their injury for the sake of protecting the player. I am very proud that the Andrews Institute was instrumental in recently getting such a law passed in the state of Florida. Protecting the long-term health of our children is far more important than the score of a sporting event.

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