Let’s face it! Accidents happen! While most of us think of concussions occurring in contact sports, the truth is that they can occur in any sport and across all age groups of athletes! According to the Centers for Disease Control and Prevention (CDC), more than 200,000 people each year suffer a concussion while playing sports. So what is a concussion? What are the signs and symptoms? How are they treated? What is the best prevention? And when can you return to your sport?
What is a concussion?
A concussion is a mild traumatic brain injury (TBI) which can occur as a result of a direct blow or with violent head rotation which “shakes” the brain inside of the skull. It is unclear whether it causes damage to brain tissue because most imaging studies such as MRI and CT scans fail to show any damage. Some describe it as a “loss of consciousness”; however, many victims are never “knocked out”. A concussion will, however, temporarily impair how the brain functions and processes information. For example, it may affect balance and coordination, memory, or speech. Fortunately, it is usually short-lived lasting only 7-10 days in most cases.
But we do know that a person who has sustained one concussion is more at risk for subsequent concussions and the long term effects of multiple concussions are well documented and potentially very serious.
What are the signs and symptoms?
Recognition is of utmost importance to prevent long term consequences. Symptoms of concussion can be varied. They are often subtle and not obvious. And the victim may not even realize that something is wrong! Here are some of the common symptoms of concussion:
Drowsiness
Headache
Confusion
Memory Loss
Loss of Consciousness
Irritability
Balance problems, dizziness
Difficulty with speech and communicating
Depression
Nausea and vomiting
Changes in sleep patterns
Once a concussion is suspected, physician evaluation is warranted. After getting details about the injury, the victim will undergo a mental status, neurological, visual, hearing, and physical exam. Imaging tests may follow and sometimes neuropsychological testing will be indicated. Once a baseline is established and emergencies are addressed these findings will be important for follow up comparison.
How are concussions treated?
The primary treatment for a concussion is rest with supervision. Not only is physical rest important, but mental and visual rest is essential. This means avoidance of computers, TV, and video games in addition to refraining from physical exercise and limiting stress. Gradual return to activity in a slow controlled situation is the primary focus.
Interval follow up during the return by a trained medical provider is optimal. As previously stated, most symptoms will resolve in 7-10 days but in severe cases can last for weeks or months. It is important not to return to full activity until all symptoms have resolved because of the risk of relapse and delayed healing. Athletes should not return to play until cleared by a physician trained in concussion management. And now most high school and higher level sports programs have a concussion management protocol that includes baseline computer evaluations of athletes to help safely determine return to play.
How can concussions be prevented?
The most obvious answer to this question is obviously use of proper head gear equipment. But of course nothing is “concussion proof”. Proper techniques should be taught and followed. In many sports, such as football, rules are continuously being changed to protect athletes and limit the incidence of concussions. And finally, awareness programs for parents, coaches, athletes and medical personnel are important in prevention by increasing recognition of these injuries and instituting protocols for management.
No matter what your sport or fitness activity, safety is paramount. All head injuries should be considered serious until thoroughly evaluated. By using proper gear and technique along with good common sense, most of these injuries can be prevented.