In the past few years, we have seen the media bring the subject of concussions into the spotlight. One movie in particular, “Concussion” starring Will Smith highlighted the potential long-term effects of repetitive brain trauma in NFL players. The Center for Disease Control estimates that 1.6 to 3.8 million people in the United States will suffer a sports-related mild traumatic brain injury this year, which we can all agree is a significant number. This raises several questions with athletes, parents, coaches, and athletic trainers. How do we know if an athlete has sustained a concussion? How should they be treated? When can they return to their daily activities, school, and sports? How are they prevented?
Concussions have several different definitions ranging from “complete loss of consciousness” to “getting your bell rung”. In the 2016 Journal of the American Academy of Orthopaedic Surgeons article Concussions in Sports: What Orthopaedic Surgeons Need to Know? it was stated “The Concussion in Sport Group formally defined concussion as a complex pathophysiological process affecting the brain, induced by biomechanical forces.” What does this mean? Essentially, after the brain sustains an injury whether direct or indirect, the chemicals produced in the brain go into overdrive leading to symptoms such as confusion, headaches, irritability, nausea, vomiting, depression, or dizziness. Why don’t we just order a CT or MRI to determine if a concussion is present? A great question! The answer is that these tests are typically normal in a concussed patient and do not help us with diagnosis. This is why it is important for players, parents, coaches, and athletic trainers to know the symptoms. The severity of the symptoms can range from person to person. This in turn can make it difficult to determine if an athlete has sustained a concussion, but once the symptoms are recognized it is essential for them to be removed from the sport until cleared by a medical provider. Your family physician, a sports medicine physician, or a neurologist are doctors that can treat patients with concussions. If a player returns to sports too soon or before being cleared by a doctor, it may prolong or even worsen their symptoms.
Once we have determined an athlete is concussed, how should they be treated? The answer always incorporates REST in the treatment plan! Both mental and physical rest may be necessary until patients are symptom free. We all know what physical rest is, but what is meant by mental rest? This includes limiting television, video games, and occasionally reading until symptoms resolve. Both players and parents of young athletes must be educated on the importance of being symptom free prior to return to play. While concussions may not be 100% avoidable, prevention is still an important factor. Making sure players have proper equipment and understand safe techniques for their sport can potentially aid in the prevention of concussions.
The following is a link to more information about concussions through the American Academy of Orthopaedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=A00574
-Christopher Pokabla, M.D.
-Lacy D. Johnson, P.A.