Special Caution on Concussions
Concussions occur frequently in athletes, but they are the type of sports injury about which we know the least. Experts say that's because of the brain's complexity, as well as a lack of research into concussions.
Concussions—defined as a trauma-induced alteration in mental status—are often difficult for doctors to recognize. A forceful hit to the head or any part of the body that cause a rapid movement of the head may result in a concussion.
The majority of concussions do not involve loss of consciousness. You don't even have to be hit on the head. A blow to the shoulder that violently snaps the head can cause a concussion.
According to the CDC, 65 percent of sports- and recreation-related concussions in children ages 5 to 18 years are treated annually in the emergency department. Several of these injuries are diagnosed as mild, and symptoms may include impaired thinking, memory problems, and changes in emotions or behavior.
"In the past, guys would take a shot and couldn't remember what the score was and it was considered part of the game," says Edward M. Wojtys, M.D., a University of Michigan team physician. "Now they are 35 and 40 years old, and they are having problems with some of their cognitive functions, they are having problems doing their job, and we are wondering if this has anything to do with concussions."
Helmets reduce injuries
Head injuries are most common in contact sports, but protective equipment can limit the risk. A helmet reduces the force of contact and slows the impact to the brain.
Unfortunately, helmets can give athletes a sense of invulnerability. "You see kids doing things with their helmet in place that they would never do without a helmet," Dr. Wojtys says.
Soccer isn't risk-free, either. Children should not "head" the ball until they are in their mid-teens, although flying elbows, kicked balls, or collisions may pose bigger threats to unprotected heads.
The CDC recommends that you know your concussion ABCs: Assess the situation; Be alert for signs and symptoms, and Contact a health care provider. It's important to remember that you should not return to sports or recreation activities until you are evaluated by a health care provider experienced in treating concussions.
Rest is key for the treatment of a concussion; the brain needs time to repair itself.
Often athletes experience no symptoms after a few days. But headaches, nausea, and other problems may return from plunging back into sports too soon.
Other rules of treatment:
Immediately after injury, a physician, school nurse, coach, or trainer who is experienced in evaluating concussions should check the person's mental status.
Remove the person from the activity, especially after loss of consciousness, until a health care provider experienced in evaluating concussions gives the person approval to resume sports or recreation activities.
Initially monitor the person's level of consciousness very closely for 30 minutes, then monitor his or her state of consciousness closely for 24 to 48 hours.
Restrict activity until the person is cleared by his or her health care provider to resume normal activities.
The person should gradually return to light activity. Contact the person's health care provider if symptoms recur.
We need more research on concussions, experts agree. Having had one concussion increases your risk for a second, and may cause slower recovery from the second one if it occurs. "Athletes are bigger, stronger and faster these days," Dr. Wojtys says. "They are capable of causing much greater trauma than in the past."
Signs of a concussion
Although symptoms may not occur immediately, common signs include: