HealthView column: More than getting your bell rung: concussion management during spring sports
Spring sports are in full swing (literally in some cases) with baseball, soccer, lacrosse and other team-based and individual sports. Although collision sports like football account for the highest concussion rate, concussions can occur in all sports and are observed in girls’ sports at rates similar to or higher than those of boys’ sports.
A concussion is an injury to the brain, caused by a hit to the head or body that causes the brain to move rapidly inside the skull. Concussions are also known as a mild traumatic brain injury. The result can be a temporary loss of normal brain function. Approximately 90 percent of diagnosed concussions do not involve a loss of consciousness. In many cases, there are no external signs of head trauma, so it’s important to know the signs and symptoms of a concussion, which can include headache, loss of memory and confusion.
For residents of the Roaring Fork Valley, Valley View provides the services of certified athletic trainers at Basalt High School, Roaring Fork High School and Glenwood Springs High School. Kristin, Ryan and Marni are at every game and know most students by name. After a potential concussion event takes place, they are the first on the scene to provide medical attention and offer their feedback for next steps. If there is a suspected concussion, an individual should be removed from participation immediately until a diagnosis can be made by a local emergency department, or the individual’s primary care physician.
During the first 24 hours after a concussion, the individual should be monitored for worsening symptoms or the appearance of new symptoms. It’s typically advisable to take an acetaminophen, such as Tylenol, for a headache. Sunglasses and earplugs can be worn for light and sound sensitivity. If symptoms worsen, please go to the nearest medical facility for evaluation.
In addition to physical rest, cognitive rest is essential to recovering from a concussion. Limiting the use of cell phones, tablets, computer and video games and even schoolwork for at least three days, even for minor concussions, is recommended. Ultimately, returning to play is a step-wise progression that helps ensure a safe return to competition, and is different for everyone.
As symptoms start to improve, low exertion activities are permitted, such as walking, low level elliptical and using a stationary bike, as long as symptoms do not reappear or worsen. Ultimately, it’s up to a medical professional to determine whether or not an individual is healthy enough to return to play.
Long-term effects of a concussion can add up, even from very minor events. In recent years, chronic traumatic encephalopathy, or CTE, has been more closely studied due to the lifelong injuries suffered from former NFL players. Symptoms such as increased irritability, impulsivity and dementia are common in those with CTE, but unfortunately currently technology allows CTE to be diagnosed only after death by examining brain tissue.
The Centers for Disease Control offers resources for coaches on how to create a safe sports culture by creating a concussion action plan. As many as seven in 10 young athletes with a possible concussion report playing with concussion symptoms, and out of those, four in 10 said their coaches were unaware they had a possible concussion. Worse yet, athletes may be less likely to tell their coach or athletic trainer about a possible concussion during a high stakes game. It’s important to develop a culture of safe reporting and encouraging student athletes to report a concussion even if they don’t think it’s very serious. It’s not simply getting your “bell rung” when it comes to concussion reporting and management.
Craig Martin, MD, is a child and adolescent health physician at Pediatric Partners at Valley View. For more information, visit http://www.vvh.org/pediatricpartners.
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