Along with football season, come the frequent reminders of the danger of sports-related concussions. Head injuries are especially upsetting in young athletes because of their still developing brains. An adolescent who suffers a head injury is at a higher risk for long-term developmental and cognitive problems.
Many concussions are caused by head contact with other players or with sporting balls. In the past, athletes with brief symptoms were put back into the game after 15 minutes if they stopped showing symptoms and had a normal exam. Now, if you take them out of the game when you suspect a concussion, they’re done for the day.
“The rule is, when in doubt, put them out; this refers to all levels of play,” said Dr. James Jagger, primary care sports medicine specialist and medical care director of OrthoIndy Urgent Care.
The symptoms of a concussion include: staggering, grogginess, dizziness, vomiting and headache.
“Oftentimes, with experience, you can look at the athlete’s eyes and you know,” said Dr. Jagger. “They have this blank look; this flat affect when they are concussed.”
A concussion is a neurophysiologic trauma. It affects the physiology of the brain without leaving a permanent mark. You don’t have damage that can be seen on a CT scan. There are some chemical changes that take place in the brain, but these are mostly electrical changes in the brain or neurons.
“A concussion is a form of traumatic brain injury and should not be taken lightly,” said Dr. Jagger. “One of my pet peeves is hearing somebody call a sports concussion a ‘mild traumatic brain injury.’ Mild implies no serious or dangerous complications. We hope they’re all mild, but you can’t assume that.”
Dr. Jagger added that if a high school athlete sustains a concussion, he or she is three times more likely to get another that same season. The possibility of being concussed gets higher and higher. It takes less force and less impact to cause a second or third concussion.
“Another thing we worry about is the second-impact syndrome, which typically occurs only in those 18 or younger,” said Dr. Jagger. “If they are still suffering from the first concussion and go back into the game while still having symptoms, another blow to the head can cause swelling in the brain and sometimes death.”
Concussions are evaluated based on symptoms and cognitive testing. If the patient has no further symptoms after testing, they’re entered into a return-to-play program. After 24 hours of no symptoms, they’re allowed to do light exercise. If they develop a headache, it’s back to ground zero.
If there is no headache, they may do more intense running and exercises, but with no collisions allowed. After that, an athlete is allowed contact. Typically, it takes three to four days to return to contact and collision.
“It’s important that coaches, trainers, parents and even the athletes themselves be educated about danger of concussions,” said Dr. Jagger. “That way, athletes can get the proper attention to determine if they can safely return to sports.”
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