I recently had the opportunity to speak with the coaches of the Tony Glavin Soccer Club about concussions. The coaches are very interested in the health of their athletes and how best to take care of them if such an injury does occur. Stories of head injuries have dotted the sports pages and often the front pages quite a bit lately, as more and more athletes, parents, and coaches attempt to understand the injury. We are figuring out that getting “dinged” or ‘rung” may actually be a more serious injury.
A concussion is a traumatic injury to the brain. It can occur from a blow to the head or even to the body if that hit causes movement of the brain inside the skull. It results in any number of symptoms because of a change in how the brain is working. It does not cause a structural injury, so you can’t see a concussion on a CT scan or MRI. And you don’t have to get knocked out to have a concussion. In fact, a brief loss of consciousness doesn’t even mean an athlete has suffered a more severe injury.
Evaluating head injuries can be tricky, as symptoms are often explained away as another illness or injury. Coaches are often the first responders to an injured athlete, and they should be conservative when it comes to head injuries. They are taught, “when in doubt, sit them out,” even if they aren’t sure of the diagnosis. A medical professional, such as a doctor or athletic trainer, should evaluate an injured athlete as soon as possible after a head injury. The risk of much more serious injury is very high if an athlete suffering from the effects of a concussion is allowed to continue playing and endures another hit.
Not every injury causes the same issues. The signs and symptoms of concussion vary between individuals. These can include balance problems, dizziness, concentration and memory issues, drowsiness, mental fogginess, headache, feeling emotional, nausea, irritability, light or noise sensitivity, trouble falling asleep, and vision problems. If your athlete is describing any of these symptoms after a head injury, get them to the doctor. Be careful not to judge the severity of the injury yourself.
When a concussed athlete comes into my office, I perform a very thorough evaluation. I talk with both the athlete and his or her parents about how the athlete is acting. I examine the nervous system from head to toe. I include memory and concentration tests, as well as balance and visual tests as part of the visit. Then we spend a great deal of time discussing the injury and how to minimize the time the athlete is suffering. Often I have to recommend shorter school days or make changes to the work the student does at school while having symptoms.
Once an athlete is feeling back to normal at rest and then at school, they move through a progression of physical activity to test their readiness to return to sports. If he or she is successful and does not have a return of their symptoms, I allow them to return to play fully.