Advances in concussion diagnosis, treatment spreads to all high school contact sports
Awareness of concussions, particularly among athletes, has come a long way in the past few years, thanks to high-profile cases of college and professional football players.
The Center for Disease Control and Prevention estimates that 1.6 million to 3.8 million concussions occur each year. The statistic’s wide range is due to lack of accurate reporting.
Between 5 percent and 10 percent of athletes will experience a concussion in any given sport season.
Fewer than 10 percent of sport-related concussions involve a loss of consciousness, or blacking out.
Football is the most common sport with concussion risk for males, with a 75 percent chance. Soccer is the most common for females, with a 50 percent chance.
Some studies suggest that females are twice as likely to sustain a concussion as males.
The most commonly reported symptoms immediately following a concussion are headache (80 percent) and dizziness (70 to 80 percent).
Source: Sports Concussion Institute
A week never seems to go by without some quarterback, receiver or defender taking a blow to the head or a former player discussing related issues with memory, depression or violent behavior.
But concussions are far from being confined to football players or male athletes, even though that’s what gets the most attention in the United States, according to Dr. Benjamin Rodgers, a pediatric sports medicine specialist with Sweetgrass Pediatrics.
“In the last 10 years, there’s been more research and medical articles published about concussions than there was in the previous 50 years. We’re gaining more knowledge about it each and every day,” says Rodgers, who is contracted by Trident Sports Medicine as high school sports physician.
Rodgers says that information is quickly finding its way into all high school sports that involve contact.
Despite the concerns about concussions, he and local trainers say parents and athletes should not let the risk of concussions deter them from reaping the rewards of playing sports. Instead, the efforts should focus more attention on prevention, recognition and treatment of what is a form of brain injury.
Lawmakers in the Palmetto State recognized the importance of the issue earlier this year when Gov. Nikki Haley signed the Student Athletes Concussion Act which, in part, required that students suspected of having a concussion be removed from practice or play.
The act also requires that nationally credentialed guidelines for identification and treatment of concussions apply to all high school-sanctioned athletic events.
Haley said at the bill signing in August that she supported the law as both the governor and mother of children involved in sports.
“It tells me as a mother what to watch out for, and, more importantly, I know that if there is an injury, the school and coaches are going to know what to do, that the school district has a plan in place. This is about quality of life for our kids and I am proud to be part of it.”
Risk all around
Hanahan High School cheerleader and pole vaulter Caroline Davidson has had two concussions, neither of which were from pole vaulting, in the past year. Both took place while Davidson was practicing cheerleading. In her latter concussion, the advanced placement math student had to take a week off from school to heal.
Risk all around
Davidson, a senior, says she thinks that while awareness of concussions is increasing, many still have misconceptions as to who is at risk.
“I still don’t think awareness is where it should be, especially among female athletes,” says Davidson, noting that all contact sports carry risks.
“People don’t take us (cheerleaders) seriously, but we don’t have helmets and pads like football players. All we have is a mat (during practices).
Wave of change
Kenny Snider, Ashley Ridge’s head athletic trainer, notes a major change in attitude about concussions among coaches, trainers and doctors in the past few years.
Wave of change
A big part of that change, Snider says, is that trainers and doctors label concussion with fewer symptoms. Some even prefer to use the term “mild traumatic brain injury” rather than concussion.
“In the past, people thought if you had a concussion, you were knocked out or something really severe. Now if you have some trauma to the head, and even have a headache, we consider and treat it as a concussion because there is some evidence of mild trauma to the brain,” says Snider, who is contracted to the school through Trident Health System.
“Now, if a kid takes a blow to the head and has a headache, we take him or her out and they are not allowed to go back in (to play) until he has clearance in recovery.”
Increasingly, trainers across the country are using a neurocognitive tests, which assesses memory, recall and reaction time, on the computer to help determine recovery.
Trident Health System, which works with Berkeley and Dorchester county schools, uses ImPACT to aid in the assessment.
Snider says all student athletes involved in contact sports, which is nearly all but cross-country, swimming and track, start by taking a baseline test. In the event of a concussion, the athlete would retake it and the results of both tests are compared.
Dr. Rodgers says the ImPACT tests help in that concussions vary from person-to-person.
“Everybody’s concussion is their own concussion. It’s a very individual thing,” he says. “Some people may feel better the next day. Some may take the average of two to three weeks. The miserable minority will have symptoms for months.”
Rodgers stresses that ImPACT is not used to diagnose a concussion but rather “one piece of the puzzle to get you back in the game.”
“The most important piece of the puzzle is the kid being honest about symptoms,” he says, adding that a doctor’s exam also is critical.
In recovery, the ImPACT test can aid a doctor in picking up on subtleties that are practically imperceptible, he says.
“The computer can measure a reaction to 1/100th of a second, so it works well with the (doctor’s) exam, he says.
Another advancement in helping people recover from concussion is recognizing brain rest, not just avoiding physical contact in play or practice.
“It (recovering from concussion) is not just a sports problem,” says Rodgers, noting that recovery is about brain metabolism. The brain requires energy to function but because of the injury, it’s not getting enough energy to function.
“We try to tell them that they need to be in a cocoon and rest their brain. Once they start to get better, they can ease back into school activities, including text messaging and participating in social media.
Even when they are allowed to return to school, Rodgers says he recommends further precautions such as wearing sunglasses indoors to prevent strain from light glare and leaving classes five minutes before the bell rings.
“A crowded hallway with all that movement can make them feel like a salmon swimming upstream. It can be dizzying,” says Rodgers.
“There’s probably a no more challenging environment to someone who has had a concussion than being at school. Think about it. Injuring your brain is just like injuring your leg. You have to rest it. The noise, lights and all the activity in school will slow down their recovery.”
Reach David Quick at 937-5516.