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Friday, September 2, 2011

Concussions in Athletes

Concussions in athletes has been the subject of many headlines over the past couple years.  For as much as we know about concussions, there is still much more we need to learn about head injuries and their healing. While most kids recover from concussions within days to weeks, there are some who suffer for months.  This can disrupt not only sport participation, but also reading, concentration, and the ability to learn.

What we know:
  • We know that children's brains are still developing and are more at risk with concussions than mature brains. 
  • We know that many athletes attempt to hide symptoms of a concussion so they can continue to play. (Bad idea!)
  • After a concussion -- even serious ones that affect the daily activities of a teen -- kids are often eager to return to the game that puts them at risk for another injury.
  • Symptoms of a concussion range from mild to severe.
  • headache
  • nausea or vomiting
  • slurred speech 
  • dizziness 
  • ringing in the ears
  • trouble concentrating
  • sensitivity to light or noise
  • sleep problems
  • balance problems
  • memory loss  
Treatments:

  • There are no specific treatments for concussion.
  • Rest is important. This includes not only avoiding activities that increase the risk of another injury, but also brain rest. Some kids need quiet time in bed without lights, sounds, television, computers, or books.
  • Headaches can be treated with pain relievers and sometimes migraine medications.
  • Memory and thinking problems are treated with rehabilitation and memory devices (like a calendar or planner).  Occasionally stimulants (the medicines used for ADHD) are used temporarily.
  • Depression and anxiety should be managed by someone experienced in dealing with post-concussion syndrome.
Return to play is a gradual process, in which the athlete progresses in a step wise manner.  If any symptoms return during the stepwise process, the athlete must stop activities and return to a medical practitioner for evaluation.

Step 1: Light aerobic exercise 5-10 minutes without weight lifting, resistance training or other exercises
Step 2: Moderate aerobic exercise 15-20 minutes of running at moderate intensity without a helmet or other equipment.
Step 3: Non-contact training drills in full uniform. May begin weight lifting and resistance training.
Step 4: Full contact practice.
Step 5: Full game play.

Kansas has a new Concussion Law effective July 1, 2011, that requires the State Board of Education and the Kansas State High School Activities Association to provide information about the risks of head injury to coaches, athletes, and parents and guardians of the school athletes. This information should include the risks of playing or practicing with a concussion.  Under the new law an athlete may not participate in a school sport or practice unless the athlete and the parent/guardian have turned in a signed head injury release form each year.  Any school athlete who is suspected of having a concussion or head injury will immediately be removed from play or practice and will be allowed to return to play only after a health care provider gives medical clearance to return to play.

Athletic trainers are available at many local schools to help identify the athletes at risk of concussion. They will be testing kids with various methods, and at this time there is still a lot of variability in what each school program is doing.  It is best to have baseline testing done BEFORE any brain injuries (ie the start of the season) to compare to testing done after a suspected concussion.

If your child is suspected of having a concussion, bring any available test results (both from before and after injury if possible) to your appointment with a healthcare provider.

Prevention is still the best medicine!

  • Wear proper gear at all times.  
  • Be sure helmets are in good condition and fit properly. 
  • Wear mouth guards at all times.  
  • Follow the rules of the game. 
  • Sit out if injured.  
  • If you suspect someone might have a concussion, speak up!

To read the Kansas State High School Activities Association Recommendations for Compliance with the Kansas School Sports Head Prevention Act and Implementation of the National Federation Sports Playing Rules Related to Concussions, click here