Concussions: the impact on you as an athlete
By Colin Sisco, DPT
Head injuries can occur in almost all recreational activities. The Centers for Disease Control and Prevention (CDCP) estimates as many as 3.8 million sports and recreation related concussions occur in the United States every year and there are about 900 sports-related traumatic brain injury deaths each year.
A concussion may or may not cause loss of consciousness. Symptoms usually include confusion, head ache and blurred vision. In the more extreme cases vomiting and loss of consciousness can occur. Because of the varied symptoms that can be present, the injury may not always be easy to recognize at first.
In the population of young people (15-24 years old), the CDCP estimates that concussions account for nearly one in 10 sports injuries, making sports second only to motor vehicle accidents as the leading cause of brain injury. The reason for this, according to a 2009 study conducted by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio, may be due to athletes returning to the playing field too soon. In fact, their study concludes that 40% of high school athletes who suffer concussions return to the field of play prematurely, putting themselves at greater risk for more severe injuries.
Signs of concussions can be divided into two categories: Immediate signs (seconds to minutes) after the injury, and Later signs (hours to days post injury).
|Immediate signs (seconds to minutes):
|Later signs (hours to days):
As with all injuries, there are variations in the severity of concussions. The severity is often used in determining when a person can return to play. These are defined below:
|Grade 1:1. Transient confusion
2. NO loss of consciousness
3. Concussion symptoms or mental status abnormalities resolve in LESS than 15 minutes
|Grade 2:1.Transient confusion
2. NO loss of consciousness
3. Concussion symptoms or mental status abnormalities resolve in MORE than 15 minutes
|Grade 3: 1.ANY loss of consciousness, either brief (seconds) or prolonged (minutes)|
When to return to play, a decision often made on the sideline, is a critical issue. The effects of multiple injuries are more severe and can lead to long-lasting problems.
The general rules for returning to play are guided by the severity:
1. When there are no more symptoms, and
2. Symptoms and neurological assessments are normal (both at rest and during exercise).
Guidelines for return to activity:
|Grade 1:1.First time: 15 min or less
2. Multiple times: 1 week
|Grade 2: 1.First time: 1 week
2.Multiple times: 2 weeks
|Grade 3: 1.First time: 2 weeks
2.Multiple times: 1 month or longer
The evaluation of the athlete can be relatively easily done to assess the severity of the injury. In the absence of a healthcare professional, the following testing can be administered. The athlete should be able to answer all questions correctly.
On-Field Cognitive Testing:
|Orientation:Ask the athlete the following questions.||
|Anterograde amnesia: Ask the athlete to repeat the following words.||
|Concentration: Ask the athlete to do the following.||
|Word list memory: Ask the athlete to repeat the three words from earlier.||
Any failure should be considered abnormal. Consult a physician following a suspected concussion.
Play hard, Play safe!
Resources and references: