OHIO VALLEY — In recognition of Traumatic Brain Injury Awareness Month throughout March, Dr. Kelly Roush, Certified Chiropractic Sports Physician/Certified Athletic Trainer, Director of Sports Medicine at Holzer Health System, and author of Sports Concussion and Neck Trauma: Preventing Injury for Future Generations has provided safety information for athletes.
A concussion is a brain injury which results in a temporary disruption of normal brain function. Approximately 140,000 high school athletes suffer a concussion in the U.S. each year. Concussions occur most often in football but can occur in any sport and are also common in soccer, wrestling, gymnastic, baseball, softball and basketball.
The athlete may complain of headache, nausea, balance problems or dizziness, sensitivity to light, feeling overly fatigued/tired, have trouble concentrating, have confusion, complain of blurred vision or have ringing in the ears. Athletes however may not always tell you if they are experiencing these symptoms for fear of being removed from participation. Therefore it is important to observe all athletes for the following signs: the athlete appears dazed or stunned, forgets plays, appears unsteady, is slow to answer questions or appears more confused than normal when answering questions, loses consciousness, shows irrational behavior or has personality change, can’t recall events prior to or after taking a hit to the head or jolt to the body, has a drop in grades suddenly or has a lack of concentration.
As a Spine and Sports Specialist, I recognize the danger of concussion as I have evaluated numerous concussed athletes both on the field and in my office. Concussion is a hot topic in the media right now and I often get asked the following questions:
Is it safe to play contact sports and what can we do to prevent a serious head/neck injury?
Sustaining one concussion is not typically the area of concern. It is the accumulative effect of repetitive blows that you need to be concerned about. The best thing you can do is to be educated in the signs/symptoms so that you are aware when an injury has occurred and the most important thing is making sure that the athlete does not return to participation until the brain has had time to heal. Make sure that the athlete is in good physical shape utilizes proper technique, that their protective equipment fits properly and do not give any athlete aspirin products when they are participating in sports as it makes them more prone to have a brain bleed if they do sustain a concussion.
Why is it so important that an athlete not return to play until completely recovered from a concussion?
Athletes who are not fully recovered from an initial concussion are significantly vulnerable for recurrent, cumulative conditions, and are more susceptible to a life-threatening condition called second impact syndrome. Such difficulties can possible be prevented if the athlete is allowed time to recover from the initial concussion.
If the CAT scan or MRI is normal, does that mean that the athlete did not have a concussion?
No. a CT scan and /or MRI is helpful to identifying life-threatening brain injuries (skull fractures, bleeding, swelling on the brain) but do not reveal if a concussion has occurred. The diagnosis of a concussion is based on the history of how the injury occurred, observed signs and the physical exam including cognitive testing, memory recall, balance testing, cranial nerve testing, neuromuscular testing, vision testing by a properly trained health care professional.
Is there any treatment for concussion?
The best treatment for a concussion is rest. Exposure to loud noises, bright lights, computers, video games, television and phones (including text messaging) all may worsen the symptoms of a concussion. You should allow your child to rest as much as possible in the days following a concussion and watch them closely. As the symptoms lessen, you can allow increased use of cell phones (texting), computers, phone, video games, etc.
How long do the symptoms of a concussion usually last?
The symptoms of a concussion will usually go away within one week of initial injury. However, in some cases symptoms may last for several weeks, or even months with ongoing symptoms such as headache, confusion, poor concentration and fatigue.
How many concussions can an athlete have before he/she should stop playing sports?
There is no “set number” of concussions that determine when an athlete should give up playing contact or collision sports. The circumstances surrounding each individual injury, presence of any congenital defects, mechanism of injury and length of symptoms following the concussion, are very important and must be considered when assessing and athlete’s risk for further and potentially more serious concussions. The athlete should be evaluated by a physician who specializes in treating sports concussion.
What is the ‘Return to Play’ protocol following a concussion?
In both Ohio and West Virginia, an athlete that shows signs/symptoms of a concussion shall be immediately evaluated by an appropriate health care professional. If no appropriate health care professional is available, the athlete should not be allowed to return to play. If it is determined that the athlete suffered a concussion, the athlete shall not return to play on that same day. If the health care professional determines that no concussion is present, then the athlete may return to play. Some officials may ask for a written clearance from the appropriate health care professional prior to the athlete returning to play. Appropriate health care professionals in WV include all physicians (Medical Doctors, Doctors of Osteopathy, Doctors of Chiropractic), Advanced Registered Nurse Practitioners, Physician Assistants, and Registered Certified Athletic Trainers. In Ohio, only physicians and Athletic Trainers can return an athlete to play according to the OHSAA.
What is CTE?
CTE is a degenerative brain disease that results in abnormal behaviors similar to those seen in individuals with Alzheimer’s disease. CTE is caused by repetitive brain trauma rather than a genetic factor. Symptoms of CTE include: confusion, disorientation, dizziness, headache, poor judgment, staggered gait, impaired speech, vertigo, tremors, poor concentration and dementia. Head trauma occurs which leads to inflammation of the brain followed by degeneration of brain tissue, tare protein develops and TDP-43 which causes the athletes mental stated to deteriorate. They experience social instability, erotic behavior, memory loss, depression and even suicide. Several former NFL players and boxers have been diagnosed with CTE, post suicide thought to be caused by the repetitive blows taken to the head over the years.
Roush received her medical education and completed her internship at the Palmer College of Chiropractic and Palmer Clinic Sports Injury and Rehabilitation in Davenport, Iowa. She is Board Certified by the National Board of Chiropractic Examiners, Certified Chiropractics Sports Physician and a Certified Athletic Trainer. She joined Holzer in 1997, and provides care at the Sycamore Outpatient Facility in Gallipolis, Ohio.
For more information, or to make an appointment with Roush, please call 1-855-4-HOLZER.