Play it safe with concussions
Checkup on Health
In days past, it wasn’t uncommon to try “shaking off” fogginess, confusion or lapse of consciousness that could follow a hard football tackle, a hotly contested soccer header or a ski crash. Now we know just how dangerous that kind of thinking can be.
Thanks to advancements in both brain science and the way that we track injury and disease – and also due to media attention about the plight of affected athletes – there is a growing and proper awareness that concussions are serious health events to be handled with caution and care.
“Toughing out” a concussion in hopes of returning for another first down or an overtime goal can mean lasting and tragic health consequences.
"It can be hard to tell a talented athlete to leave the game, or to stay away from practice, but it’s an essential responsibility for a coach or parent,” says Jeff Tanji, a UC Davis sports medicine specialist who frequently evaluates and treats concussions as a member of the Sacramento Valley Concussion Care Consortium.
“On the field a ‘bump to the head’ or ‘having your bell rung’ should really be given the same serious and immediate consideration as a broken leg, open wound or another acute injury, because it can be that serious," Tanji says. "You just can’t see it.”
What it is
If not given proper consideration, concussions can affect or damage an individual’s memory, behavior or ability to learn. In rare cases, they can even be fatal.
The Centers of Disease Control describes a concussion as a type of traumatic brain injury, or “TBI.” It can be caused by an obvious direct impact or jolt to the head, but also a body blow that causes the head and brain to move rapidly back and forth. The trauma causes changes to the way the brain normally works.
While concussions are sometimes termed “mild” brain injury in the sense that they are usually not life-threatening, if not given proper consideration they can affect or damage an individual’s memory, behavior or ability to learn. In rare cases, they can even be fatal.
What to look for
Dr. Tanji is one of the featured experts in “Sidelined: Concussions in Sports,” a KVIE documentary that focuses on the dangers of concussions.
It’s estimated at least 10 percent of all contact-sport athletes sustain concussions yearly. But the opportunity for concussion is present in any sport or athletic activity.
“Everyone -- parents, coaches and the athletes themselves -- all should be well-aware about how to identify the signs and symptoms of a concussion, and know how to respond if they suspect one,” Tanji said.
Symptoms fall into three main categories: cognitive or thinking abilities, physical, and mood and behavior. A person may have many symptoms or only a couple:
- Physical symptoms can include dizziness, confusion, headache, fatigue, changes in vision or hearing, sensitivity to light and/or noise, nausea or vomiting and/or problems sleeping.
- Symptoms that involve thinking or cognitive ability can include trouble remembering the time directly before and after the injury, as well as slower thinking, difficulty concentrating, general forgetfulness and even trouble understanding language.
Mood or behavioral changes can include irritability, depression, anxiety, mood swings, and low tolerance for frustration, among other similar symptoms.
What to do
Parents, coaches and teammates can follow these steps if an athlete takes a knock or blow to the head or a hard jolt to the body:
- Remove the athlete from play.
- Look for the signs and symptoms of concussion. When in doubt, sit them out.
- Seek medical attention and have the athlete evaluated by a health-care provider as soon as possible.
- Inform parents or guardians.
Studies show that most concussions go unreported because the athlete did not think the injury was serious enough to report. But only a qualified healthcare professional experienced with concussion assessment can determine whether an athlete has had a concussion.
Awareness has grown enough that concussions and their handling are now subject of two California laws passed this year. One requires any athlete suspected of having a concussion to be removed from play and not allowed to return on the same day. The athlete may not return until they receive written clearance from a health-care provider who is trained in the management of concussions.
Another law requires school sports coaches to have training that includes a basic understanding of concussion signs and symptoms and appropriate responses.
The recovery process
Chronic traumatic encephalopathy
UC Davis researchers are studying the brain damage found in professional football players and other contact-sport athletes.
Chronic traumatic encephalopathy (CTE) is thought to be caused by blunt force impacts to the head. It can take years to manifest and can possibly culminate in dementia.
Most concussions resolve fully, but the recovery period can range from days to months depending on age, health, the severity of the injury and other factors.
After a concussion the brain is extremely vulnerable versus normal circumstances, and even a slight bump or jarring can risk brain swelling or brain damage.
Getting rest and avoiding reinjury are both extremely important to support recovery. After a concussion the brain is extremely vulnerable versus normal circumstances, and even a slight bump or jarring can risk brain swelling or brain damage.
“During recovery it’s important to take cues from a medical provider about what to do and what activities to avoid – and then be sure to follow their instructions to the letter,” Tanji said. This usually means lots of rest and avoiding sports or physical activity for a while.
Patients may also be asked to avoid activities that involve concentration, such as schoolwork or video games. A gradual easing back into activities is the norm, he said.
Prevent future concussions
After recovery, it becomes important for the patient to try to prevent future concussions. As the CDC notes, people who have had repeated concussions may have serious long-term problems, including chronic difficulty with concentration, memory, headache, and occasionally, physical skills, such as keeping one’s balance. In the worst cases, severe depression and emotional instability can result.
Discretion is definitely the better part of valor when it comes to concussions,” Tanji says. “Fighting through symptoms can only make them worse – and increase the chances of long-term damage or effects, a few weeks from now or years down the line when they’re least expected.”