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Sports Concussion

    Brain Injury in Sports

    According to research by the U.S. Centers for Disease Control and Prevention, around 200,000 people in the United States sustain concussions while playing sports each year. Concussions occur in a wide range of sports and affect all athletes, from professional players to little leaguers.

    Concussions are minor traumatic brain injuries, and sports concussion has developed into a significant problem. It’s recently made headlines with data about the effects of going back to play too quickly, as well as research findings into the long-term effects of the injury.

    Recognizing concussion and providing appropriate treatment is particularly important for younger athletes since it typically takes them longer than older people to fully recover.

    In addition, coaches, parents, and school administrators in the central Missouri area should know that concussion causes a wide range of symptoms and can interfere not only with sports participation, but with school and social relationships. Most athletes will fully recover from concussion, and understanding the varied symptoms can help with the process of healing.

    Description

    In spite of numerous attempts by experts, there’s no clear definition of concussion. It is uncertain whether any injury to the brain takes place from a concussion. Imaging exams, including computed tomography (CT) scans and magnetic resonance imaging (MRI) scans, typically don’t detect any brain damage — such as bruising or bleeding — in concussion patients.

    A concussion does, however, briefly impair how the brain functions and processes information. For instance, following a concussion, a patient may have difficulty with balance and coordination, memory, and speech.

    A concussion is typically short-lived. The majority of people recover within 7 to 10 days. Regrettably, once a player has sustained a concussion, he or she is at greater risk for further concussions. Repeat concussions can have long-term consequences, so prevention is very important.

    Cause

    Derived from the Latin word concusses, concussion means to shake violently. A concussion takes place when a force causes the brain to rapidly move back and forth within the skull. This may be due to either a direct blow or by a blow to the body that forces the head to quickly rotate.

    Although some sports have increased instances of concussion — including football, ice hockey, and soccer — concussions can happen in any sport or recreational task.

    Symptoms

    As a result of the potential lasting effects of sports concussion, it is important that athletes, coaches, and parents in Mexico, Columbia, Jefferson City, Moberly, and everywhere else in mid-Missouri know as much as possible about how to recognize them.

    Symptoms are not always evident. Although it’s generally presumed that concussions cause loss of consciousness, many people with concussions have not been “knocked out.”

    Concussion creates a wide variety of symptoms. These may appear straight away, or may be delayed for a couple of days following the injury. Some symptoms are physical, such as drowsiness. Others are cognitive, such as memory loss. In many cases, people with concussions are more emotional than normal.

    The most common symptoms of concussion include:

    • Drowsiness
    • Headache
    • Loss of consciousness
    • Memory issues
    • Irritability
    • Confusion
    • Balance issues, dizziness
    • Problems speaking and communicating
    • Depression
    • Nausea and vomiting
    • Variations in sleep patterns

    Doctor Examination

    Throughout the evaluation, your physician will make inquiries about the injury and how it occurred. He or she may ask how severe the force was and whether you lost consciousness or had memory loss following the blow. It’s particularly important that you tell your doctor about any previous concussions you’ve had.

    Your physician will probably perform a neurological examination, which checks for balance, coordination, vision, hearing, and reflexes.

    Imaging Tests

    Magnetic resonance imaging (MRI) and computed tomography (CT) scans supply doctors like Dr. Weaver with comprehensive images of the skull and brain. As stated above, results from MRI scans and CT scans are most often normal in concussion patients, so these tests aren’t usually helpful in diagnosing the injury.

    If the neurological examination indicates problems, like issues with your vision, your doctor will order imaging scans. Also, if your symptoms worsen with time, CT and MRI scans are important for guiding treatment.

    Neuropsychological Assessment

    Neuropsychological testing helps to appraise the effects of concussion on mental capabilities. This kind of assessment is possible using computerized tests, or during a session with a neuropsychologist.

    The assessment provides valuable information on a variety of mental functions, like short-term and long-term memory, attention and concentration, problem-solving, and speech.

    Balance Assessment

    Many athletes are unsteady on their feet for a few days following a concussion. Balance testing is a way for doctors to assess how well the part of the brain that controls movement is functioning.

    There are numerous balance tests your physician might utilize, and more sophisticated force plate technology. Force plates are instruments that measure the forces of stepping, running, jumping and other actions. They are typically rectangular and can be used in a stand-alone device, or placed in machines that resemble exercise equipment, like treadmills or stair steppers.

    Treatment

    The key to healing from a concussion is total rest. This consists of not just physical rest, but mental rest too. Reading, computer work, video games — even tv — ought to be limited until all symptoms have resolved. This often takes 7 to 10 days, even though some people have symptoms for weeks or months after the injury.

    Once you are free from symptoms, you can gradually return to mental and physical activity. It is essential to slowly return to daily activities since being symptom-free doesn’t mean the brain injury has totally healed. Your physician may recommend a step-by-step program: first add an activity, then monitor your symptoms. If your symptoms don’t return, you can continue increasing the challenges.

    This slow, steady approach customarily reduces the time spent out of school, work, and athletics since it provides enough time for the injury to mend. Plunging back into activities the instant your symptoms have resolved can bring them back on and require a return to complete rest.

    Return to Play

    Getting back into the game too soon puts you in danger of another concussion.

    If you sustain a repeat concussion before your initial concussion has healed, it could take much longer for your symptoms to resolve and you may have long-term problems, like learning difficulties or persistent headaches. Although it seldom happens, repeat concussion can cause permanent brain damage and even death.

    New Recommendations

    In 2010, the American Academy of Pediatrics suggested that young athletes with concussions be evaluated and cleared by a physician before returning to sports. The American Academy of Neurology released a comparable statement, and stressed that doctors who clear athletes for return to sports should be trained in managing and assessing sports concussions.

    Baseline Evaluations

    Since it is hard to figure out when a concussion has completely healed, baseline neurocognitive evaluation is an important tool for examining whether it’s safe for an athlete to return to play. Before the sports season begins, each athlete takes a computerized test that measures brain functions, such as memory and reaction time. If an athlete subsequently has a concussion, post-injury tests can be compared to the baseline evaluation to measure the seriousness of the concussion and help physicians monitor recovery.

    In addition, pre-season assessments can help identify athletes who’ve had previous, unestablished concussions and who’re in danger of repeat concussions. For example, prior injuries to the face or neck could have been coupled with an unrecognized concussion.

    Prevention

    Although injury prevention begins with proper equipment, there is no such thing as a concussion-proof helmet or mouthguard.

    Young athletes need to be trained in safe sports technique and to follow the rules of the game. In addition, rule changes should be considered in sports where force is delivered head first. This not only promotes fair play, but also protects both participants.

    To get back into the game, most athletes will downplay their symptoms. Knowing the long-lasting consequences of repeat concussion is an essential part of prevention. Several medical and sports groups have recently put together concussion awareness programs for athletes, coaches, and parents. These instructional programs play a vital role in helping to recognize concussions and prevent repeat injury.

    If you would like more information, contact Dr. Weaver today at her office in Mexico, Missouri.