By Jessica Ellis, MD, ORA Orthopedics
Concussions are a
common injury in contact or collision sports. A concussion is a mild
traumatic brain injury that is caused by either a direct blow to the
head or an indirect blow causing the brain to jar up against the skull.
There
has been a lot of confusion in identifying concussions because many
people do not understand what kind of symptoms can be present with a
concussion. A common myth is that you must be knocked out in order to
have a concussion. Although it is a common sign, it is possible to have a
very severe concussion without ever losing consciousness.
Other
signs can include brief seizure activity, poor balance, vomiting,
decreased alertness, looking dazed, slurring of speech, confusion,
memory loss of events before and/or after the injury, inability to
concentrate, personality changes, or expression of inappropriate
emotion. The athlete may report headache, nausea, dizziness, abnormal
vision, sensitivity to light or noise, ringing in the ears, feeling
sluggish, and/or feeling fatigued. Other signs and symptoms can appear
later such as sleep disturbance, poor academic performance due to poor
concentration and poor memory, depression, or persistent headache.
A
physician must evaluate all concussions prior to an athlete’s return to
their sport, and no athlete should be allowed to participate if any
symptom is still present. If a second injury occurs while the athlete is
still symptomatic, it may result in a much more severe concussion and,
in rare cases, death. The cornerstone of management is to have the
athlete rest until all symptoms have resolved, and then undergo a
graduated program of exertion before a return to contact/collision sport
is allowed. If any of the symptoms return during the graduated
exercise, then the athlete must again rest.
School-aged athletes are
more sensitive to having long-term consequences of head injury due to
their brains not being fully developed, and therefore are treated more
conservatively. Even professional athletes are not immune to the
consequences of sustaining a concussion. Long-term memory problems,
depression, and other problems are linked to athletes having a history
of recurrent concussions. Many professional leagues now mandate that
athletes undergo neuropsychological testing prior to returning to their
sport. Computer-based neuropsychological testing, which has been shown
to be sensitive in measuring subtle symptoms of concussions, is now
widely available. Many teams have their athletes do preseason baseline
testing in order to have a normal exam to compare to if an athlete
receives a concussion during the season.
As the team
physicians for the Quad Cities’ collegiate and high school sports teams,
the fellowship-trained sports medicine physicians at ORA Orthopedics
have extensive experience in identifying and diagnosing concussions in
athletes. The ORA physicians work closely with the coaches and athletic
trainers to ensure that athletes with collision injuries are properly
evaluated and are safely returned to play.
For more information, go
to www.cdc.gov/ConcussionInYouthSports. To learn more about Jessica
Ellis, MD, and ORA Orthopedics, visit qcora.com. Like us on
facebook.com/oraorthopedics and follow us on Twitter/oraorthopedics.