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| Smart Fit - The Dangers of Concussions by Michael Adesso |
| It is the time of year when athletes have returned to playing high school and college sports. It is also the time of year when my staff and I review the management of sports concussions, as we are often providing athletic training coverage for these sporting events. |
| The recognition and proper care of the athlete with a concussion continues to be one of our most difficult tasks. Symptoms of a concussion can be hard to evaluate, even with the proper training. |
| Parents, coaches and athletes need to be informed in order to make better decisions when dealing with this injury. |
| A concussion, by definition, is a change in mental status resulting from a mechanical force to the brain, such as a direct hit of two football helmets. There is speculation that a concussion can involve metabolic changes in the brain that are subtle in nature and may take up to two weeks or more to recede. It is important to note that these changes do not show up on MRI or CAT scans. These tests are important to identify brain bleeding or fracture, but can still be read as "normal" for an athlete with a concussion. |
| Symptoms of a concussion can vary based on what area of the brain was injured, the athlete's age, previous concussions, etc. Some of the more common symptoms include confusion, amnesia, dizziness, loss of consciousness, headache, balance or coordination problems, irritability or emotional changes, personality changes, nausea, visual problems, poor concentration, and deterioration of sports performance. |
| One important point to remember: Any of the above symptoms may occur alone or in any combination. You can still have a concussion without loss of consciousness. |
| There is debate among experts as to how a concussion should be graded. The most current thinking is that if all symptoms have resolved in 10 days or less, you have suffered a simple concussion. |
| Treatment should be removal from the athletic contest with complete rest from activity until all symptoms are gone. Then a stepwise progression from light aerobic activity to sport-specific exercise should be performed. |
| If any symptoms occur during this process, rest for 24 hours is needed before trying again. This may take anywhere from 5-7 days to complete. This may be managed under the guidance of your family physician. An athletic trainer may also be involved in the recovery process. |
| If symptoms persist for more than 10 days, you have a complex concussion. This should be managed by a physician with expertise in concussion recovery. |
| Other facts about concussion: |
| - More than 300,000 athletes report concussion injuries yearly. |
| - The more concussions an individual has, the longer it may take to recover. |
| - Symptoms may eventually become irreversible. |
| - Someone who experiences a concussion is four times more likely to experience another. |
| - The younger the athlete, the longer it may take to recover. When players show any symptoms or signs of a simple or complex concussion, they must be examined by a physician. The following precautions should be followed: |
| - Players should not be allowed to return to play in the current game or practice. |
| - Players should not be left alone, and regular monitoring for worsening of symptoms is necessary during the initial few hours after the injury. |
| - Return to play must follow a medically supervised series of steps. |
| - Players should never return to play while symptoms persist. Remember: When in doubt, sit out. |
| Michael Adesso, PT, ATC Director of Physical Therapy University Sports Medicine Amherst Location |