Heads Up: Understanding Concussions, Part 1

It’s starting to feel a bit like fall – cooler mornings and a bit of that ‘snap’ in the air that makes autumn my favorite time of year. Fall also means it’s time for the football season to start again. But what comes with all that gridiron excitement? Concussions. Football has the highest reported incidence of concussions for high-school aged athletes.

Rules of the Game

Concussions have been a hot topic for the last few years, and in 2011 South Dakota followed many other states by enacting legislation on the subject. As a part of that law, parents with children in high school sports have probably noticed that extra page or two on their sports physical paperwork addressing concussions.

There are many great websites that provide information and resources regarding concussions for athletes, parents, teachers and coaches.  This is because a concussion does not just impact the athlete – parents and family members notice the most obvious signs and symptoms. After a concussion, an athlete’s schoolwork is affected, and the process for clearing them to resume their activity is more involved than in years past.

Concussion 101

As most people know, concussions are caused by trauma to the head, usually occurring as part of a collision during sporting activities. One myth regarding concussions is that you have to have a loss of consciousness, or ‘get knocked out’, for the injury to be classified as a concussion. This is not true, and in fact most concussions do not involve a loss of consciousness.

We also used to think that an athlete could return one week after a concussion, or maybe after two weeks. While this is partly true because we know the average length of recovery for high-school athletes is 10 to 14 days (much longer than we used to think), the reality is that every athlete and every concussion is different. The symptoms of the concussion typically resolve over time, but that length of time is unique to each injury.

The most important parts of concussion management involve identifying the athlete who has suffered a concussion, and then making sure they are fully recovered before they are cleared to return to their sport.

Identification of a concussion can be challenging at times because the symptoms do not always start with the initial injury. There is also the potential for this injury not to be brought to medical attention because the outward signs can be subtle and easily missed if the athlete does not tell anyone about their symptoms. Occasionally athletes will not report their symptoms because they want to continue playing their sport and know they will be pulled from the game if they are even suspected of having a concussion.

Not Worth the Risk

The biggest risk to the athlete is a rare but tragic event called second impact syndrome. This occurs when an athlete with a concussion receives a second concussion before they have recovered from the first one. The results can be catastrophic, and athletes have died following that second concussion. It is for this reason that our legislation reflects the current medical consensus regarding concussions – that is, if there is any concern for concussion, the athlete should sit out from sports until they have been medically cleared by a health professional.

In my next post, I’ll talk more about concussions – specifically, the common signs and symptoms associated with a concussion. I’ll also discuss how we, as medical providers, treat and eventually clear the athlete to return to their sport.  So stay tuned . . .

By Dr. Samuel Schimelpfenig

Pediatrician at Avera McKennan

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