Every Friday night over the next several months you likely will see the sky filled with bright lights coming from various football stadiums across East Texas as teams compete, hoping the long hours of practicing throughout the week will culminate in a victory.
All those involved - students, parents, alumni and the local community - excitedly anticipate that football will be on their Friday night schedules until late December. But as football gets underway, it is a good time to educate athletes, parents, coaches and medical providers about sports-related concussions. Concussions can occur in any sport or activity where a traumatic injury occurs, but, being a contact/collision sport, football is high risk - as are sports such as soccer, basketball, lacrosse, ice hockey, cheerleading and pole vaulting.
In the United States, it is estimated there are 1 million to 4 million concussions annually due to organized or recreational sports. For participants younger than 18, studies show 5 to 9 percent of all sports-related injuries are concussions, so these are not uncommon. In order to recognize this injury and promptly begin management, education is critical.
A concussion is when a person sustains trauma to the head, face or to the body which then causes an impulsive force to be transmitted to the head, resulting in a brain injury. Concussions are distinct from other traumatic brain injuries such as a bleeding in the brain (subdural hemorrhage, epidural hemorrhage), brain contusions or skull fractures. They can occur in a variety of circumstances, such as an injury in sports, car accidents and falling from any mechanism (such as off a bike or from furniture), to give just a few examples.
If there has been a traumatic injury, it is important to be suspicious for a concussion if any one of the following develops: headache, dizziness, feeling off balance, confusion, vision changes, nausea, vomiting, difficulty paying attention, becoming more emotional than normal, feeling suddenly more tired than normal or just “not feeling right.”
Other things you may notice could be an athlete stumbling off the field after being hit, going to the wrong huddle, acting in a clumsy manner, behaving in a way that is out of character, repeating the same questions over and over, or having difficulty remembering events.
Even if you simply notice your child does not seem like himself/herself after sustaining trauma, this should be cause for concern and seeking medical evaluation is recommended. The presence of any one symptom resulting from a traumatic injury should make you suspect your child has sustained a concussion.
With concussions, the immediate treatment is to remove the athlete from the game/practice. They should not return to any type of exercise/sports. If an athletic trainer is available at the school, they should be notified immediately. If an athletic trainer is not available, a parent should monitor the child for several hours.
If the symptoms are progressively worsening, take your child to the ER immediately. However, if the symptoms are present but not worsening, contact your primary care provider to get them into the clinic as soon as possible.
Most concussions do not need to go to the ER, but parents should use their discretion - if there is ever any doubt, do not hesitate taking them to be seen right away.
As long as any symptoms are present (even if only intermittent), it is not safe for them to be cleared to return to sports, as this puts them at high risk for complications including sustaining a catastrophic brain injury.
Additionally, all concussions should be seen by a medical provider, as it is important they have a thorough neurologic exam.
Other recommendations while symptomatic from a concussion is to limit use of a cellphone/TV/computer and to sleep as much as possible. Once symptoms have completely resolved, there is a gradual return to play protocol which is recommended for all concussions but is required by state law for anyone who participates in school sports to help ensure a safe return following the injury.
This is an important topic and there are many great educational resources available. If you have specific questions, our local medical community is always here to help.
Dr. Allison Tobola, MD is a board certified Primary Care Sports Medicine provider with Christus Trinity Mother Frances Orthopedics and Sports Medicine