Lessening the Impact to Stay in the Game

By Karyn Odway

An estimated 173,000 children and teenagers are treated for concussions and other traumatic brain injuries each year in hospital emergency rooms across America, according to the Centers for Disease Control and Prevention (CDC). Sports Health recently published a CDC study concluding youth tackle football athletes (ages 6 to 14) sustained 15 times more head impacts than flag football athletes and sustained 23 times more high-magnitude head impact.

“Symptoms can be very subtle, and a concussion doesn’t only occur with a hit to head,” said Peter J. Waller, DO, a primary care sports medicine specialist at NorthShore Orthopaedic & Spine Institute. “For example, a high school football player who takes a hit to the chest causing significant force that transmits to the brain could cause a concussion.”

Symptoms may include headache, neck pain, lack of coordination, memory loss, nausea, dizziness, ringing in the ears, balance problems, sleepiness, excessive fatigue, and mood changes such as irritability, sadness or anxiety.

“Most concussions resolve within the first 3-4 weeks after injury, but it is important to be able to recognize the signs to better manage them and prevent the potential serious consequences of a misdiagnosis or delay in treatment,” Dr. Waller said.

A concussion is hard to confirm with lab tests and imaging like CT or MRI since the damage is usually done at the cellular level. “The ability to observe an athlete at the time of injury is extremely important for potential recognition and initial management of sport-related concussion,” Dr. Waller said. 

He advises coaches or parents to remove their student athlete from a game or practice for immediate evaluation when the following occurs: a loss of consciousness, seizure, confusion, amnesia, severe or worsening headache, repeated vomiting, blurred vision or suspicion of significant spinal cord injury.

“If there’s a concern of a more significant head injury, the student athlete should be sent to the emergency room or an immediate care center further evaluation,” Dr. Waller said. He also says it’s best for an athlete to be evaluated by a medical professional most familiar with them in order to detect subtle changes in personality or test performance.  “If there is continued concern for potential concussion, they should not be allowed to return to play.”

What should coaches, parents and physicians look for initially? Dr. Waller said first focus on two areas:

• Concentration. Special attention should go to a student athlete’s responses to questions and situations as well as their speech pattern and how they appear to be processing information.
• Balance. Vision problems can impact postural balance and make the recovery process more challenging.

Any concerns with these initial tests should lead to a more thorough concussion assessment.

“There's no single cure for concussion,” Dr. Waller said, “but adequate sleep, combined with brief cognitive and physical rest are recommended for the first few days after being injured.”

Student athletes should consult a concussion specialist for a recovery plan of action for the following days and weeks.

Initially, in addition to restricting sports play, the student athlete should also reduce playing video games, watching TV, computer and smartphone screen time, social-media scrolling and even excessive in-person socializing.

Medications such as acetaminophen can be used for headache pain or anti-nausea pills could relieve vomiting and dizziness. Student athletes might also find physical therapy helpful for some symptoms like neck pain.

For cognitive concerns, behavioral therapy for mood disorders, and academic accommodations – such as extended time on tests and assignments and breaks during the school day – are recommended.   

Prevention plays a part, too. Here are two ways to protect against a concussion:

• Abide by new rules in football and other contact sports on blocks and hits.
• Wear the right equipment, even though helmets don’t prevent all potential injury. 

Dr. Waller said student athletes need to take a multifaceted approach to avoid and heal from a concussion, so they can return to play quickly.  

Peter Waller, D.O. is a primary care sports medicine specialist with expertise in concussion management at the NorthShore Orthopaedic & Spine Institute. You may schedule an appointment with him online or call (847) 866-7846.