There is a greater degree of awareness and concern about concussion among athletes, coaches and physicians these days.
“In my experience over the past couple of years, the awareness of concussion has significantly risen,” said Chris Sharrock, PT, DPT, CSCS with KORT (Kentucky Orthopedic Rehab Team) in Winchester. “There are more reported concussions than there have been in the past, just because of the information that’s come out about the seriousness of them.”
Concussion is a mild, almost nostalgic term for a more serious condition.
“The word ‘concussion’ has been kind of watered down in our society,” Sharrock said. He believes using a stronger phrase to describe the event will make people take concussions more seriously.
“There’s a big movement right now to not even call them concussions, instead calling it a mild traumatic brain injury,” he said. “Brain injuries are things like stroke, and we take those very seriously. We need to have the sports community do the same.”
KORT uses a computer-based comprehensive concussion program to perform a baseline testing of athletes before they incur a head injury. Sharrock calls it a “preseason physical for the brain.”
“We have a baseline measurement of their cognitive function,” Sharrock said. “If they have some sort of concussion, we can bring them back in and test them again and compare their results to what they tested at baseline.”
The program asks the athlete questions and scores him or her on memory, recall ability, reaction time and other facets of brain function. If a suspected brain injury occurs, the baseline results are compared to the results obtained after the injury.
“We can say, ‘Oh, they scored 75 percent in individual memory (after the incident) compared to what they did at the baseline test,’ so that lets us know there’s a deficit and there’s a problem,” Sharrock explained.
Recent research is showing that the long-term consequences of concussion are much worse than was originally thought, Sharrock said.
“That’s been driven by the NFL and the research they’ve done on some of the players that have passed away,” he said. “They’ve studied their brains and they’ve looked at the changes that have happened with these guys that have had multiple concussions. So what we know is that concussions at a young age are a red flag for problems later in life.”
Education is vital for helping athletes and their coaches recognize and prevent concussions.
“I think the most important thing that we can do is educate the community, especially the parents and coaches, so that everyone knows concussion is a brain injury, and a brain injury is very serious and we need to take it seriously,” Sharrock said.
Another essential strategy is learning and using proper technique and form, especially in contact and collision sports.
“We need to enforce safety rules especially during competition, such as not allowing spearing in football,” Sharrock said.
Improving protective equipment such as helmets and mouthpieces will also make a difference in lowering the incidences of concussion. In addition, athletes who are in better condition will be able to absorb and deal with collisions. “Preparation is critical,” Sharrock said.
For a variety of reasons, younger athletes are more susceptible to concussion. They are not quite as strong as seasoned athletes, and their larger heads and smaller necks make it more difficult for their bodies to absorb force.
“If an athlete is having concussions at a younger age, not only are they susceptible for more concussions later on, but it’s definitely a big red flag,” Sharrock said.
There is ongoing debate about how many concussion should totally disqualify an athlete from competition.
“Some people will say after the third concussion, (the athlete) is usually done,” Sharrock said. “If you get an athlete into a situation where they’ve already had three concussions, you’re looking at some serious, possibly long-term complications.”
Diagnosing concussion can sometimes be tricky.
“There’s a constellation of symptoms that can happen with a concussion, and that’s why they’re sometimes tricky to identify,” Sharrock said. The most common symptoms include headache, dizziness, nausea, blurry vision, difficulty remembering new information and photosensitivity. The Centers for Disease Control says the symptoms may appear right away, while others may not be noticed for a few days after the injury occurs. Some signs that indicate a need for immediate medical attention include a headache that gets worse and doesn’t go away; weakness, numbness or decreased coordination; slurred speech; one pupil appearing larger than the other; and convulsions and seizures. If the victim cannot be awakened, he or she should be taken to the emergency room.
The current standard of care is to remove an athlete from the playing field if a concussion is even suspected. Until the athlete has been examined and cleared by a physician, he or she should not be allowed to return to the sport.
By Tanya J. Tyler, Associate Editor