Sport Concussion Awareness by Bill McLaughlin, GHS Athletic Trainer

By Bill McLaughlin M.A., A.T.,C 

The spring sports season is getting underway in schools and township leagues alike. As with all forms of athletic competitions at all age levels, the risk of injury looms present in every contest. One of the most controversial types of injury an athlete can undergo is that of the sports related concussion.

A concussion, simply put, is a bruise to the brain that results in a \”graded\” set of clinical symptoms ranging from simple (confusion, headache, nausea) to complex (seizures, slurred speech, coma) states.

The biggest mistake made by athletes, parents and even some physicians is to downplay the seriousness of a concussion simply because the athlete did not \”black out\” at onset.

In November of 2001 and then again in 2004, The International Conferences on Concussion in Sport were held in Europe to establish a definitive criteria on the treatment and management of sport related concussion. The findings of these professionals, which included physicians and specialists in varied areas of sports, established protocols that alter and in some cases, contradict management techniques used in athletic medicine as recent as five years ago.

This includes elimination of the words \”ding\” and \”bell rung\” as to not downplay the seriousness of any brain related injury, however seemingly innocent.

We now know that loss of consciousness alone is not a predictor of the long-term effects of concussion and that having a single concussion increases the chances of more down the line. A concussion in the middle school years or younger, may set an athlete up for more cumulative effects of neurological function with each incident as they continue to compete in sports over their \”athletic\” lifetime.

Signs of simple concussion include but are not limited to:

amnesia, \”fogginess\”, headache and nausea. An athletic trainer can determine the initial severity of the concussion but physician consultation is essential to determine follow up care and the length of activity cessation.

The minimal time an athlete should stay out of activity based on a simple concussion is seven days from the end of all symptoms. This is only for the first simple concussion. Any seceding concussion will compound the down time and care of the athlete.

Returning the athlete to activity too early risks the \”layering\” of another concussion before the first one has healed complicating neuropathology even further.

A complex concussion results when the athlete is unconsciousness on the field for over five seconds or has sustained multiple simple concussions. Symptoms such as vomiting, disorientation and seizure can follow. This injury may even warrant being removed from the field via ambulance and transferred to the nearest hospital. A quick reference for acute concussion from the International Conferences on Concussion in Sport* is as follows:

 

When a player shows ANY sign of concussion:

1. The player should not be allowed to return to the current game or practice.
2. The player should not be left alone; and regular monitoring for deterioration is essential over the initial few hours following injury.
3. The player should be medically evaluated following the injury.
4. Return to play must follow a medically supervised stepwise process.
5. A player should NEVER return to play while symptomatic…\”When in doubt, sit them out!\”

 

* Summary and Agreement Statement of the 2^nd International Conference on Concussion in Sport, Prague 2004

 

Remember, concussions are always serious sports injury no matter how benign they may initially appear. Knowing what to look for and how to act will help the athlete get the most appropriate care in the least amount of time. Play it safe this year!

 

Bill McLaughlin, M.A., A.T.,C. is the certified athletic trainer at Gloucester City Junior – Senior High School. He can be reached at [email protected]