By: Robert S. Gray, MS, ATC
Annually, approximately 1.6 to 3.8 million concussions are linked to sports. Football, soccer, field and ice hockey, lacrosse and basketball players are at increased risk. Concussions are injuries to the brain following a traumatic event. While they do not affect its anatomy, they disturb the brain’s metabolism. Poor management of concussions can result in serious injury. Interscholastic, intercollegiate and recreational athletes with concussions can – and should – receive the same expert care that professional athletes do.
Know the signs and symptoms
Concussions do not always cause loss of consciousness. Here are some of the most common signs and symptoms:
Coaches/parents may notice:
- a dazed or stunned appearance
- confusion about the play
- clumsy movements
- slow responses to questions
- personality/behavior changes
- retrograde amnesia (forgetting play prior to "hit")
- anterograde amnesia (forgetting play after "hit")
- loss of consciousness (even temporary)
Athletes may report:
- headache
- nausea
- balance problems
- double vision
- sensitivity to light
- feeling sluggish
- changed sleep patterns
- cognitive (mental) changes
Certified Athletic Trainers and coaches who suspect a player has sustained a concussion should remove the athlete from play, practice or games immediately and should not return until evaluated by a medical professional. A medical professional should provide a neurological check, along with a mental status evaluation that includes orientation, concentration and amnesia, both anterograde and retrograde. Any positive findings preclude a return to play the same day.
ImPACT testing useful
Used correctly, the ImPACT test can also provide valuable information to athletes, parents and sports medicine practitioners, and promote a safer return to competition. This computer-based neuropsychological test is administered online at home or school to measure verbal memory, visual memory, reaction time, processing speed and impulse control.
Cleveland Clinic Sports Health experts highly recommend baseline ImPACT testing prior to the season for collision/contact sports. The test can be re-administered 24 to 72 hours after a concussion and before the return to competition. Even with ImPACT testing, a thorough medical evaluation is a must after a concussion. This includes neuropsychological assessment. CT and MRI tests will be performed to rule out more serious head injury. Learn More about ImPACT: Sports Concussion Program
Recovery from concussion
Recovery from a concussion may take days to several weeks, and begins with complete rest. This means no activity. The athlete remains under the observation of an adult or healthcare professional.
Once the signs and symptoms of a concussion have resolved, gradual exertion (such as light aerobic training) is permitted to the degree that the athlete can withstand. The athlete can then move on to sport specific training. Non-contact drills are followed by full-contact drills, and, if no symptoms appear, a return to competition.
If at any point signs or symptoms of concussion recur, the athlete must return to full rest and start the process over. Honesty from the athlete is absolutely key! Athletes should not return to play until the appropriate healthcare professional ensures that they are totally symptom-free.
Late effects of concussion may include short-term memory problems, academic difficulties, fatigue and sleep disturbances, irritability and depression. School teachers, administrators, guidance counselors and nurses should be familiar with the signs and symptoms of concussion to monitor the athlete academically during healing.
Prevention
To reduce the risks of concussion, teams should provide the correct protective equipment and ensure that athletes wear them, and coaches should insist that players follow the rules of the game and display good sportsmanship.
If one of your athletes sustains a concussion during the season, that athlete should not return to play until he or she has been evaluated by the appropriate healthcare professional and received permission to return to competition.
- For more information on concussion management or ImPACT testing, contact Bob Gray, Coordinator of Athletic Training Community Affairs, at grayb1@ccf.org
Published October 2008 (revised August 2010)
