You may have noticed that concussions have become a hot topic and we here at The Village Doctor think that is great. Concussion research is booming and continues to shed light on traumatic brain injury, but also makes us realize that we have a lot to learn. Aside from wearing the appropriate safety gear for the sport or activity, children need to learn proper techniques and methods of safe play to prevent concussions. Additionally, raising awareness and opening the discussion amongst parents, coaches, teachers, kids and their doctors is one way that we can help keep student athletes safer!
A concussion is a complex brain injury that results from traumatic forces directed at the head or transmitted to the head after a hit to another part of the body. The injury causes neurologic impairments to develop rapidly and while symptoms can be short-lived, they often evolve after the injury and the recovery course can be prolonged. Symptoms usually reflect a functional disturbance to the brain and may include physical (e.g., headaches, nausea), cognitive (e.g., difficulty with concentration or memory), emotional (e.g., irritability, sadness), and ‘maintenance’ (e.g., sleep disturbances, changes in appetite or energy levels) symptoms. It is important to recognize that less than 1 in 10 individuals will have loss of consciousness and thus other signs and symptoms must be carefully evaluated.
Coaches and athletic trainers play a big role in the diagnosis of athlete’s concussions and luckily some of our local high schools are making big efforts to change the concussion culture. Quick sideline screening tests such as the King Devick test can help determine if athletes can immediately return to play or if further evaluation is necessary. The saying “when in doubt, sit them out” has become a mantra to prevent further damage and more importantly, to avoid Second Impact Syndrome. Further screening tests can also be done on the sideline to rule out more serious injuries and to help determine the course of action.
Once removed from play, the decision to return requires medical clearance and thus the athlete must visit their physician. After a thorough neurological assessment, it is our job as doctors to create a graded plan for return to activity and return to play. Brain rest is crucial for healing after a concussion, so doctors, parents, teachers and coaches must work together as a team with the athlete to guide them to a full recovery. As symptoms resolve, athletes can slowly get back to normal activities and school work and once symptom free, they are ready to get back on to the field for a gradual return to the game.
Check with your school to make sure that they have a concussion action plan and please feel free to ask your physician at The Village Doctor if you have more questions. For more information, visit the CDC’s “HeadsUp” website which has many useful resources and even a smart phone app to help people better understand concussions.
Jackie Phillips, MD, June 4, 2021