RECOVER: September 2012

Concussions of the Young Athlete

The whistle blows and the game begins.  Welcome to fall and fall sports!  If this time of year brings images of standing on the sidelines watching your football player, cheerleader or soccer player back in action, you are not alone.  And, while those thoughts of great plays and brisk fall days should be forefront in your mind, we should not lose sight of the very real potential for significant injury in our young players.

Concussion has gotten a great deal of press in the past few years.  Neuroscientists and physicians are producing research and guidelines that prevent potential catastrophic injuries through attention to what might seem like a minor “bell ringer”.  States, medical societies and professional organizations including the American Physical Therapy Association are working hard to address this area of athlete safety.  Although there is still work to be done, one thing is certain, a concussion is a brain injury and even in the absence of bleeding or other obvious trauma, this type of "closed head injury" can be incredibly serious, possibly even just masking the severity of the injury.

The Centers for Disease Control and Prevention estimates that nearly 3.8 million sports related concussions occur annually.  In the state of New Jersey, legislation reads, “any student who participates in an interscholastic sports program and who sustains or is suspected of having sustained a concussion or other head injury while engaged in a sports competition or practice shall be immediately removed from the sports competition or practice. A student-athlete who is removed from competition or practice shall not participate in further sports activity until he/she is evaluated by a physician or other licensed healthcare provider trained in the evaluation and management of concussions, and receives written clearance from a physician trained in the evaluation and management of concussions to return to competition or practice.”

According to the CDC, here are some signs and symptoms to look out for:

SIGNS OBSERVED BY COACHING STAFF OR PARENT:
• Appears dazed or stunned  
• Is confused about assignment or position  
• Forgets sports plays  
• Is unsure of game, score, or opponent  
• Moves clumsily   
• Answers questions slowly 
• Loses consciousness (even briefly)  or groggy 
• Shows behavior or personality changes  
• Can’t recall events prior to hit or fall  
• Can’t recall events after hit or fall 

SYMPTOMS REPORTED BY ATHLETE:

• Headache or “pressure” in head 
• Nausea or vomiting 
• Balance problems or dizziness 
• Double or blurry vision 
• Sensitivity to light 
• Sensitivity to noise 
• Feeling sluggish, hazy, foggy, 
• Concentration or memory problems 
• Confusion 
• Does not “feel right” 
Adapted from Lovell et al. 2004

If you think your athlete has sustained a concussion......

• DON'T assess it yourself,
• Take him/her out of play,
• Seek the advice of a health care professional.

Pro-Activity Physical Therapists have worked closely with area doctors to return our injured players to the field in a safe and efficient manner and are closely monitoring this area of our practice as more and more cases surface.  

Exertion testing after concussion is one way to verify that the athlete is able to handle the rigors of physical activity at the level of their sport prior to making their full return.  If your athlete sustains a concussion, we urge you to take all necessary precautions.  Then, call us to help get them back to their sport as quickly and as safely as possible.

Have a great fall-season, we're looking forward to hearing and reading about your latest successes!

Written by Amy Weller, PT, DPT, GCS.  Amy is a Partner and Director of Clinical services with Pro-Activity.