By Dr. Dennis Rodin | Special to the REPUBLICAN-AMERICAN
Sports-related concussions have gained a lot of attention over the past several years. The media has brought this to the forefront with coverage of injuries to NFL players as well as a current lawsuit against the league.
This lawsuit, the largest in sports history, involves more than 4,500 former NFL players suing the league for allegedly concealing information linking concussions to long-term brain damage. Management policies of the injury, including criteria for return to play, have come into question.
The NHL has not been immune to this problem either with current star Sidney Crosby missing substantial playing time and former players Eric and Brett Lindros having had multiple concussions, forcing Brett to retire at age 20. The increased awareness of concussions and its potential long-term effects is now seen at the high school level. This is particularly relevant this time of year with football season underway.
A concussion is a traumatic brain injury caused by direct or indirect forces to the head, face, neck or elsewhere on the body. Symptoms are typically broken down into four categories: physical, cognitive, emotional and sleep. Physical complaints most commonly involve headaches but may also include dizziness, nausea and poor balance. Cognitive effects involve short-term memory loss and difficulty with concentration. Irritability, anger and sleep disturbance can also be seen.
Initial treatment of concussions is rest. This means removal from sport and avoiding any strenuous form of exercise. Cognitive rest is now also regarded as vital in the recovery process. Students may need to miss time from school until their memory and mental processing have returned to normal. Most symptoms of a concussion will resolve within two weeks.
Before consideration for return to play is made, an athlete must be symptom-free at rest. Then they are started on a rehabilitation program, which entails a slow transition back to both physical and cognitive activities. If a player is returned too soon, they are at increased risk of developing second impact syndrome which can have catastrophic results including death. This is most commonly seen in the adolescent athlete.
The U.S. Centers for Disease Control and Prevention (CDC) estimate that 1.6 to 3.8 million sports-related concussions occur annually. Many of these occur in high school athletes with the most numbers seen in football players. Adolescents are more vulnerable to concussions when compared to adults. This may be because their brains are not fully developed, and skulls are thinner at younger ages.
Changes in concussion protocols have trickled down from professional sports to collegiate and high school levels. This has led to rule changes including increased protection of “defenseless” players and barring tackling when leading with the head. Medical professionals and coaches now understand the need to err on the side of caution when dealing with concussions, and immediately removing a player from action suspected of having a head injury.
Increased media coverage of this injury has led to a change in culture among football players. Players, coaches, parents, and medical professionals alike have taken a more cautious approach in dealing with concussions. “Getting your bell rung” is a more serious injury than once thought.
Dr. Dennis Rodin is a physician at Waterbury Orthopaedic Associates with Drs. Eric Olson and Michelle Mariani.
Reprinted from the article in the Waterbury Republican.