Concussions: Tackling the Topic of Sports-Related Head Injuries

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Concussions: Tackling the Topic of Sports-Related Head Injuries

Concussions and chronic traumatic encephalopathy (CTE) are common threads of conversation, when discussing serious sports injuries. In the last several years, increased media emphasis has highlighted protecting athletes from head injuries during games, as well as after they no longer compete.

Everything from movies to national news stories of players suffering from CTE puts football specifically at the center of the head injury discussion. With heavy contact, aggressive hits and a large fan base, football receives arguably the worst reputation for concussions. UnityPoint Health Sports Medicine physician, Shawn Spooner, M.D., has seen his fair share of injured athletes and shares his expertise about concussions in football and other sports.

Concussion Signs and Symptoms

According to the American Medical Society for Sports Medicine (AMSSM), a concussion is defined as a type of mild, traumatic brain injury (MTBI), where an injury to the head or body causes temporary disturbance of brain function. Concussion is, by definition, temporary and will resolve with appropriate treatment and time. Such an injury might occur due to a blow to the head by contact with another player or the playing surface. However, direct injury to the head is not required. Any injury to the body can transmit forces to the brain, causing a concussion. Tremendous force is not always required to cause a concussion. Even seemingly minor injury can sometimes be enough to induce concussion in the right circumstances. Side effects range in type and severity, with headache being the most common experience.

Concussion Signs & Symptoms

(As defined by the American Medical Society for Sports Medicine)

Physical Cognitive Emotional Sleep
Headache Mentally "Foggy" Irritable Drowsiness
Nausea/Vomiting Feeling Slowed Down Sadness Sleeping More Than Usual
Balance Problems Difficulty Concentrating Unusually Emotional Sleeping Less Than Usual
Dizziness Difficulty Remembering Nervousness Difficulty Falling Asleep
Visual Problems Forgetful or Confused about Recent Information or Conversations    
Fatigue Answer Questions Slowly    
Sensitivity to Light/Noise Repeats Questions    
Dazed & Confused      

While concussions are primarily seen in contact sports, such as football, but head injuries span a variety of athletics.

“Concussions occur in every sport,” Dr. Spooner says. “Football, on average, is only a small proportion of athletic concussions. More concussions are seen in men’s and women’s soccer and basketball combined than football alone. Rugby, hockey and cheerleading are also sports high in concussions rates per participant.”

Dr. Spooner says the average recovery time for concussions is between seven and 11 days, but no standard period of rest applies to each person.

“It would be irresponsible as a physician, trainer or coach to utilize an arbitrary number of rest days to dictate return to play. Concussion recovery should be approached on a case-by-case basis,” Dr. Spooner says.

Concussions in Youth Sports

Sports put young athletes at greater risk for concussions and head injuries. The AMSSM sites that roughly 30 percent of all concussions in children ages 5- to 19-years-old are sports-related.

“Early participation in contact sports may place young athletes at risk for significant musculoskeletal injury. Some significant orthopedic injuries may result in the need for surgery and may lead to premature degenerative processes, such as arthritis, that may limit future athletic participation and capabilities,” Dr. Spooner says.

Most individuals will not experience any long-term effects of concussion. However, multiple concussions and especially frequency of concussion over a short period of time may increase the risk of long term adverse outcome of concussion. Dr. Spooner says while there is no definite limit to the total number of concussions an individual can “safely” sustain, he generally recommends not allowing more than two concussions per sports season, or three in a calendar year. Multiple factors, including severity and timing of concussions, other underlying medical/health concerns and genetics, likely determine long-term risk of recurrent concussion. These factors, as well as the long-term life goals and priorities of the athlete, should be considered when deciding if and when to continue high-risk sports and activities. Dr. Spooner also says children may be more impacted by concussion than adults.

“Due to the nature of the developing brain, recovery from concussion may take longer. However, certainly we have observed prolonged and complicated recovery in both youth as well as adults. We simply don’t know yet, based on current studies, why this might be the case. From a practical perspective, sustaining a concussion at a young age may impact studies at school and sometimes sets a student behind for some time. In short, there’s never a “good” time to get a concussion,” Dr. Spooner says.

The competitiveness of youth athletics may also contribute to possible injury.

“Ever-increasing requirements for success in competitive sports have created added pressure for young athletes to train with greater intensity at earlier ages. This has resulted in an increased demand for year-round sport training programs, facilities and products. But, this approach often leads to youth burnout and overuse injuries,” Dr. Spooner says.

Dr. Spooner doesn’t advise families to steer their children away from certain sports, but rather, to evaluate the possibilities with every genre of athletics.

“Athletes and families need to consider risks inherent in playing any sport to include the risk of concussion, other traumatic musculoskeletal injury, as well as the physical and social benefit of participating in organized sports,” Dr. Spooner says. “Youth athletes should be encouraged to try a variety of sports and activities.”

If your child experiences any form of head injury or concussion, contact your UnityPoint Health provider immediately.