New Game Plan for Concussions

4 Apr

Neurology Now – A well written article discusses the prevelence of concussion in sports and the incompetence of the general public in recognizing the signs and symptoms of a concussion.  I have peiced together many of the better parts of the article below.  It is worth the read and highlights the importance of access to athletic trainers for all athletes.

Over the past few years, a number of stories have made the headlines involving mismanaged injuries in young athletes that turned catastrophic. Too many times, players have been moved off the field when they shouldn’t have been or cleared to return to play before they fully recovered. Instead of heading off to college, teenagers like Matthew Newman of Cowiche, WA, are spending what would be their freshman year making trips to rehabilitation facilities. Newman suffered a traumatic brain injury (TBI) during a football game in September 2009, and has been fighting a long battle to recover ever since.

As a result, dangerous hits are being taken more seriously. Athletic organizations at every level—from Pop Warner football to the National Football League—are changing the rules that dictate when players can return to the field, what type of personnel must be present at sporting events, and how to determine if an athlete can suit up… or should sit down.

Additionally, a number of states have begun to adopt legislation requiring that players who are suspected to have suffered a concussion be removed from play. (See box, “Making Concussion Safety a Law.”) Data from the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, OH, show that as many as 40 percent of high school athletes who sustain concussions return to action prematurely, which raises the risk for more severe injuries.

“Letting someone continue to play when they are concussed will commonly cause a longer, more complex injury,” says Jeffrey Kutcher, M.D., assistant professor of neurology at University of Michigan Health System in Ann Arbor, MI, and director of the Michigan Neurosport Program. If an athlete re-enters a game or practice, he or she faces serious risks—even if there is no further physical contact. “If they continue to exert themselves physically and mentally at high levels, the injury worsens, with more complex symptoms and a more difficult recovery,” he says.

What is known is that concussions are happening far too often. According to the Centers for Disease Control and Prevention (CDC), three million concussions occur every year in the United States. Among people 15 to 24 years old, sports are second only to motor vehicle accidents as the leading cause of TBI. Concussions represent an estimated 8.9 percent of all high school athletic injuries, according to a report from the American Academy of Pediatrics (AAP).

“These injuries are happening more frequently than we ever realized,” and they’re not always easy to detect, says Julian Bailes, M.D., director of the Brain Injury Research Institute and professor and chairman of the department of neurosurgery at West Virginia University School of Medicine in Morgantown. “It can be very difficult to discern how serious a hit is by just seeing or hearing what happened,” Dr. Bailes says.

That was one of the key drivers behind the AAN’s recommendations: to take the decision of whether a player can return to the field out of the coach’s hand, and to leverage the technological innovations and advances in research that have surfaced in recent months to improve the care of athletes, says Dr. Kutcher.

The bottom line of the new position is actually quite simple: Got a possible concussion? Get off the field.

While experts such as neurologists and certified athletic trainers are qualified to identify the signs of a concussion, doing so can be much more difficult for the untrained. Many people believe that concussions only occur when a player is unconscious. This assumption, says Dr. Bailes, is both incorrect and dangerous. “With the vast majority of concussions in sports—90 percent of the time, in fact—athletes don’t get knocked out,” he notes. “They’re walking around and talking, and they look normal.”

That’s where testing comes into play. Through a neuropsychological evaluation, physicians acquire important information about a patient’s cognitive, motor, behavioral, language, and executive functioning, which can guide them in making a diagnosis and determining when it is safe for an athlete to return to play. According to the AAP, evaluation is based on several computerized neuropsychological tests designed to objectively evaluate an athlete’s post-injury condition and track recovery to prevent cumulative effects of concussion. A neuropsychologist may also administer a pencil-and-paper test to the patient.

Why athletic trainers are needed

WHY TRAINERS ARE NEEDED

One step that can assist in identifying and assessing possible concussions is the presence of a certified athletic trainer. According to Dr. Kutcher, this is important for several reasons.

“Athletic trainers have the experience and the training to be able to block out all of the environmental distractions that exist during games and triage an injury,” says Dr. Kutcher, who is also a team physician for the University of Michigan and Eastern Michigan University athletic programs. And trainers are taught to be completely objective when evaluating athletes.

“While I would love to think that all parents, coaches, and teammates can have objective viewpoints on these injuries, the truth is, that’s hard to do. Athletic trainers accept that responsibility, and they’ve developed the skills to not let the person’s position of importance to the team—for example, the starting quarterback—affect their clinical judgment.”

What distinguishes certified athletic trainers from other professionals such as personal trainers is the fact that they must graduate with a bachelor’s or master’s degree from an accredited professional athletic training education program and pass a test administered by the Board of Certification, according to the National Athletic Trainer’s Association. Once certified, they must meet ongoing continuing education requirements.

Original article

One Response to “New Game Plan for Concussions”

Trackbacks/Pingbacks

  1. Eastbay and Axon Sports Partner to Raise Awareness of Sports-Related Concussions - April 5, 2011

    […] New Game Plan for Concussions « promotetheprofession […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: