Special Caution on Concussions

Concussions occur frequently in athletes, but they are the type of sports injury about which we know the least. Experts say that's because of the brain's complexity, as well as a lack of research into concussions.

Concussions—defined as a trauma-induced alteration in mental status—are often difficult for doctors to recognize. A forceful hit to the head or any part of the body that cause a rapid movement of the head may result in a concussion.

The majority of concussions do not involve loss of consciousness. You don't even have to be hit on the head. A blow to the shoulder that violently snaps the head can cause a concussion.

According to the CDC, 65 percent of sports- and recreation-related concussions seen in the emergency department are in children ages 5 to 18 years. Symptoms may not happen immediately, but include impaired thinking, memory problems, and changes in emotions or behavior.

Helmets reduce injuries

Head injuries are most common in contact sports, but protective equipment can limit the risk. A helmet reduces the force of contact and slows the impact to the brain.

Unfortunately, helmets can give athletes a sense of invulnerability.

Soccer isn't risk-free, either. Children should not "head" the ball until they are in their mid-teens, although flying elbows, kicked balls, or collisions may pose bigger threats to unprotected heads.

The CDC recommends that you know your concussion ABCs: Assess the situation; Be alert for signs and symptoms, and Contact a health care provider. It's important to remember that you should not return to sports or recreation activities until you are evaluated by a health care provider experienced in treating concussions.

Rest is key for the treatment of a concussion; the brain needs time to repair itself.

Often athletes experience no symptoms after a few days. Headaches, nausea, and other problems may return from plunging back into sports too soon, though.

Other rules of treatment:

• Immediately after injury, a doctor, school nurse, coach, or trainer who is experienced in evaluating concussions should check the person's mental status.

• Remove the person from the activity, especially after loss of consciousness, until a health care provider experienced in evaluating concussions gives the person approval to resume sports or recreation activities. 

• Initially monitor the person's level of consciousness very closely for 30 minutes, then monitor his or her state of consciousness closely for the next 24 to 72 hours.

• Restrict activity until the person is cleared by his or her health care provider to resume normal activities.

• The person should gradually return to light activity. Contact the person's health care provider if symptoms recur.

Experts agree that more research on concussions is needed. Having had one concussion increases your risk for a second, and may cause slower recovery from the second one if it occurs. Athletes tend to be bigger, stronger and faster these days. They are capable of causing much greater trauma than in the past.

Signs of a concussion

Although symptoms may not occur immediately, common signs include:

• Headache

• Dizziness or vertigo

• Lack of awareness

• Nausea and vomiting

• Poor attention and concentration

• Fatigue

• Double or blurred vision

• Irritability and/or bothered by light or noise

• Memory problems