Tuesday, May 5, 2009

Heads Up - A Parents and Coaches Guide to Concussions in Middle School and High School Athletes

Finally, it appears the medical and sports performance field is taking the issue of concussions seriously and not making it a badge of honor amongst athletes and their peers. Having a concussion is no joke as essentially your brain, which essentially floats inside your skull, is banged/concussed against your skull with these being some of the possible effects: headaches, nausea, loss of motor control/coordination and loss of short term memory. Those are just some of the short term effects. The long term effects, which are only now beginning to be understood, are even more dire: permanent brain damage resulting in permanent loss of memory/cognitive function, headaches, depression (to point of suicide), and loss of motor skills.

One only has to remember the tragic stories of Andre Waters and Mike Webster to recall how severe post concussion symptoms can be. Waters committed suicide due largely to the symptoms he suffered as a result of multiple concussions during his NFL career. Webster, who is in the pro football Hall of Fame, and played on 4 winning Super Bowl teams died homeless. jobless and penniless after living out of his car. He couldn't sustain a normal life due to the loss of function he had suffered because of concussions. These are tragic but powerful reminders of the fact that concussions are not to be trifled with and should be taken seriously and treated promptly and properly.

In the high school realm there are about 300,000 sports related traumatic brain injuries annually in the U.S. This number is 2nd only to auto accidents for severe brain injuries amongst the 15-24 yr. old age group.

In a study done at Ohio State University/Nationwide Children's Hospital of Columbus, Ohio the researchers studied athletes at 100 U.S. high schools and 180 U.S. colleges. Amongst high school athletes concussions comprised 8.9% of sports injuries; amongst college athletes they comprised 5.8% of injuries. The highest incident rates were in football and soccer.

In high school sports played by both sexes, girls had higher concussion rates and concussions comprised a greater percentage of injuries than amongst boys. Of course, this might be due to girls being more willing to admit they may have suffered a concussion and boys trying to adhere to some warrior/macho code.

Another study showed that from 2005-2008, 41% of high school athletes that were concussed, returned to play too soon.

These are all alarming statistics but what are we to do as parents, coaches, administrators of high school and youth sports?

First of all, what exactly is a concussion and why are they so dangerous? When some suffers a concussion, the arteries constrict which reduces blood supply to the brain. Simultaneously, calcium overwhelms the energy producing sections of the brain which further blocking oxygen and blood from getting the necessary energy to the neurons. The implications on brain function are obvious: slower reflexes and reactions which makes an athlete more susceptible to all types of injury including a 2nd concussion. A 2nd concussion in short order just exacerbates an already bad situation.

One of the first steps is making sure your high school sports program has a full time, certified athletic trainer. These professionals are worth their weight in gold not only in the concussion arena but is rapid response to sport injuries of all types. The sooner the response, no matter the injury, the less severe the aftermath will be and the more likely further injury will be prevented. Not having an athletic trainer is penny wise and dollar foolish in terms of the long term costs incurred from not treating concussions and other injuries promptly and properly.

There also should be a standard procedure applied for return to play. For example, if a player has suffered a concussion if they suffer symptoms for longer than 15 minutes (nausea, dizziness, loss of balance, etc.) they have to be symptom free for a week before they can play again. 16% of high school football players that suffered a concussion returned to play the same day....that is insanity!

The consequences of returning to play too soon can be fatal. 2nd impact syndrome is essentially the result of multiple concussions in short order. One of the concussions alone would not have been fatal but two in short order can be deadly. Young, adolescent brains are evidently less prepared to handle these 2nd concussions and thus the results can be fatal.

Another study done at Nationwide Children's Hospital found that over 50% of concussed boys' basketball and baseball and girls volleyball players returned to play too soon. That is not a good trend, obviously.

So it is up to parents, coaches, and administrators to do the right things: hire a full-time, certified athletic trainer, have a strictly enforced return to play policy in place, and observe your athletes for possible signs of concussion. Many times the warrior code of athletics places a premium on toughness at the expense of safety and common sense. Scaring young athletes "straight" with stories like Mike Webster and Andre Waters might be what it takes to "allow" kids to make the right choices.

Bruce Kelly, MS, CSCS, is a trainer/coach located in Media, Pa. Bruce is the owner of Kelly High Performance Training/Fitness Together in Media. He has coached/trained athletes in a variety of sports as well as trained clients to look better, feel better, and perform better. Bruce has over 25 years experience in the training/fitness field, has authored articles for strengthcoach.com and other websites, has contributed to several books on training, and presented seminars on a variety of health, fitness, and training topics at high schools, health clubs, and service clubs. You can visit Bruce on the web at: http://www.ftswarthmore.com if you are interested in training with him or his staff. They also train teams/individuals on site/at home as well

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