Concussions are a major buzzword in the world of sports today. And it’s no surprise concussions have captured widespread attention – there are 3.8 million sports-related concussions in the U.S. every year and no definitive prognostic indicators of when it’s safe for an athlete to return to play. The combination of concussion prevalence and underwhelming scientific research has made this lethal and often lifestyle-related injury the topic of a national conversation.
Concussions have become a serious concern for athletes, athletic trainers, coaches, fans, and families. The autopsy of former NFL player Mike Webster in 2002 raised deep concerns after he was the first NFL player to be diagnosed with chronic traumatic encephalopathy (CTE) – a degenerative disease caused by repeated brain trauma commonly seen in sports. Since then, the topic of concussions has made its way to Congress, cropped up in sports not typically associated with concussions (like NASCAR) and perhaps most importantly in schools and athletic programs across the country.
Concussions in Student Athletes
It’s estimated that among youth football players, 70 percent are playing outside of national oversight. For every professional NFL player, there are 2,000 kids playing football. That’s a staggering 3.5 million children who are playing football without standardized oversight – a substantial number of athletes there’s little information on.
In addition to the lack of oversight, these young athletes who are particularly vulnerable to concussions are at the mercy of whatever healthcare professionals they have access to - geographically and financially. This means athletic trainers and coaches are the first line of defense for both youth and professional athletes across the country.
Concussion Education – It’s Vital
Studies show that concussion “education is essential to the athlete’s recovery” when both the healthcare professional and athlete are informed on evaluations and protocol. It’s not enough for just the healthcare professional to have concussion education because athletes need to understand the importance of cooperation and asking for help.
Part of the problem with current concussion evaluations is that many symptoms cannot be observed without the full disclosure of the athlete. Healthcare professionals still receive push back from athletes that don’t fully understand the long-term implications of concussions. Athletes are worried about losing playtime and often end up sacrificing their health. This is why concussion education should be part of every athletic program – at both the student and professional level.
How to Make Your Concussion Evaluations Better
For most concussions, there is an initial period directly after the blow that may be symptomless. That’s why these evaluations take time and cooperation from the athlete for a thorough diagnosis.
A person suspected of a concussion should be evaluated in a calm environment with limited distractions so that symptoms can be better observed. This is typically a locker room or somewhere away from the activity.
Also, this evaluation should take at least 15 minutes because many symptoms do not occur until 5-15 minutes after a concussive hit. For a comprehensive list of observable and subjective symptoms, you can check out this guide to evaluating a concussion.
It’s important to note that concussion tests are more effective if there is a pre-assessment for baseline function comparison. While this may seem like common sense, baseline concussion testing is not as widely practiced in athletic programs across the United States as they should be.
Why Concussion Management Matters
Concussion treatment should really be considered concussion management. The brain may only be 2 percent of a person’s body weight, but it uses 25 percent of the body’s blood, 30 percent of its oxygen, and 33–35 percent of total glucose and energy consumed is utilized by the brain. It’s a complex, energy-hungry system that, when damaged, requires rest.
Symptoms of concussions are a result of the brain trying to heal itself. This is why someone with a concussion may experience severe headaches if they exert themselves.
Anything that takes energy or focus away from your brain healing itself can amplify painful concussion symptoms. The brain needs relative rest - meaning initially limiting activities and gradually returning to a normal lifestyle.
Concussion management is crucial for preventing long-term damage. It also keeps athletes from being increasingly susceptible to future concussions. With more focus on concussion management, studies are looking for ways to diagnose and offer more concrete guidelines for concussion patients.
Understanding Concussions Better – Hope for the Future
Recently, a study by the National Institute of Health found that levels of the blood protein tau might be a biomarker for determining the return-to-play time for concussed athletes. By comparing the symptoms of 632 athletes and their tau levels, researchers found that those who needed longer recovery times had higher tau levels. These elevated levels of tau presented in the athlete’s blood only six hours after the injury.
While promising studies on concussions may eventually take the guesswork out of concussion diagnosis, at this point, concussion evaluation and concussion management is only a best-practice method.
Current Best-Practice Concussion Guidelines
The future of successful concussion treatment requires three key components in athletic programs for the best chance of a favorable outcome:
- Education & Cooperation
- Pre-Evaluations & Thorough Evaluations
- Concussion Management
By incorporating concussion education and pre-evaluations into every athletics program across the country and approaching concussion treatments as concussion management, athletic directors, coaches and student athletes can improve best-practice concussion guidelines in their respective programs.
The Importance of Understanding Limitations
The concussion guidelines above are best practices as they stand today. Concussions are serious injuries that require additional research to hone these best-practices and help save the lives of athletes and other victims of brain trauma. It’s important to understand that as concussion studies are performed, these best-practices will change to reflect the most current medical information available.
Resources:
http://www.neurology.org/content/early/2017/01/06/WNL.0000000000003587.full.pdf+html
http://www.pbs.org/wgbh/frontline/article/the-autopsy-that-changed-football
https://www.nytimes.com/2016/05/24/sports/football/nfl-tried-to-influence-concussion-research-congressional-study-finds.html
http://www.nascar.com/en_us/news-media/articles/2016/9/2/dale-earnhardt-jr-sit-out-rest-of-2016-injury-concussion.html
https://www.theatlantic.com/health/archive/2016/10/football-kids-heads/504863
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414075
https://www.youtube.com/watch?v=9XB18kxoyi0&t=12s
http://blog.performancehealthacademy.com/2016/10/19/how-to-evaluate-a-concussion
http://www.ncaa.org/sport-science-institute/concussion-diagnosis-and-management-best-practices
http://blog.performancehealthacademy.com/2016/10/27/the-6-elements-of-concussion-management/
http://www.cramersportsmed.com/first-aider/biomarker-in-blood-may-help-predict-recovery-time-for-sports-concussions.html
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