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When In Doubt, Sit Them Out: Concussions In Young Athletes

July 4, 2014

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A concussion is a type of brain injury that can have a serious effect on a young, developing brain. According to the CDC website, each year, the U.S. emergency departments treat an estimated 173,285 sports- and recreation-related traumatic brain injuries (TBIs), including concussions, among children and adolescents. The majority of those with a sport-related concussion recover within a 7-10 day period, but children and adolescents require more time for the brain to heal.

Nearly a third of athletes have sustained blows to the head resulting in concussion-like symptoms, yet were never diagnosed or evaluated by a professional. Any athlete suspected of incurring a concussion should immediately stop playing and seek assessment by a healthcare provider trained in the evaluation and management of concussions. There are many tools and evaluations available for identifying injury, but vigilant monitoring after the injury is essential. Critical symptoms of concussion include behavior changes, balance difficulties, and cognitive changes. Over the course of the first 24 hours, the most common symptoms include headache, nausea, dizziness, blurred vision, confusion, memory loss, and fatigue. Concussions can further be classified as simple or complex, which may help determine their duration of recovery before returning to their sport.

It is vitally important for parents and coaches to recognize when return to play is inappropriate. Current policies in place in a majority of states dictate preventative measures to protect athletes from receiving multiple concussions and permanent damage. The following three “action steps” are included in the majority of policies to prevent concussions:

Minimal Running Shoes:

  • Education of coaches, parents, and athletes is a critical component of ensuring athlete safety
  • If an athlete is believed to have a concussion, he or she should be removed from play immediately
  • Once diagnosed, the athlete should only return to play once cleared by a health care professional trained in concussion management

Heads Up!

The CDC and it’s “Heads Up” program provides an excellent resource for all youth and high school athletes, coaches, and parents. Through the CDC’s website there are available links for extensive educational materials on sport-related concussions.

References:

“Heads Up Concussion Program” Centers for Disease Control and Prevention
http://www.cdc.gov/concussion/headsup/index.html

“Get a Heads up on Concussion in Sports Policies: Information for Parents, Coaches, and School & Sports Professionals ” Centers for Disease Control and Prevention
http://www.cdc.gov/concussion/pdf/HeadsUpOnConcussionInSportsPolicies-a.pdf

Hammeke TA, McCrea M, Coats SM, et al.“Acute and subacute changes in neural activation during the recovery from sport-related concussion.” J Int Neuropsychol Soc., 2013; 8:1-10.

Harmon KG, Drezner J, Gammons M, Guskiewicz KM, et al. “American Medical Society for Sports Medicine position statement: concussion in sport. ” Clin J Sport Med, 2013; 23(1):1-18.

Iverson G. “Predicting slow recovery from sport-related concussion: the new simple complex distinction.” Clin J Sport Med , 2007; 17:31-7.

Leddy JJ, Sandhu H, Sodhi V, Baker JG, Willer B. “Rehabilitation of concussion and post-concussion syndrome.” Sports Health, 2012; 4(2):147-54.

Ma R, Miller CD, Hogan MV, Diduch BK, Carson EW, Miller MD.“ Sports-related concussion: assessment and management. ” J Bone Joint Surg Am, 2012; 94(17):1618-27.

McCroy P, Meeuwisse WH, Echemendia RJ, Iverson GL, Dvorák J, Kutcher JS. “ What is the lowest threshold to make a diagnosis of concussion? ” Br J Sports Med, 2013; 47(5):268-71.

Meehan WP 3rd, Mannix RC, O’brien MJ, Collins MW. “ The prevalence of undiagnosed concussions in athletes.” Clin J Sport Med, 2013; [Epub ahead of print]

Video: Keeping Quiet Can Keep You Out of the Game…a Mother’s Story

Student Program

One of the hit movies of 2000 was titled “Pay it Forward”, and starred Kevin Spacey and Haley Joel Osment. The theme centered on a teacher and young boy who turned adults onto doing three good deeds for others without the expectation of a reward or pay back. Often in Medicine, professionals are asked to do the same by mentoring students and encouraging them to mentor others. The staff at BIMPT “Pay it Forward”, and have done so often since the practice was founded in 2002. We routinely mentor PT students from the following Universities:

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smithp.141300Our most recent student, Patrick Smith, came to us from Mary Mount University. Patrick exemplified the PT of the future with a strong background in the basic sciences and current treatment techniques. Aside from his classroom training, Patrick came with the qualities that the BIMPT staff brings to the office each and every day. No matter where you go for treatment, all Physical Therapists are grounded in traditional techniques. However, at BIMPT we pride ourselves on putting the best interests of the patient first. Not by just applying a technique, but by constantly exploring and questioning the interaction between the treatment, provider, participant, and the environment we work in. Patrick went beyond the usual treatment techniques. He questioned every move we made and along with his strong work ethic contributed to a positive outcome for our patients.

We encourage students to follow our mentor approach in a therapeutic environment that contributes to their training while optimizing patient recovery. When patients respond to treatment, we ask they tell others about the care they received. In a sense Patrick, the BIMPT staff, and you our patients follow the “Pay it Forward” philosophy!