Concussions and Sports

Probably the hottest topic in sports medicine today is concussions.   It's been featured on television shows from 60 Minutes to NFL Today.  I've half expected to hear about a feature on Ellen and The View (or maybe it has already--I would never know either way).

It's partly because of several high profile cases, mostly retired NFL players.   Junior Seau's suicide was widely attributed to concussions he suffered while playing football.  Jim McMahon, who led the Chicago Bears to the Super Bowl, is a sad sight, suffering from early-onset dementia that he blames on multiple concussions.

He and others are suing the NFL for what they claim was negligence by ignoring evidence of the long term effects.  But it wasn't until research performed at Boston University demonstrated that even minor blows to the head could produce symptoms of concussion that we began to understand the seriousness of those injuries.

Football seems to be the focus but no sport is immune from concussions.   Hockey is notorious for producing concussions.  Heading the soccer ball can produce concussion-like symptoms.  Any sport where there is a chance for a collision or a chance for a fall (which is just about everything), can produce a concussion.

What we didn't know even 10 years ago is that we should never take these injuries lightly.  And we don't.

High school athletes and those from Maryville College are monitored closely by athletic trainers and attended by team physicians. We are ever diligent in making sure that every one of those athletes is protected.

For example, during a football game, we will watch for collisions that might produce a concussion.   Instead of waiting for that player to come to us and complain of a headache or dizziness or other symptoms, we will seek them out to make sure they are OK.  Goodness knows we can't wait on them to come to us.  Some will.  Most won't. 

I find myself telling athletes all the time that they simply must be honest with me, that this is not something to ignore.

With little variation, when an athlete has a blow to the head, regardless of the origin, we consider it a concussion until proven differently.   If they have any symptoms at all (symptoms can include headache, dizziness, blurred vision, memory loss, and disorientation), then they are pulled from competition and evaluated more thoroughly.

If they lose consciousness, the game is over and they are getting an ambulance ride.

Once a diagnosis of concussion is established, they must have a medical evaluation before they can return to their sport.  That's not just good medical care, since earlier this year, it's state law.

Here in Blount County, we go several steps further.  After they have been given medical clearance, they must take and pass a test called an ImPACT Study.  The ImPACT Study evaluates their cognitive function, looking at variety of things like short term memory and the ability to process mental tasks.  For most of our athletes, they have taken the same test well before the season started so that we have a baseline of information to compare their performance to.

Then they are screened for things like balance and response to activity.   Then and only then are they considered for return to their sport.