| Each
year more than a million high school athletes are involved in contact sports.
And out of that group, an estimated 63,000 concussions will occur. It's
an area of sports medicine that's been largely ignored, until recently.
Dr. Michael Collins is assistant director of the sports concussion program
at the University of Pittsburgh Medical Center. He's also co-author of a
recently published study in the Journal of Neurosurgery titled: "Recovery
from Mild Concussion in High School Athletes." He discusses the impact
of concussions in kids on "Today." Read some of his thoughts below.
Why Study High School
Athletes And Concussion?
Because it hasn't been done before and they're the athletes at greatest
risk because the largest group of athletes are high school athletes. The
coverage for high school athletes is not as extensive as it is for college
and professional athletes. As a clinician, this is what I do all day every
day is see athletes with concussions, the worst cases I see are in high
school athletes. So, for every Troy Aikman, Steve Young, Merill Hodge
or Eric Lindros there are thousands of high school athletes who have the
same problems with far less fanfare.
One Of The Big Problems
Is That Many Of The Mild Concussions Go Unreported And Undiagnosed. Why
Is That?
In the mild concussion by definition, you're not going to have much of
the loss of conciousness. And often times these symptoms are subtle and
also the athlete needs to report the injury himself. But athletes are
taught to play through injury, so they often go under the radar when something
is wrong. Why? Well, first they want to play. Second, they may not be
aware that these subtle signs may be signs of a head injury. We know that
the brain is vulnerable to second trauma when you're still recovering
from a first concussion. I often see athletes with multiple mild concussions
who do go under the radar, that's when the cumulative effects of injury
become very pronounced.
Symptoms of a concussion:
- headache
- nausea
- balance problems
or dizziness
- double or fuzzy
vision
- sensitivity to light
or noise
- feeling sluggish
- feeling "foggy"
- change in sleep
pattern
- concentration or
memory problems
So What Are The Headlines
From This Study?
The take home point is that every concussion needs to be taken seriously.
The traditional way of dealing with athletes with concussions is that
if they're fine they get put back on the field within minutes following
a mild concussion or a mild injury. We all know the 'how many fingers
am I holding', 'who's the president', etc. and that predicates getting
back into the game. We wanted to test the assumption that a mild concussion
is really mild. So, we looked at 64 high school athletes diagnosed with
'bell-ringers' or mild concussion, meaning there was no loss of consciousness
and their on-field symptoms disappeared within 15 minutes.
Traditional guidelines
and parameters regarding return to play suggest that an athlete can return
to play within 15 minutes if their symptoms disappear within that time.
So, we tested that hypothesis. And we found that these mild concussions
have consequences in terms of brain function that we need to take very
seriously.
Did You Notice Any
Difference In Either Recovery Time Or Symptoms?
Yes. You've just hit on a very important issue. We found that the athletes
reported feeling fine by day four, post injury as a group. Whereas the
deficits on impact lasted until at least day seven. So, if we're relying
on the self report of the athlete, it may be a slippery slope.
Were There Any Differences
Between Female And Male Athletes?
In this study the samples weren't large enough to compare that. We are
studying that issue right now. There are some hypothesis out there about
that.
If The Athlete Is
Placed Back In The Game Before The Brain Has Completely Healed, Specifically
What Kind Of Damage Could We Be Talking About?
There are really several different levels. The very rare event, but
possible, is what we call second impact syndrome. It's very rare but when
it does happen, it's extremely catastrophic. There's been approximately
30-35 high school athletes who have died second to having two concussions
in a short period of time. In each of those cases, the athlete had had
a mild concussion and was still symptomatic from that injury, but whether
they reported it or not, went back to play.
The more likely occurrence
is that they become more vulnerable. Less of a blow is going to cause
them to have a concussion. The brain is not ready to handle a second blow
while it's recovering from the first blow. The symptoms may also be a
lot more severe. Then it's much harder to hit the reset button on those
athletes. They start going down that road of commutative effects to injury
and that's when you can't get them back.
The Reality Is, Most
Of These Kids, Will Not Go On To Professional Athletics. They Will Need
To Be Sharp For Whatever They May Do In Their Lives.
Exactly. High School kids need their brains for far more important
things down the road. They have a lifetime of thinking ahead of them.
Based On This Study,
Should Parents And Students Be Concerned About High School Contact Sports?
Absolutely not. That is not the message here at all. We are pro sport.
We want kids to be competitive and we want them to be itching to get back
on the field. We want kids to be playing sports. But the best prevention
for concussion problems is managing it properly when you have one. If
you allow the brain to recover following a concussion, 99 percent of the
time everything will be fine and there will be full recovery. This is
the message we want to send. Let's just manage this injury sensibly.
What Should Parents
Know?
What a parent needs to be aware of, is we need to take every concussion
seriously. I think a common misconception is that you need to have a loss
of consciousness to have a concussion. That's not true and parents need
to know that. But many other symptoms are also important. Memory loss,
balance issues, personality changes, difficulties in the classroom, continued
headache, not feeling right, feeling foggy, having sleep problems. These
are all signs that the brain has not recovered from injury. An athlete
exhibiting any of those symptoms should not return to play until all of
their symptoms are gone both at rest and exertion. And that's what parents
should know.
The Reality Is As
Long As There Are Contact Sports, There Will Be Concussions, Right?
Force equals mass times acceleration. And athletes are heavier and
faster than they've ever been. This is a problem that's not going away.
A guest on "Today,"
Dr. Michael Collins is assistant director of the sports concussion program
at the University of Pittsburgh Medical
Center. He's also co-author of a recently published study in the Journal
of Neurosurgery titled: "Recovery
from Mild Concussion in High School Athletes."
Related Journal Abstracts
Relationship
between concussion and neuropsychological performance in college football
players.
Cumulative
effects of concussion in high school athletes.
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