Concussions & Athletes

From the desk of Nurse Practitioner Jessica Pech:

Nearly 60% of high school students in the United States participate in organized sports, with numbers growing annually and many more involved in the younger years. As the number of high school athletes increase so does the risk for head trauma and other related injuries such as concussions. Nearly all sports pose some risk of concussive injury. Among the more commonly played high school sports, football and ice hockey have the highest incidence of concussion, followed by soccer, wrestling, basketball, field hockey, baseball, softball, and volleyball.1,2

A concussion is an injury to the brain that is caused by a blow or impact to the head. A concussion can have effects on an athlete's physical, cognitive and emotional functioning.

The most common symptoms include headache, dizziness, blurred vision, fatigue, nausea, vomiting, difficulty concentrating, memory deficits, sleep disturbance, confusion and mood changes. Seizures may result in about 5% of more severe cases.

While some children lose consciousness briefly at the time of injury, it is important to know that the majority of concussions do not involve any loss of consciousness.

Recovery from a concussion takes time. Symptoms may persist for a few days, weeks or even months after an injury3.

The bottom line is�.You should always seek immediate medical attention with any injury or blow to the head!

When is it safe to return to playing sports?
The timeline on the �return to the team� is dependent upon clearance from your physician. Your physician will base the decision on the severity of symptoms experienced in addition to the complete resolution of symptoms. This is usually done in a gradual stepwise approach, rather than an abrupt change because of possible symptom aggravation with increased levels of exertion4.

Prevention
Education regarding the prevention of head injuries is essential, including the use of appropriate protective equipment while participating in sports (ex: football helmet). In addition all athletes should adhere to the following:
-Appropriate supervision of athletes by coaches and parents
-Avoidance of high-risk activities
-Bicycle helmets for older children

For more information, please visit the following websites:
http://www.aap.org/sections/sportsmedicine/RelatedLinks.cfm
http://www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm

References
1. Koh JO, Cassidy JD, Watkinson EJ. Incidence of concussion in contact sports: a systematic review of the evidence. Brain Inj. 2003;17 :901 �917[CrossRef][Web of Science][Medline]

2. Powell JW, Barber-Foss KD. Traumatic brain injury in high school athletes. JAMA. 1999;282 :958 �963[Abstract/Free Full Text]

3. Centers for Disease Control and Prevention. Physical activity levels among children aged 9�13 years: United States, 2002. MMWR Morb Mortal Wkly Rep. 2003;52 :785 �788.

4. Michael W. Kirkwood, PhDa,b, Keith Owen Yeates, PhDc,d and Pamela E. Wilson, MDa,b PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1359-1371 (doi:10.1542/peds.2004. Pediatric Sport-Related Concussion: A Review of the Clinical Management of an Oft-Neglected Population