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Keep concussion awareness on your health radar

Tue., Aug. 27, 2013

A new school year means renewed sports seasons for you and your kids. Contact sports like football, soccer, basketball and hockey mean more opportunities for concussions at practice and during a game.

Understanding of the possible long-term effects of concussion and cumulative effects of multiple concussions is leading to changes in sports. Improperly treated concussions or the cumulative damage from multiple concussions can lead to depression and permanent disability. The National Hockey League requires players who receive a significant hit to the head be evaluated for concussion by a physician in a quiet area before a return to play.

Full-contact football practices in Ivy League colleges have been reduced and body and stick checking in lacrosse is limited. Younger soccer players are not allowed to head the ball. The NCAA and the Centers for Disease Control and Prevention have created educational resources for coaches, student-athletes and team medical staff to increase awareness of concussion signs and symptoms, educate on handling of concussions and improve evaluation of when athletes can safely return to full participation in games.

A concussion occurs when the head, with or without a helmet, is hit and the brain is injured. Concussion injuries may not be visible on any scan or test. Symptoms may include amnesia, confusion, headache, loss of consciousness, balance problems, double or fuzzy vision, sensitivity to light or sound, nausea, lethargy, irritability, memory problems, difficulty concentrating and slowed reaction time. Symptoms may be noticeable immediately or not for hours or even days after the injury.

Athletes’ reaction times can be measured with a long wooden stick with a hockey puck attached to the end. A concussed athlete has a slower reaction time when catching the dropped device, and catches the dowel farther down than when not concussed. It would be simple to use this quick test at the beginning of each sports season to establish baseline reaction times and have the device on hand at practice and at games to help determine if a player has been concussed.

Playing through the symptoms makes the problem worse. All athletes – or anyone who has experienced a hit to the head – should report symptoms and be checked by a team physician, athletic trainer or health care professional. It is crucial to follow instructions for recovery, which can mean restricted activity for days or weeks as the brain heals.

Exercise and activities that require concentration can cause symptoms to recur or get worse. Even watching television or listening to music takes some concentration and may be difficult after a concussion. Take it seriously when you are told to rest.

After you are cleared by your health care provider or certified athletic trainer, return gradually to training and play in the following order:

• Light, low-impact aerobic activity such as walking or swimming;

• Some sport-specific exercise that does not include head impact;

• Non-contact training drills and light resistance training;

• Full-contact practice and play (neither should be resumed until a medical professional deems it safe).

If you have no concussion symptoms for 24 hours after participating in each level of activity, move on to the next level. If any symptoms return, go back to the previous level of activity until you have no symptoms for at least 24 hours before attempting the increased level again. After more than one concussion, you may need longer recovery times.

Be aware of the symptoms of concussion and seek help if they occur. Other more serious head injuries can also cause some of these problems, so have a medical evaluation if you suspect a problem.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears the first and third Tuesday of the month in the Today section.


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