Expert Care for Concussions
A mountain bike crash, an aggressive soccer “header,” or a simple fall are just some of the many common causes of concussion. Concussions are any amount of injury to the brain caused by a blow or jolt to the head that causes a short-term disturbance in brain function. And even mild concussions can cause chronic problems if not managed appropriately.
Centura Health sports medicine physicians provide comprehensive care for concussions, from diagnosis and treatment to post-concussion testing and education on prevention.
Concussion Risk Factors
An estimated 3.8 million concussions occur in the U.S. during competitive sports and recreational activities each year. Concussions can occur in any sport but have a higher incidence in football, hockey, rugby, soccer, and basketball. And they’re not just for kids. Adults are at risk as well from such activities as mountain biking, skiing and snowboarding, hiking on difficult terrain, and even falls in their homes. In fact, falls account for one-third of all concussions; and more than 60 percent of concussions in seniors. People who have had a previous concussion at any age are at an increased risk of getting another one. And subsequent concussions right after an initial concussion can have serious, even deadly, results.
Concussion Signs and Symptoms
A concussion may or may not be associated with loss of consciousness; most concussions occur without loss of consciousness. But even what seems like a mild bump to the head can be a serious injury. Concussion symptoms fall into two primary categories: those experienced or reported by the injured and the physical signs observed by others.
You may experience:
- Headache or head pressure
- Nausea or vomiting
- Dizziness or imbalance
- Blurred or double vision
- Sensitivity to light or sound
- Feeling slowed down, tired, or foggy
- Difficulty concentrating
- Memory problems
- Mood changes or irritability
- Changes in sleep patterns
Parents, coaches, or others may notice the person:
- Appears dazed or distracted
- Is confused about the game, score, or opponent
- Forgets assignment or instruction
- Asks the same question repeatedly
- Is slow to react or answer questions
- Loses consciousness
- Experiences imbalance or clumsiness
- Experiences mood, behavior, or personality changes
- Forgets events before and/or after the head trauma
Taking Action After a Concussion
Whether you witness an injury on the field or slopes or your elderly parent takes a tumble in their house, if you think someone may have a concussion, take these steps:
Seek medical attention immediately.
If the injury happens during a practice or game, the athlete should cease play immediately.
Continuing to play with a concussion is dangerous. It is important to protect the athlete from additional injury, including a second head injury.
Anyone suspected of a concussion should be evaluated as soon as possible. If you or a loved one experience a fall or hit their head, go to an emergency room or urgent care if severe symptoms occur. For more minor symptoms—and even if you are not experiencing noticeable symptoms—it’s best to see your primary care physician or a sports medicine doctor for an accurate assessment. On the sidelines, a trainer or sports medicine physician can do an on-the-spot assessment and determine how to best treat the athlete.
It is important to allow the brain to rest while recovering from a concussion. Minimize activities that require a lot of concentration and physical exertion. In general, avoid activities that make symptoms worse.
Student athletes recovering from a concussion are required by Colorado state law to sit out of practices and games until cleared by a physician to return to play. Additionally, it may be necessary for teachers to reduce school workload until the student athlete has fully recovered. Primary care sports medicine doctors are specially trained in assessing, managing and clearing patients who have suffered a concussion.
Be alert for worsening symptoms.
Go to the emergency department immediately for any new or worsening symptoms, such as:
- Repeated vomiting
- Inability to be awakened easily from sleep
- Slurred speech
- Loss of balance or coordination
- Unequal pupil sizes
- Weakness or numbness involving any part of the body or face
- Bleeding from the ears, nose, or mouth
- Change in personality
- Fever or stiff neck
Concussions cannot be “seen” and do not show up on a CT scan or an MRI. The Banyan Brain Trauma Indicator could help determine when a CT scan of the head may be likely to show significant findings after head trauma. The test is not meant to detect concussions. However, that test is not yet being widely used. Typically, a concussion is diagnosed according to the symptoms the person experiences or the physical signs noted by a loved one, physician, trainer, or an athlete’s parent or coach. These may be present immediately following the head injury or hours later. It is important to be evaluated by a sports medicine doctor trained in diagnosing and treating concussions.
Concussion treatment should be done under the supervision of a sports medicine physician trained in concussion management. Centura primary care sports medicine doctors evaluate the patient’s symptoms, perform a physical exam, and may administer Immediate Post-Concussion Assessment and Cognitive Testing, also called ImPACT®.
Concussions are managed by allowing the brain to rest. As such, if you’ve been diagnosed with a concussion, avoid activities that require a lot of concentration, such as reading or use of video games, smart phones, tablets, computers, and television. It’s also important to allow the body to rest, as exercise and other forms of physical exertion can put stress on the brain. Don’t participate in any practices, games, or personal exercise until symptoms have resolved and you have been cleared by a physician to return to activity.
Because reaction time, coordination and memory are often impaired from a concussion, it’s important to protect the athlete from repeated head injury or other more serious injuries that may occur during play. Likewise, you should also refrain from driving until you have received clearance by your physician.
ImPACT® is the most widely used computerized neurocognitive test to evaluate and manage concussions. Centura Health sports medicine physicians use it to more accurately assess various components of each a person’s brain function, such as memory, attention span, problem-solving, and reaction time. ImPACT® comes in two forms: a Baseline Test, which is typically administered to athletes prior to the start of their season, and a Post-Injury Test, which is administered when a concussion is suspected. Post-injury test results are compared to baseline scores or normative data scores as part of the physician’s assessment of the injury. Multiple post-injury tests may be throughout the course of rehabilitation. ImPACT® can be helpful for physicians in determining when a patient can safely return to activities.
Just as concussions can happen on or off the playing field, it’s important to consider prevention in various environments. When it comes to sports, coaches, athletic trainers and sports medicine doctors can identify the most effective ways to help prevent concussions in each sport. Overall, here are a few tips athletes can take to protect themselves:
- Follow the rules of your sport and your coach’s rules for safety.
- Practice good sportsmanship and playing technique.
- Use the proper equipment for the specific sport played, such as helmets, padding, mouth guards, and eyewear. Equipment should be fitted properly, worn correctly, and used at all times during play. But keep in mind that, although equipment may help prevent more serious injuries, it has not been shown to prevent concussions.
ff the field, all ages can protect themselves by wearing a properly fitted helmet during activities such as cycling, skiing, and ice skating. You can help prevent concussions caused by falls in the home by doing exercises such as tai chi that improve your balance, and taking these steps:
- Remove loose rugs or use non-slip rugs.
- Make sure walking paths are free of cords and furniture.
- Install grab rails in the bathroom.
- Use nonslip mats in your bathtub or shower.
- Keep pathways clear and well-lit.