Debbie Bracewell provides a summary from the recent 2011 ERG Youth Concussion Forum. The 4-part live webcast series featured expert faculty comprised of pediatric physicians, neurologists, and psychologists. Topics included the latest developments in concussion research, legislation, diagnosis and treatment.
Throughout this webcast series, several experts presented information vital to coaches of all sports and athletic activities. The focus was on concussions in youth athletes—recognition, treatment, prevention and general information about concussions. Several common themes ran through all the presentations: education, teamwork, social effects of concussions and prevention.
All presenters described a concussion as a traumatic brain injury that has a large variety of symptoms.
The injured does not have to be unconscious to suffer a concussion or experience a hit to the head. Symptoms vary and are individualized due to the severity of the impact.
The outcome of a concussion cannot be predicted.
Healing can take place in one to three weeks, but the healing process could also require months or years.
Concussions are invisible injuries, the injured athlete does not have stitches, use crutches or wear a brace.
Diagnosis and treatment should be handled by a physician who specializes in these types of injuries.
Beginning with Kyle Turley, a former NFL offensive lineman, and reiterated by the other presenters, the theme of education was prominent. Coaches should have training to help them recognize the signs of a concussion and help them prevent concussions. Coaches should know their athletes so well they can look at a child and know something is not “right.”
Basic training on concussions should be made available to coaches, parents, and athletes. Due to pressure from parents, peers, and the athlete himself to continue playing/participating, the athlete may not report the symptoms of a concussion. Many authorities agree that anyone—friend, parent, coach—should be able to tell those in charge of the athlete that the athlete has suffered what appears to be a concussion and should be removed from play to be evaluated. Prompt attention to the injury is needed so that further injury does not occur. The CDCs website, Heads Up: Concussion in Youth Sports (http://www.cdc.gov/concussion/HeadsUp/youth.html), has free materials for coaches, parents, and athletes, and even has a free training video.
Teamwork was emphasized by all presenters. Teamwork begins with the educational process as mentioned above. Teamwork should continue through the treatment and recovery process. Coaches, parents, athletes, teachers and the medical professionals all contribute to the healing process. Coaches should be knowledgeable about return to play procedures, a five step process that is dependent upon the athlete being asymptomatic as they progress from one step to the next. Classroom teachers should be aware that brain rest is necessary for the healing process of a concussion. This may mean a reduced school day, reduced school load, untimed tests, tutoring, etc. Parents must monitor the athlete’s activities and restrict computer use, television viewing, texting, video gaming, etc. Friends and siblings are also part of the team as they support the athlete’s efforts to heal.
The most eye-opening presentation for me as a coach dealt with the psychology of athletic injuries. As already mentioned, a concussion is an invisible injury. While a broken leg has a defined recovery process, concussion recovery may be phrased in terms of “if” and “when” recovery may take place.
The emotional response to a concussion can be similar to the grieving process. The athlete may experience denial, anger, depression, confusion, guilt about letting down the team, and disbelief that recovery will occur. The athlete needs a supportive environment to speed recovery; this means positive and regular contact with teammates, coaches, and friends. Again, the importance of education and teamwork is necessary. Having a great support system will aid the athlete’s feelings of self-worth; lack of social support will add to the anxiety the athlete experiences.
It is very unlikely we will never be able to prevent all concussions. New technology in mouth guards and helmets has not yet been proven to reduce the incidences of concussion. Athletes that use helmets should make sure the helmet has been properly reconditioned and fits properly. One expert said that helmets can give a false sense of security—they should be used, but they are not a sure way to prevent concussions. We need a way to stop the brain from moving within the skull—not something that is yet possible.
Dr. Mark Halstead, assistant professor of Nonsurgical Sports Medicine in the Departments of Orthopedic Surgery and Pediatrics, reported that in November of 2009 two former super bowl quarterbacks reported that they could not play in upcoming games due to persistent headaches and/or not feeling that they had recovered from their most recent concussion. They were vilified in the media and became the butt of jokes. Where are our priorities? How important is that upcoming high school game? It’s time we put our health and sports participation in the proper perspective.