12/02/2003 - Approximately ten percent of all athletes involved in contact sports, such as football, hockey and soccer suffer a concussion each season (some estimates are as high as 19 percent). Because many mild concussions go undiagnosed and unreported, it is difficult to estimate precisely the rate of concussion in any sport.
Approximately ten percent of all athletes involved in contact sports, such as football, hockey, and soccer suffer a concussion each season (some estimates are as high as 19 percent). Because many mild concussions go undiagnosed and unreported, it is difficult to estimate precisely the rate of concussion in any sport. Symptoms are not always definite and knowing when it is safe for an athlete to return to play is not always clear.
The recognition and management of concussion in athletes can be difficult for a number of reasons:
Athletes who have experienced a concussion can display a wide variety of symptoms.
Post-concussion symptoms can be subtle and may go unnoticed by the athlete, team medical staff or coaches.
Methods and tools used to detect concussion and help make accurate return-to-play decisions are inadequate.
Traditional neurological and radiological procedures, such as CT, MRI and BEG, although invaluable in discerning more serious head injuries, are not consistently useful in evaluating the effects of mild head injuries.
Recovery And Safe Return-To-Play
Allowing enough healing and recovery time following a concussion is crucial in preventing further damage. Research suggests that the effects of repeated concussion are cumulative. Most athletes who experience an initial concussion can recover completely as long as they are not returned to contact sports too soon. Following a concussion, there is a period of change in brain function that may last anywhere from 24 hours to 10 days.
During this time, the brain may be vulnerable to more severe or permanent injury. If the athlete sustains a second concussion during this time period, the risk of permanent brain injury increases. Thus, the rule in athlete's recuperation is they stay on the sideline for a week. Two recent studies bear this out. Published in the The Journal of the American Medical Association.
Both studies drew on data collected on more than 1,500 football players at 15 colleges over three seasons. The athletes were given tests of their mental abilities before the season and were tested after a concussion.
One study found that problems with various mental abilities took an average of five to seven days to resolve, but that 9 percent of the injured players had not returned to their normal functioning levels after a week.
The other study looked at the cumulative effects of concussions. Players who had suffered three or more concussions were three times as likely as those who had not been injured to suffer another concussion, and players who had been hurt before took longer to recover.
The study also found that athletes who returned to the game after a concussion were more likely to report new symptoms later. But the study's most alarming finding was that in 11 of the 12 cases involving players who suffered two concussions in one season, the second injury took place within 10 days of the first.
Based on these studies, Dr. Kevin M. Guskiewicz of the University of North Carolina, who was involved in both, said that trainers and team doctors should rely on objective tests of ability in deciding whether to clear an athlete to return to play, not on what the player says. A simple alternative, he said, is to bar all play until a week from the time all symptoms disappear.
New York Times: http://www.nytimes.com/2003/11/25/health/25SPOR.html
University of Pittsburgh Medical Center Sports Medicine: http://sportsmedicine.upmc.com/InjuriesConcussionSports.htm#Recovery
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