Thank you to Kim Myers from the Brain Injury Alliance of New Jersey for her discussion on sports safety, particularly as it relates to concussions. The risk of brain injury from sports for children is always present, especially as kids age and start playing contact sports. In 2019, 15% of all high schoolers sustained at least 1 concussion according to the CDC. For those aged 10-17 who visited a hospital for a traumatic brain injury (TBI), 45% were caused by contact sports. While it is mandated for all coaches in New Jersey to complete trainings dealing with identifying and preventing concussions, many concussions are often misdiagnosed or undiagnosed for a variety of reasons. Let’s take a closer look at concussions and ways that we can increase sports safety.
What is a Concussion?
A concussion is a type of traumatic brain injury that results from a bump, blow, or jolt to the head, face, or neck, causing the brain itself to impact the skull. While this rarely causes any structural damage, it does result in chemical changes that impact the brain’s ability to function properly. As a result, a concussion will not show up on CT scans or MRIs, which can make diagnosing a concussion much more difficult. Once someone sustains a concussion, they are at higher risk of sustaining more concussions and risk the development of other brain complications, including Chronic Traumatic Encephalopathy (CTE) and Second Impact Syndrome, which can cause brain swelling, herniation, permanent changes in behavior and physiology, and even death.
What are the Symptoms?
If someone is suspected of sustaining a concussion, it is important to evaluate the individual immediately. Some immediate signs and symptoms of a concussion include:
- Confusion
- Loss of balance
- Changes in mood or behavior
- Delay in answering questions
- Disorientation
- Loss of consciousness (a rare occurrence)
After the initial examination, it is important to continue monitoring the individual because symptoms may take minutes, hours, or days to appear. Other symptoms to look out for after the initial examination include:
- Headaches
- Nausea
- Blurred or double vision
- Light sensitivity
- Difficulty remembering or thinking clearly
- Irritability or changes in emotions
- Changes in sleep patterns, including increases or decreases in sleep amounts or having trouble getting to or staying asleep
If someone experiences any of the following, seek medical help immediately as these could indicate other, more severe medical conditions:
- One pupil is larger than the other
- Repeated vomiting or nausea
- Convulsions or seizures
- Inability to wake up or extended periods of drowsiness
- Slurred speech, numbness, weakness, or decreased coordination
- Headache that will not go away or gets worse
- Loss of consciousness
- Confusion
Managing a Concussion
There is no set timetable for when one recovers from a concussion; on average, it takes about 4 weeks to recover from a concussion, but that can vary widely depending on the symptoms. Guidelines for recovery have recently changed and it is no longer recommended for individuals to try and “sleep it off”. Instead, there should be moderate rest as symptoms are observed, with a return to light and relaxing activities, such as walking and reading. Once able to complete these activities without any issues, then one can resume normal activities that do not include participation in sports, especially contact sports.
When trying to return to sports activities, there are a set of steps known as Return to Play that are widely accepted and used to help introduce individuals who have suffered a concussion back into their sport:
- Daily activities that do not worsen symptoms
- Light aerobic activities that slowly move to moderate ones
- Individual sport specific exercises
- Non-contact training drills
- Full contact practice
- Return to sport – normal gameplay
It is critically important to follow these steps in a safe manner to help prevent further injuries to the brain, including post concussion syndrome and Second Impact Syndrome.
Preventing Concussions
Unfortunately, there is no way to prevent a concussion. While helmet technology has gotten better, they are primarily designed to prevent skull fractures, not concussions. However, there are some things we can do to try and limit the exposure risk of concussions to those participating in sports. First, make sure all of the equipment is in good working order, conforms with standards and codes associated with the sport, and that all staff and players utilize the equipment in an appropriate manner. Second, all applicable rules of the sport should be followed and proper techniques should be taught and used in gameplay to reduce risk of injury. Third, follow the Return to Play protocol for any individual who has suffered a concussion. Lastly, be proactive; ensure that all team staff and parents are familiar with rules and regulations, as well as how to spot a potential traumatic brain injury.
More Information
If you would like more information about sports safety, particularly concussions, please visit the Brain Injury Alliance of New Jersey at https://www.bianj.org/sports-concussion/. You can also view a recording of the program on our YouTube channel at https://youtu.be/lmrnl35MPlk. If you have any questions, please contact Kim Myers at kmyers@bianj.org. You can download copies of the handouts below:
