by Jim Chesnutt, M.D., Sports Medicine, Medical Director,
OHSU Orthopaedics and Rehabilitation
Head injuries in sports are more common than many people think. It is no surprise that the sports with the highest incidence of concussion include football, soccer, hockey and lacrosse, but concussion can occur in any activity if the head is hit with the right amount of force. Most people think that a concussion only occurs if some one gets knocked out, but concussion occurs when there is any alteration in brain function. Common concussion symptoms include dizziness, blurred vision, headache and poor concentration and memory. Studies have shown that it takes about one week for our brain to recover from a concussion and recommend that the athlete should avoid head trauma during that time. Previous recommendations allowed an athlete with a mild concussion to return to the game if symptoms resolved in less than 15 minutes. Given our new scientific evidence of delayed brain recovery after concussion, the recommendations have recently been changed to limit return to the same game. The current recommendation is to limit contact sport for approximately one week. These guidelines are outlined in the Sports Concussion Assessment Tool (SCAT) on the American Medical Society of Sports Medicine web site at http://www.newamssm.org/Public.html.
Most athletes will recover very quickly within minutes from a concussion without any problems. Some athletes will have prolonged symptoms, which might include headache and some other neurologic or cognitive symptoms. If these symptoms are severe or persistent, then medical evaluation is needed on an ongoing basis. Additionally, if loss of consciousness occurs with the initial injury, 911 should be called and the athlete should be sent to the Emergency Department for medical evaluation. Returning to contact sports too early can be associated with higher recurrence and more severe symptoms including death.
Education about concussion prevention and treatment is important for coaches and athletes and their families. Proper helmet fitting and inflation as well as newer helmet technology have shown to decrease concussion rates. Heading the ball in soccer is not as likely to cause concussion as hitting the ground or colliding with another player. We all need to help identify concussion symptoms early and limit play until symptoms are gone and the athlete can transition back into their sport without problems. Computer -based cognitive testing can be helpful to assess athletes at baseline and after concussion to help make decisions about return to play. If you have more questions about concussion symptoms or management or about computer-based cognitive testing for concussions, please call OHSU Sports Medicine at 503-494-6400.