A concussion is an injury to the brain resulting in temporary loss of normal brain function. It can be caused by mechanical force or trauma sustained during any sport/athletic activity. Most frequently, but not always, it results from a direct blow to the head. A concussion might also be caused by a blow to the body, as when an athlete makes contact with another, or hits a hard surface, or is hit by a piece of equipment.
A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination, and it can occur without loss of consciousness. In extreme situations, permanent brain damage can occur, or even death. Such situations should always be considered serious – there is no such thing as a “minor concussion.”
It’s key to remember that with concussion, the young athlete need not lose consciousness. In fact, often there are no external signs of head trauma, and currently available diagnostic imaging tests – CT and MRI – will often show no abnormalities. For that reason, the athlete must be examined carefully for these possible indicators of a concussion:
- Memory loss
- Loss of consciousness
- Balance problems or dizziness
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish, foggy or groggy
- Feeling unusually irritable or depressed
- Concentration or memory problems (forgetting game plays, facts, meeting times)
- Slow reaction time
- Nausea (feeling like you might vomit)
Facts & Figures
- Research indicates that more than 300,000 children sustain sports-related concussions in the U.S. each year.
- Concussions make up about 15% of all high school sports injuries
- For any athlete participating in a contact sport, it’s estimated that the risk of concussion might be as high as 19% per season.
Fortunately, the vast majority of head injuries in sports are nothing more than mild injuries, and serious acute injuries are rare.
What to do in the Event of Concussion
It’s important to recognize and properly respond to a concussion immediately to help prevent further injury or, in extreme instances, even death. If any change in behavior is noticed, or there are any other significant signs or symptoms, contact the nearest hospital or emergency medical services. “When in doubt, Get checked out.”
Here are important precautions for the athlete who might have sustained a concussion:
- Rest and avoid strenuous activity: Exercise or activities involving concentration – such as studying, working on the computer or playing video games – might cause concussion symptoms to reappear or get worse.
- Prevent re-injury: Avoid all sports until your doctor has given you clearance. Ask when it it’s safe to drive a car, ride a bike, or work.
- No alcohol or illicit drugs
- Do not take medications to assist with sleep
- Do not drive until medically cleared
- Do not take aspirin or other non-steroidal anti-inflammatory medications
Risks and Dangers
There is no such thing as a minor concussion. The effects can be severe, and individuals who suffer a head injury might suffer effects for weeks or months. This is known as the “post-concussion syndrome.” Much research is still necessary to determine the risk factors, true causality and prevalence of the functional consequences, both acute and long-term.
Much work also remains in order to adequately predict when an individual with a concussion can safely return to play; to determine who is most at risk of suffering a concussion; and to determine whether a history of concussion leads to dementia later in life (referred to as CTE (chronic traumatic encephalopathy).
Enduring a second concussion before recovery from the previous injury is known as second-impact syndrome. Acute, possibly fatal, brain swelling can occur. That second concussion, which need not be severe, can be deadly or permanently disabling. Though rare, second impact syndrome is thought to be more common for younger athletes. The risk is higher in sports such as football, baseball, soccer, basketball and boxing. Research suggests that repeated concussive and sub-concussive head injuries have consequences both acute and long-term (known as chronic neurologic disorders).
According to the Centers for Disease Control, sports concussions lead to an average of 1.5 deaths each year.
Young adolescents and all children sustaining a concussion might be more susceptible than adults to prolonged recovery and poorer acute and long-term outcomes. For this reason, prevention and instruction is especially important.
Of course, prevention is the key to avoiding concussions. Proper equipment should be used, as should proper technique, such as football coaches’ instruction in tackling. This is especially important for the young athlete, who is especially vulnerable.
Because of the seriousness of concussions, a student-athlete showing any signs, symptoms or behaviors consistent with a concussion – both at rest and during exertion – should be removed immediately from practice or competition. They then are not to return to participation until cleared by an appropriate health care professional, and not on that same day.
It is suggested that the affected student-athlete be evaluated within 24 hours by a licensed health care professional familiar with concussion management to prevent or lessen any consequences.
Player Safety – Who’s at Risk?
- Football – Accounts for the majority of team sport-related concussions – about 250,000 each year. Helmet-to-helmet hits, improper tackling and hard contact with the ground are a few ways that players can sustain a concussion while playing football.
- Cheerleading – Risky stunts, like tossing a participant high in the air, have led to an increase in cheerleading concussions.
- Baseball and Softball – Concussions may result when players collide with other players, run into fences and backstops, or are hit by a ball or bat.
- Basketball – Hitting your head on the floor or being hit in the head by an opponent may cause a concussion.
- Soccer – Head injuries may be caused by falls and player-to-player contact. “Heading” the ball is not considered dangerous, but improper technique may lead to injury, particularly in young players.
- Lacrosse – Falling to the ground, getting hit by the ball and collisions with other players may result in head injuries.
- Skiing and Snowboarding – About 20 percent of skiing and snowboarding injuries are head injuries. Hard falls and collisions with trees, signs and other skiers may lead to concussions.
- Wrestling, Boxing and Martial Arts – Blows to the head are central to boxing and some martial arts. Hits to the head are not allowed in wrestling, but takedowns may produce head injuries.
- Ice Hockey – Collisions with other players, a stick to the head, falls to the ice and hard contact with the boards around the rink may cause concussions.
- Bicycling – When a rider traveling at a high speed falls from a bike, serious head injuries can occur.