Concussions...how bad are they really?

Concussions are a lot more serious than you may think. They have been referred to in the past as a "ding" or "getting your bell rung" but these injuries are serious and even life threatening.

Definition
A concussion can result from either a direct hit or an action that causes violent shaking of the head. Either of these actions then cause an alteration or disturbance in the brain's functioning thus resulting in a concussion.

Signs and Symptoms
A common misconception when identifying concussions is that in order to actually have a concussion the individual must have sustained Loss of Consciousness (LOC). This is not true! An individual may still have a concussion without LOC and display signs and symptoms of another sort (see list below).

Each individual will display different signs and symptoms when they have a concussion. Symptoms may show up immediately or they may be delayed and show up 1-2 days after the incident. Some common signs and symptoms of concussions are listed below. Keep in mind that this is not a complete list and symptoms may vary.

Signs and Symptoms YOU may observe:

The individual appears dazed, confused, stunned, or in shock
The individual is unable to tell their location, the sport they are playing, the opponent, or the score of the competition
When asked questions the individual responds slowly or hesitantly
They have LOC even if temporarily
The individual's demeanor or personality changes; they move clumsily
The individual does not remember events leading up to the incident (retrograde amnesia) or events that happen immediately after the incident (anterograde amnesia)

Signs and Symptoms reported by the ATHLETE:

Headache
Ringing in the ears
Nausea
Balance problems
Numbness or tingling in any part of their body (send to ER)
Double vision
Blurred vision
Sensitivity to light or sound
Unable to sleep or sleeps more than usual
Feels "foggy"
Unable to concentrate on homework, meetings, reading, school, etc.

Resource: ImPACT Test

Treatment
The first and best thing to do when someone sustains a concussion is to remove them from the setting, game, or practice in which they were injured. The next immediate action to take is have them properly evaluated by a Certified Athletic Trainer or a Medical Doctor who is up to date on concussion evaluations. Certified Athletic Trainers go through extensive training when it comes to concussion evaluations and are aware of current concussion guidelines. This is one of the many reasons why it is valuable to have a Certified Athletic Trainer on staff (read some of the testimonials at the bottom of the page).

When an individual sustains a concussion, especially if they are an athlete, there are several steps to take before they can return to play, in addition to the two primary steps listed in the previous paragraph. If signs and symptoms are severe enough or life threatening, this will be determined by the Certified Athletic Trainer (ATC) of Medical Doctor (MD), advanced medical procedures need to be done to rule out any intracranial pathologies. MRI's or CT Scans are often common tools to determine such immediate and STRUCTURAL intracranial pathologies such as subdural hematomas or skull fractures, but these imaging tools only HELP assess concussions. An MRI or CT Scan is not reactive to metabolic injury and thus is not a definitive diagnosis of a concussion.

Resource: ImPACT Test

Once any intracranial pathologies are ruled out the next step is to wait. Yeah it's a hard thing to do in society, but it is absolutely necessary for our bodies to heal from injury. The amount of time that it takes individual 1 to recover from a concussion may be weeks earlier than individual 2...there cannot be a definitive timeline that covers everyone, that's just the way our bodies work. In any case, the concussed individual must be completely assymptomatic before attempting any activity and progressing on must be cleared through and supervised by the ATC or MD. The ATC or MD may take the individual through a progression of light aerobic exercises then to sport specific drills (i.e. ladder drills). The progression may continue as long as the individual is not experiencing any symptoms. Before complete return to play or activity the ATC or MD may limit contact in practice to ensure an increase in activity does not recreate symptoms. Pending clearance of this the ATC or MD may fully clear the individual to return to participation.

Again, all of this is to be taken on a case by case basis and may not pertain to every individual. The biggest point is to make sure the individual is examined by an ATC or MD and that that professional follows them through and clears them for full participation.

Do not ever return an individual to activity if they still have symptoms and their brain is not healed, this could lead to FATALITY!

TESTIMONIALS

As a state legislator concerned with health policy, affordable and accessible health care for all people is my primary concern. We must look for innovative solutions to providing health care because of the increasing shortages of nurses and other health care workers. One of the best ways to deliver health care services in the community is to better utilize certified athletic trainers. Athletic trainers are multi-skilled allied health care professionals who provide a unique combination of injury and illness treatment and rehabilitation with a substantial dose of injury prevention and general wellness.

- Representative Jerry Krummel Oregon House of Representatives, District 26

"I am a primary care sports medicine specialist and I work in the high school, college and clinic settings in sports medicine. I have worked closely with athletic trainers for 18 years. Athletic trainers play an indispensable role in the care of athletes in all of those settings. In the high school setting, the athletic trainers are frequently the main point person in initially evaluating and treating sports injuries. Athletic trainers have to be well-versed in treating problems from blisters to life-threatening problems such as heat illness and cardiac arrest. The key component is preparation for the worst problems that can occur."

"Athletic trainers need to disseminate information in an understandable way for parents, athletes and coaches. They play an essential role in patient information in the world of sports medicine. They also oversee rehabilitation, appropriate strength conditioning and nutritional programs."

"In summary, athletic trainers are an essential part of the health care team in sports medicine. They play a central role both by their actions and their preparation."

-- Joe Congeni, M.D. Medical Director of Sports Medicine, Akron Children's Hospital, Akron, OH

(Resource: NATA)

WHAT ARE ATHLETIC TRAINERS?

Athletic Trainers not "Trainers"

Check out this link above!!

Who Are Certified Athletic Trainers?

Certified Athletic Trainers (ATC's) are health care professionals who work under the supervision of physicians to provide athletes and athletic individuals with the best care in order to optimize their activity and participation in sports as well as life. This care is provided through education, prevention, first aid and emergency intervention, and assessment and diagnosis of acute and chronic injuries.

Certified Athletic Trainers go through extensive schooling, graduating from accredited programs and most often continuing through graduate and professional schooling.

Where do ATC's work?

ATC's can work in several different settings including: