With school starting back up, sports are in full swing again for the returning students. Two sports in particular, football and soccer will see an occurrence of concussions. It is important for us to know the basics about concussions, so that we may recognize when there may be one present and what can be done to manage it safely.
A concussion can be thought of quite simply as a contusion or bruising to the brain. This most commonly occurs from a direct blow, such as two players colliding heads, a player’s head hitting the ground or a player’s head being hit by a ball. Some concussions can be caused from an indirect blow, such as forces transmitted through a blow to the jaw or spine, or a hit to the thorax that creates a whiplash-type force to the head and neck region. Sometimes the cause will be obvious, sometimes not.
The symptoms of a concussion will vary, but here are some of the most common. The athlete will usually complain of some sort of headache or neck pain. If you are familiar with the athlete’s personality, you may notice that they are not acting like “themselves”, or “out of sorts.”
Recently, in regards to concussions there has been some dispute about the grading of severity of the concussion. Saying one concussion is mild and another is severe is starting to lose influence. More often, experts in neuroscience are saying that the terms “simple” and “complex” concussions should be abandoned, saying that the majority (80-90%) resolve in a 7-10 day period. What is more important than trying to decide whether or not a concussion was minor or severe, is the number and history of previous concussions suffered by any particular individual. This should be a huge factor in the return to play decision making for the athlete. Multiple concussions can cause irreversible damage that last a lifetime.
When trying to decide about the safety of returning to play for someone that has had a concussion, there are some serious things to consider in making this decision and it is important to educate yourself on the process. Any concussion is going to take about 7-10 days to heal. They will need much rest, both physically and mentally until their symptoms resolve.
One of the most serious concussive injuries that can occur and ultimately lead to death is known as “second impact” syndrome, occurring when a previously concussed brain is not given adequate time to recover and a second blow to the head is received. In this scenario, a healing brain is going through a chemical process to recover and has a reversal of this process, causing extremely sudden and large amounts of swelling to occur in the brain, resulting in possible shut down of respiratory centers and ultimately brain death. There are well-documented cases of eager coaches, parents and kids allowing concussed athletes to play before they are ready, and these individuals unfortunately end up paying the ultimate price- their life. A simple rule to follow in regards to concussions and return to play is “when in doubt, sit ‘em out”.
Prevention is achieved through education—proper technique in hitting is key. No equipment can eliminate a concussion from occurring, but if properly fitted it can reduce exposure. If concussion is suspected, seek medical care.
Stephen Domzalski, MPT, ATC, CSCS is an Assistant Athletic Trainer with Wayne State University in Detroit, MI




