Concussions have been in the news recently, because of several high-profile lawsuits brought against the NFL by current and former players, who are suing the organization for damages resulting from concussions suffered while on the field. There are currently more than 2700 players involved in such lawsuits, who say they have been the victims of untreated concussions.
Concussion is an injury to the brain, through impact on the skull after a bump or sudden jolt to the head. The brain itself has the consistency of rather thick gelatin, which is cushioned against everyday bumps and shocks by surrounding cerebrospinal fluid. Sudden acceleration or deceleration of the head, neck and upper torso can cause the brain to bump against the skull, causing concussion. Such injuries are often the result of car crashes and what is known as “shaken baby syndrome.” It is also one of the risks associated with contact sports such as football.
According to staff at the Mayo Clinic, this type of traumatic brain injury can alter how the brain functions. A blow to the head can also cause bleeding in or around the brain, which can be very serious. Anyone who suffers from this type of accidental injury should be monitored for several hours to determine if the effects will be mild and disappear quickly, as is usually the case, or be more severe and require emergency medical care.
Signs and symptoms of concussion may include any of a long list:
- Headaches or “pressure” in the head
- Any loss of consciousness or confusion
- Amnesia, especially surrounding the event itself
- Dizziness or ringing ears
- Slurred speech
- Vision blurriness or other disturbance
- Dilated pupils or unequal pupil size
In April, 2010, the National Collegiate Athletic Association put in place new guidelines that require each school to have a concussion management plan, to include this four-step approach:
- Athletes are informed of concussion symptoms at the start of the new season.
- Athletes sign a statement that they will report concussion-related symptoms to the team’s medical staff.
- Athletes with concussion symptoms must be removed from the sport for at least one day.
- Athletes may not return to play until the team doctor clears them and all signs and symptoms of concussion are resolved.
In Portland, the Oregon State Activities Association, along with the National Federation of High Schools, has for the last few years required all coaches, whether volunteer or paid, to take an online training course in concussion yearly. The Portland Interscholastic League (PIL) tracks all coaches in Portland Public Schools (PPS) to confirm that each coach has taken the course.
In addition, at preseason meetings, Dr. Jim Chesnutt, a sports medicine specialist at Oregon Health Sciences University, is present to answer questions and to make sure that coaches understand what to do, or not do, in case of head injury. Also, PPS is implementing a new process to update students’ parental contact information on a monthly basis, to be sure that in case of any injury or other problem, parents can be contacted right away.
However, these procedures do not apply to younger children, because elementary and middle school sports are conductd either through private clubs or the Portland Public Parks Bureau. Parents whose children participate in sports, whatever the organization, need to understand the risks and take the necessary steps to assure their children are safe.
Other factors which may influence the severity of head injury are the conditions of play, such as the size of opponents (for example, adults playing against children) and the playing surface (such as a grassy field versus concrete or asphalt). The speed and momentum during such accidents will also affect the severity of an injury. Proper safety gear such as helmets, mouth guards, eye protection and padding should always be used, and must be the correct size, adjusted properly to the individual player.
One thing on which all the experts agree is that after any head injury, the patient should not return to any vigorous activity right away. It is important that if a concussion is present, the brain be given time to heal itself without further injury, because this can greatly increase the severity of any damage already there. For that reason, athletes of any age should never return to play while signs and symptoms of concussion are present. Children and adolescents should not return to play the same day, or without being evaluated and cleared from a medical standpoint.