Concussions in high school sports

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A traumatic brain injury (TBI) is a blow, jolt or penetration to the head that disrupts the function of the brain. Most TBIs are caused by falls, jumps, motor vehicle traffic crashes, being struck by a person or a blunt object, and assault. Student-athletes may be put at risk in school sports, creating concern about concussions and brain injury. [1] A concussion [2] can be caused by a direct blow to the head, or an indirect blow to the body that causes reactions in the brain. The result of a concussion is neurological impairment that may resolve spontaneously but may also have long-term consequences.

Contents

Background

Many teens engage in extracurricular activities including sports that can pose risk of injury. Some sports that create a more significant risk of a head injury or concussion include basketball, cheerleading, soccer, and football. [3] [4]

High school football accounts for a significant percentage of head injuries that result from high school sports. [1] While performing intense physical activity the brains' structure and functionality can be changed. This alteration in the brain may be a reason athletes in contact sports have concussions at higher. In combination with the contact and altered brain structure this can potentially lead to more severe concussions. [5]

Effects

The symptoms of concussion may be physical, cognitive and emotional in nature. Symptoms vary between affected individuals, and symptoms immediately or be delayed. [6]

Short-term

Possible signs of concussion that may appear in a student-athlete after a jolt to the head or body include: [7] [2]

An injured student may report any of these signs as well as sensitivity to light or sound, double vision, a headache, or other abnormal feelings. A student who has been diagnosed with a concussion may become frustrated, impatient, and angry about the situation. [8]

Long-term

Concussions may have consequences that are not immediately apparent. Concussions can affect sleep quality and may cause sleep patterns to become inconsistent. Some nights an individual may sleep for an extended period of time whereas in others sleep time can be short. With acute concussions, sleep occurs for longer durations when compared to subacute. These irregular sleep patterns can have major health effects by making an individual susceptible to health concerns later on (Raikes, Schaefer, 2016, p. 2145). [9] Concussions have also been shown to increase the risk for mental issues such as depression, CTE, dementia, and other cognitive issues (Guskiewicz et al., 2005). [10]

Concussions may also have long term effects on the ability to learn and execute motor patterns. As compared to an individual with no concussions, due to damage to the brain resulting from concussion, a concussed individual may have reduced motor learning speeds and ability to progress in activity. [11]

A term known as Post-concussive Symptoms, or PCS, can be found in many children at or under 18 years of age. PCS can impact the psychosocial functions and overall quality of life of the individual. Symptoms (headaches, dizziness, memory problems, etc) can last from weeks to months. It is important to note that PCS is difficult to diagnose, so awareness for this syndrome is very necessary. [12]

Prevention

Formal concussion plans that include elements of education, prevention, recognition, evaluation and management, both reduce the chance of concussion and ensure that concussions are promptly diagnosed. [13] [14] [15]

Efforts to teach children about concussion and brain safety include the CDC's HEADS UP app, designed for children between the ages of six and eight. [16]

According to Hon, from Concussion: A global perspective, there are recommendations to add an age limit on high contact sports -- such as football -- in order to prevent traumatic brain injuries from happening at young ages. This would allow the brains of younger children to develop more before experiencing concussions, which ultimately leads to long term effect when they arrive to High School. [17]

Training and conditioning

Concussions may be reduced through physical conditioning, and the teaching and practice of techniques that reduce the chance of injury. For example, a football player who learns the proper way to tackle, spends time in the weight room, and maintains overall good health choices is more likely to avoid situations which put them in harm's way. [18] Helping athletes improve their neck strength may also reduce the probability of concussion. [19]

Protective gear

In the game of football, pads and helmets provide significant protection from head injuries, but are less effective at preventing mild traumatic brain injury and concussion. Due to the physicality of the sport, concussion or other head injuries are inevitable. [20] Chin strap monitors may be added to an athlete's helmet to assess the force of blows to the head, and to determine if an athlete has experienced a blow severe enough to warrant assessment for brain injury. [21]

Response

Concussion response programs should take concussions seriously, limit the number of concussions a student may have while continuing to participate in a sport, and that monitor for recovery and residual effects of concussion. [22] Proper care for a concussed player involves providing proper medical treatment and exclusion from practices and games until the individual is cleared to play by a qualified medical professional. [23]

After a concussion, protocols for safe return to sports practice and competition involve gradual return to play with an appropriate level of medical supervision. [24] To ensure player safety and reduce potential liability, school concussion plans should also have a formal system for tracking compliance, and for identifying and responding to any deviations from the plan's standards.

See also

Related Research Articles

<span class="mw-page-title-main">Head injury</span> Serious trauma to the cranium

A head injury is any injury that results in trauma to the skull or brain. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries.

<span class="mw-page-title-main">Sports injury</span> Physical and emotional trauma

Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three million athletes age 14 years and under experience a sports injury annually. According to a study performed at Stanford University, 21 percent of the injuries observed in elite college athletes caused the athlete to miss at least one day of sport, and approximately 77 percent of these injuries involved the knee, lower leg, ankle, or foot. In addition to those sport injuries, the leading cause of death related to sports injuries is traumatic head or neck injuries.

<span class="mw-page-title-main">Concussion</span> Medical condition

A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.

<span class="mw-page-title-main">Traumatic brain injury</span> Injury of the brain from an external source

A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity ranging from mild traumatic brain injury (mTBI/concussion) to severe traumatic brain injury. TBI can also be characterized based on mechanism or other features. Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional and behavioral symptoms, and outcomes can range from complete recovery to permanent disability or death.

Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people. Overall, closed-head injuries and other forms of mild traumatic brain injury account for about 75% of the estimated 1.7 million brain injuries that occur annually in the United States. Brain injuries such as closed-head injuries may result in lifelong physical, cognitive, or psychological impairment and, thus, are of utmost concern with regards to public health.

Post-concussion syndrome (PCS), also known as persisting symptoms after concussion, is a set of symptoms that may continue for weeks, months, or years after a concussion. PCS is medically classified as a mild traumatic brain injury (TBI). About 35% of people with concussion experience persistent or prolonged symptoms 3 to 6 months after injury. Prolonged concussion is defined as having concussion symptoms for over four weeks following the first accident in youth and for weeks or months in adults.

<span class="mw-page-title-main">Chronic traumatic encephalopathy</span> Neurodegenerative disease caused by head injury

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.

Second-impact syndrome (SIS) occurs when the brain swells rapidly, and catastrophically, after a person has a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days, or weeks after an initial concussion, and even the mildest grade of concussion can lead to second impact syndrome. The condition is often fatal, and almost everyone who is not killed is severely disabled. The cause of SIS is uncertain, but it is thought that the brain's arterioles lose their ability to regulate their diameter, and therefore lose control over cerebral blood flow, causing massive cerebral edema.

Concussion grading systems are sets of criteria used in sports medicine to determine the severity, or grade, of a concussion, the mildest form of traumatic brain injury. At least 16 such systems exist, and there is little agreement among professionals about which is the best to use. Several of the systems use loss of consciousness and amnesia as the primary determinants of the severity of the concussion.

The Rivermead Post-Concussion Symptoms Questionnaire, abbreviated RPQ, is a questionnaire that can be administered to someone who sustains a concussion or other form of traumatic brain injury to measure the severity of symptoms. The RPQ is used to determine the presence and severity of post-concussion syndrome (PCS), a set of somatic, cognitive, and emotional symptoms following traumatic brain injury that may persist anywhere from a week, to months, or even more than six months.

<span class="mw-page-title-main">Health issues in youth sports</span>

The health issues of youth sports are concerns regarding the health and wellbeing of young people between the ages of 6 and 18 who participate in an organized sport. Given that these athletes are physically and mentally underdeveloped, they are particularly susceptible to heat illness, eating disorders and injury; sufficiently severe conditions can result in death. Awareness and prevention are key factors in preventing many health issues in youth sports.

The health issues of athletics concern their physical and mental well-being in organized sport. If athletes are physically and mentally underdeveloped, they are susceptible to mental or physical problems. Efforts to improve performance can lead to harm from overtraining, adopting eating habits that damage them physically or psychologically, like using steroids or supplements.

<span class="mw-page-title-main">Prevention of concussions</span>

Prevention of mild traumatic brain injury involves taking general measures to prevent traumatic brain injury, such as wearing seat belts, using airbags in cars, securing heavy furnitures and objects before earthquake or covering and holding under the table during an earthquake. Older people are encouraged to try to prevent falls, for example by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance.

Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.

Concussions, a type of mild traumatic brain injury, are a frequent concern for those playing sports, from children and teenagers to professional athletes. Repeated concussions are known to cause neurological disorders, particularly chronic traumatic encephalopathy (CTE), which in professional athletes has led to premature retirement, erratic behavior and even suicide. A sports-related concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces". Because concussions cannot be seen on X-rays or CT scans, attempts to prevent concussions have been difficult.

A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, These sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, rollerblading, skateboarding, skiing or snowboarding.

<span class="mw-page-title-main">Concussions in Australian sport</span>

Head injuries in sports of any level are the most dangerous kind of injuries that can occur in sport, and are becoming more common in Australian sport. Concussions are the most common side effect of a head injury and are defined as "temporary unconsciousness or confusion and other symptoms caused by a blow to the head." A concussion also falls under the category of Traumatic Brain Injury (TBI). Especially in contact sports like Australian rules football and rugby, issues with concussions are prevalent, and methods to deal with, prevent and treat concussions are continuously being updated and researched to deal with the issue. Concussions pose a serious threat to the patients’ mental and physical health, as well as their playing career, and can result in lasting brain damage especially if left untreated. The signs that a player may have a concussion are: loss of consciousness or non-responsiveness, balance problems, a dazed, blank or vacant look and/or confusion and unawareness of their surroundings. Of course the signs are relevant only after the player experiences a blow to the head.

<span class="mw-page-title-main">Concussions in rugby union</span> Risk of concussion from playing rugby union

Concussions in professional rugby union are the most common injury received. Concussion can occur where an individual experiences an impact to the head, and are also notable in high-contact sports, including American football, boxing, MMA and Hockey. Concussions can occur in recreational activities like horse riding, jumping, cycling, and skiing as a result of forceful rotational moment, resulting in injuries to the brain due to the contact with the skull, giving the skull not enough time to move with the body, causing the brain to press against the skull. With the development of equipment and training methods, further education on identifying concussion symptoms, as well as adjustments to the terms of contact may allow players to make more informed decisions on their conduct on the pitch.

<span class="mw-page-title-main">Boston University CTE Center and Brain Bank</span>

The Boston University CTE Center is an independently run medical research lab located at the Boston University School of Medicine. The Center focuses on research related to the long-term effects of brain trauma and degenerative brain diseases, specializing in the diagnosis and analysis of chronic traumatic encephalopathy (CTE). According to researchers at Boston University, CTE is a brain disease involving progressive neurological deterioration common in athletes, military personnel, and others who have a history of brain trauma. The disease is primarily caused by repeated blows to the head, some of which result in concussions or sub-concussive symptoms.

A pediatric concussion, also known as pediatric mild traumatic brain injury (mTBI), is a head trauma that impacts the brain capacity. Concussion can affect functional, emotional, cognitive and physical factors and can occur in people of all ages. Symptoms following after the concussion vary and may include confusion, disorientation, lightheadedness, nausea, vomiting, blurred vision, loss of consciousness (LOC) and environment sensitivity. Concussion symptoms may vary based on the type, severity and location of the head injury. Concussion symptoms in infants, children, and adolescents often appear immediately after the injury, however, some symptoms may arise multiple days following the injury leading to a concussion. The majority of pediatric patients recover from the symptoms within one month following the injury. 10-30% of children and adolescents have a higher risk of a delayed recovery or of experiencing concussion symptoms that are persisting.

References

  1. 1 2 "Interscholastic School Sports Brain Injury Report" (PDF). Missouri State High School Activities Association. 2012. Retrieved 28 September 2017.
  2. 1 2 "Concussion". Mayo Clinic. Retrieved 28 September 2017.
  3. ↑ Kerr, Z.Y. (17 May 2017). "Concussion Rates in U.S. Middle School Athletes, 2015-2016 School Year". American Journal of Preventive Medicine. 53 (6): 914–918. doi:10.1016/j.amepre.2017.05.017. PMID   28739314.
  4. ↑ Graham, Robert; Rivara, Frederick P.; Ford, Morgan A; Spicer, Carol M. (2014). Sports-related concussions in youth : improving the science, changing the culture. Washington, D.C.: National Academies Press. ISBN   9780309288002.
  5. ↑ Tremblay, Sara; Pascual-Leone, Alvaro; Théoret, Hugo (October 2018). "A review of the effects of physical activity and sports concussion on brain function and anatomy". International Journal of Psychophysiology. 132 (Part A): 167–175. doi:10.1016/j.ijpsycho.2017.09.005. PMID   28893565.
  6. ↑ "Concussion recognition tool 5©". British Journal of Sports Medicine: bjsports–2017–097508CRT5. 26 April 2017. doi: 10.1136/bjsports-2017-097508CRT5 . PMID   28446447.
  7. ↑ "Heads Up to School Sports". Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. Retrieved 28 September 2017.
  8. ↑ "Concussions: What to Do". Teens Health. Nemours. Retrieved 28 September 2017.
  9. ↑ Raikes, Adam; Schaefer, Sydney (December 1, 2016). "Sleep Quantity and Quality during Acute Concussion: A Pilot Study". Sleep. 39 (12): 2141–2147. doi:10.5665/sleep.6314. PMC   5103802 . PMID   27748242.
  10. ↑ Guskiewicz, Kevin; Marshall, Stephen; Bailes, Julian; McCrea, Michael; Cantu, Robert; Randolph, Christopher; Jordan, Barry (October 2005). "Association between Recurrent Concussion and Late-Life Cognitive Impairment in Retired Professional Football Players". Neurosurgery. 57 (4): 719–726. doi:10.1093/neurosurgery/57.4.719. PMID   16239884.
  11. ↑ Beaulieu, Christelle; Turcotte-Giroux, Alexandre; Carrier-Toutant, Frédérike; Brisson, Benoit; Jolicoeur, Pierre; De Beaumont, Louis (2019). "Long-term effects of concussions on psychomotor speed and cognitive control processes during motor sequence learning". Journal of Psychophysiology. 33 (2): 96–108. doi:10.1027/0269-8803/a000213. S2CID   149415099.
  12. ↑ Yeates, Keith Owen (2021), Slobounov, Semyon M.; Sebastianelli, Wayne J. (eds.), "Predicting Postconcussive Symptoms After Mild Traumatic Brain Injury in Children and Adolescents: 2020 Update", Concussions in Athletics: From Brain to Behavior, Cham: Springer International Publishing, pp. 299–315, doi:10.1007/978-3-030-75564-5_15, ISBN   978-3-030-75564-5 , retrieved 2024-05-04
  13. ↑ Schmidt, Elaine (9 July 2014). "Parents, coaches and doctors learn ways to prevent concussion among young football players". UCLA Newsroom. Retrieved 28 September 2017.
  14. ↑ "Sports-Related Concussion: Understanding the Risks, Signs & Symptoms". healthychildren.org. 21 November 2015. Retrieved 28 September 2017.
  15. ↑ "Sport concussion assessment tool - 5th edition". British Journal of Sports Medicine. 51 (11): bjsports–2017–097506SCAT5. 26 April 2017. doi: 10.1136/bjsports-2017-097506SCAT5 . PMID   28446451.
  16. ↑ "HEADS UP App". www.cdc.gov. Centers for Disease Control and Prevention. 16 April 2021. Retrieved 3 May 2024.
  17. ↑ Hon, Kam Lun; Leung, Alexander K. C.; Torres, Alcy R. (2019-07-01). "Concussion: A Global Perspective". Seminars in Pediatric Neurology. SI: TRAUMATIC BRAIN INJURY IN CHILDREN: CONCUSSION. 30: 117–127. doi:10.1016/j.spen.2019.03.017. ISSN   1071-9091. PMID   31235013.
  18. ↑ "Concussion Resources for Coaches and Athletic Trainers". Sports Concussion Institute. Retrieved 28 September 2017.
  19. ↑ Collins, Christy L.; Fletcher, Erica N.; Fields, Sarah K.; Kluchurosky, Lisa; Rohrkemper, Mary Kay; Comstock, R. Dawn; Cantu, Robert C. (October 2014). "Neck strength: a protective factor reducing risk for concussion in high school sports". The Journal of Primary Prevention. 35 (5): 309–319. doi:10.1007/s10935-014-0355-2. ISSN   1573-6547. PMID   24930131.
  20. ↑ Bachynski, KE; Goldberg, DS (2014). "Youth sports & public health: framing risks of mild traumatic brain injury in American football and ice hockey". The Journal of Law, Medicine & Ethics. 42 (3): 323–333. doi:10.1111/jlme.12149. PMID   25264090. S2CID   39629829.
  21. ↑ Stack, Kyle (26 March 2012). "Concussion-Sensing Chin Strap Raises Questions". Wired. Retrieved 3 May 2024.
  22. ↑ Waeckerle, Joseph F. (2013). "Concussion Management: The Team Plan" (PDF). Missouri Department of Health & Senior Services. Retrieved 28 September 2017.
  23. ↑ Kelly, James P.; Nichols, John S.; Filley, Christopher M. (27 November 1991). "Concussion in Sports: Guidelines for the Prevention of Catastrophic Outcome". JAMA. 266 (20): 2867–2869. doi:10.1001/jama.1991.03470200079039. PMID   1942455.
  24. ↑ "Returning to Sports and Activities | HEADS UP | CDC Injury Center". HEADS Up. Centers for Disease Control & Prevention. 12 February 2019.

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