Sport-related concussion

In the last decade or so, sport-related concussion has been reported, studied, and been a topic of interest due in part to the many sport participants and sport enthusiasts worldwide.

Blunt blows to the head can cause brain injuries

This paper will provide some important information to parents, athletes, coaches and fans of sport and is intended to inform some of the topics regarding sport-related concussions (SRC). This video, Overcoming adversity, offers strategies on how to deal with this injury and other types of adversities.

Wrestling is a contact and a collision sport much like football (soccer), ice hockey, and rugby. These sports have rules in place that prevent illegal holds/contacts that safeguard against many injuries and like many sports, no rules can prevent all  accidents & injuries that stem from accidents in these sports. The above mentioned sports international governing bodies: FIFA, IIHF, and the IRB are very proactive in their efforts to identify, research, and implement best practices for athletes who suffer concussive injuries and in 2001 – the 1st International Conference on Concussion in Sport was held in Vienna, Austria in partnership with the Medical Commission of the IOC. Since that time, there have been 2 other International Conference(s) on Concussion in Sport; 2004 and 2008. Organizers are planning for the next conference to be held in December 2012.

Experts seem to give SRC, a brain injury caused by blunt blow to head, no specific definition and appear to agree on causes and signs and symptoms that include and are not limited to: headaches, feeling like in a fog, slowed reaction times, drowsiness, irritability, fatigue, confusion, memory problems, mood changes, changes in sleep patterns, concentration difficulties, balance problems, nausea, ringing in the ears, problems with emotional control, anxiety, insomnia and fluctuating levels of consciousness. Sometimes, concussed athletes are unable to self report these signs and symptoms, perhaps, because they are: afraid, unable to notice or identify or remember, and or are embarrassed to report this information because they want to train and compete.

The issue with not reporting the above signs and symptoms of SRC after a direct or indirect blow or hit to the head are dangerous for many reasons. One reason may be that athletes will compete/train too soon after a head injury and this could lead to multiple SRC or head injuries per practice session or during the same practice session (which may lead to a prolonged and slower recovery). A second reason non reporting is dangerous for athletes is because a return to play (RTP) too soon after a SRC may lead to increased chance for SRC later in the year, throughout a career, or later in life; research suggests concussed athletes are more prone to successive SRC than non concussed athletes. In other words, concussed athletes are more susceptible for successive SRC. Finally, non reporting SRC can lead to a rare secondary injury known as second impact syndrome which leads to death.

Here are some blows to the head sustained during wrestling practice wrestlers have self reported to me regarding their SRC: hit head on mat after fireman’s carry, hit head on mat several times after successive head locks, hit head on mat after jump exercises. Here is another list of self reports by wrestlers on how they believe they concussed their heads: multiple heading of ball in soccer practice, car accident, falling down stairs, tripping/slipping on ice. Those examples are sport related and non sport related which may give you an idea of how many SRC can be obtained.

Sometimes loss of consciousness (LOC) happens during SRC which can last for seconds up to minutes. When athletes have a SRC and LOC for seconds, it is difficult for them to self report the injury because they may not remember the accident/incident and not show any other signs or symptoms right away (delayed symptoms can happen from 15 minutes to 24 hours later). This could happen several times during a practice, year, or career which may lead to multiple SRC going unreported and or undiagnosed. If athletes do not self report due to not remembering the head blow or injury, they may not ever be tested, screened, or analyzed by medical professionals for SRC which may have negative affects on the athletes career and health.

Medical professionals like medical doctors, certified athletic trainers, and neuropsychologists have a variety of concussion assessment tools i.e. Sports Concussion Assessment Tool (SCAT2), Balance Error Scoring System (BESS), Standardized Assessment of Concussion (SAC), Computerized Neuropsychological Tests, and Graded Symptom Checklist (GSC). These baseline tests can be given to athletes prior to training/competing and or after SRC to determine severity of injury and when athletes may return to play. To rule out more severe types of head injuries, known as Traumatic Brain Injury, fMRI; MRI; CT scan; may be used (SRC is sometimes referred to as mild Traumatic Brain Injury).

RTP is used to describe actual physical return to play (sport) as prescribed by medical professionals. Returning to play physically too soon will cause complications like delayed recovery, multiple concussions, and second impact syndrome. Experts also suggest that returning to mental activities too soon may also complicate recovery and delay recovery. Some forms of returning to mental activities (that require concentration and attention) too soon include and are not limited to: staying up late to study, scholastic work, video games, text messaging, etc. There appears to be no precise amount of time that extraordinary physical and mental activities can and should resume. However, medical professionals suggests that 7-10 days of no symptoms, is an adequate time period for RTP.

At this time, researchers can not agree on a total number of concussions to disqualify athletes for their careers and do suggest that 3 SRC in one season should disqualify athletes for that season. As alluded to, there is no magic number of SRC for athletes to retire from sport maybe because the severity of each SRC may be different, some SRC go undetected, each person will react/respond differently to SRC, and there is no unequivocal data to suggest that ‘one size fits all’. Experts do agree, however, that multiple SRC that are not reported and or are not allowed proper time to recover may have negative affects on athletes lives and careers.

Sport-related concussion is a serious injury and must be taken serious by athletes, coaches, parents, and the general public. The above paper was given to shed some light on SRC. The above video, Overcoming adversity, is offered to help athletes deal with this adversity. The below info can be viewed for a more detailed look at SRC.

Suggested references

  1. Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008 Supplement
  2. National Athletic Trainers’ Association Position Statement: Management of Sport-Related Concussion
  3. The American Academy of Neurology Position Statement On Sports Concussion
  4. A Brief Review of Traumatic Brain Injury Rehabilitation
  5. Centers for Disease Control and Prevention Heads Up Facts for Physicians About Mild Traumatic Brain Injury (MTBI)

 Copyright © by Coach Shannyn, All rights reserved

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