Understanding Concussions: Protecting Athletes and Promoting Recovery

Concussions are a significant concern in high school sports, where athletes are at risk of sustaining head injuries that can have lasting effects on their health. As they get older, our kids are getting faster and stronger, and concussions become a much more common thing in high school sports than they were in middle and elemaentary schools.

As parents and athletes, it's crucial to have an understanding of concussions, be able to recognize the signs and symptoms, and follow proper protocols for recovery and safe return to play. In this article, we will delve into the definition of concussions, recognizing the symptoms, the importance of reporting suspected concussions, and the role of graded return to play. We will also discuss California concussion laws, which aim to safeguard student-athletes and promote their well-being.

What is a Concussion?

A concussion is a type of traumatic brain injury (TBI) caused by a blow to the head, face, or body that transmits force to the brain. It disrupts normal brain function, leading to a range of physical, cognitive, and emotional symptoms. There is no physical damage to the brain, so it will not appear on imaging such as a MRI or CT scan. The diagnosis is made clinically with a physical exam. It's important to understand that a concussion may occur even without loss of consciousness.

Recognizing the Signs and Symptoms:

Recognizing the signs of a concussion is crucial for timely intervention. Symptoms can manifest immediately after the injury or develop gradually over time. Common signs and symptoms of a concussion include:

  • Headache

  • Confusion or disorientation

  • Memory problems

  • Dizziness or balance issues

  • Nausea or vomiting

  • Sensitivity to light and noise

  • Fatigue or sleep disturbances

  • Mood changes

Importance of Reporting Suspected Concussions:

Reporting any suspected concussion is paramount for the athlete's health and well-being. Ignoring or downplaying symptoms can lead to further injury and delay recovery. Coaches, parents, and teammates should be vigilant in recognizing potential concussions and encourage athletes to report their symptoms. It’s also a good idea for athletes to give their coaches or athletic trainers a heads up if they suspect an injury in a teamate. Early reporting allows for proper evaluation and appropriate management by healthcare professionals.

Graded Return to Play:

Recovery from a concussion requires a structured approach known as a graded return to play protocol. This involves a step-by-step process that gradually reintroduces physical and cognitive activities, ensuring the brain has time to heal and adapt. It typically progresses through stages, starting with complete rest and gradually progressing to full participation. Each stage has specific criteria to be met before moving on to the next, ensuring that symptoms do not worsen during the process.

Dangers of Improper Return to Play and Second Impact Syndrome:

Returning to play too soon or without following the graded return to play protocol can pose serious risks. The brain, still in a vulnerable state, is more susceptible to a second impact, which can lead to a condition called Second Impact Syndrome (SIS). SIS is a rare but potentially life-threatening condition characterized by rapid and severe brain swelling. By adhering to proper recovery protocols, the risk of SIS and other long-term complications can be minimized.

California Concussion Laws:

California has implemented legislation to protect student-athletes and ensure their safety. According to California Youth Sports Concussion Law (Assembly Bill 2127 in 2014, and AB 2007 in 2016), if a student-athlete is suspected of sustaining a concussion, they must be immediately removed from play. They are not allowed to return to play on the same day and must receive written clearance from a licensed healthcare provider trained in concussion and working within their scope of practice, before resuming participation. The law also enforces a mandatory Return To Play protocol, which must be a minimum of 7 days long before a student-athlete can return to full participation.

Role of Healthcare Provider:

When seeking medical clearance for a student-athlete's return to play, it is crucial to consult a healthcare provider trained in evaluating and managing concussions. The California Interscholastic Society (CIF) states that this must be a physician (MD/DO) trained in concussion management, or a NP or PA under direct supervision of such a physician. The CIF specifically asks that a physician (MD/DO) sign their form. Certain specialties may not deal with concussion and may consider it beyond their scope, so ideally it should be a physician trained in Sports Medicine, Family Medicine or Neurology. If the condition seems to be an emergency, the ER is always an option. Speak to your Athletic Trainer if your unsure. Other physician specialists may feel comfortable if they have had the proper training and experience. When making your appointment, ask if the doctor is experienced in concussion. Their expertise ensures a comprehensive evaluation, proper guidance, and appropriate care throughout the recovery process.

Conclusion:

Concussions are serious injuries that require prompt attention and proper management to protect the health and well-being of student-athletes. Recognizing the signs and symptoms, reporting suspected concussions, and following graded return to play protocols are essential steps in ensuring a safe recovery. California's concussion laws further emphasize the importance of protecting student-athletes and providing them with appropriate care. By prioritizing the health of our young athletes, we can support their safe return to play and long-term well-being.

Remember, this article is for informational purposes only and should not replace professional medical advice. If you suspect a concussion, seek medical attention from a qualified healthcare provider immediately.

Resources:

  • HEADS UP - Concussion in Youth Sports Initiative

    • Produced by the CDC. Here you will find concussion information geared toward Coaches, Parents, Athletes and Officials. This includes online courses, reference cards, info sheets and even an app for your phone

    • https://www.cdc.gov/HEADSUP/

  • California State Laws regarding concussion in youth sports

  • California Interscholastic Federation (CIF)

    • CIF Bylaws regarding concussion -see section 503H

    • CIF Concussion Resources - Includes a repository of all pertinent forms and handouts required for proper return to play, physician sign off, and concussion management. There are also links to videos and outside resources including educational courses for coaches, athletes, parents and physicians.

  • Del Norte High School

    • DNHS Sports Medicine page has links to forms needed for proper return after concussion as well as other health and safety resource for students and parents.

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