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Concussions and head injuries continue to be a hotly talked about topic within the media and healthcare professionals. Prevention and management of concussions is ever evolving as we learn more about how the brain reacts and recovers from trauma. As increasing numbers of children and adults participate in sports and considering a majority of concussions go along undiagnosed, there is a need to increase awareness of the causes, signs and symptoms of a concussion, when and if to return to play, and how to manage a concussion.
A concussion, as defined by McCrory, is a “complex injury affecting the brain, caused by traumatic forces. Concussions can be caused by a direct blow to the head, neck, or elsewhere with a force transmitted to the head. This typically results in decreased neurologic function that improves spontaneously.” Some common signs and symptoms of a concussion are: loss of consciousness, amnesia, disorientation, confusion, imbalance, seizure, personality changes, headache, dizziness, nausea, and, vomiting. Warning signs to seek immediate help include: inability to wake the person, severe or worsening headaches, seizures, vomiting, urinary or bowel incontinence, weakness or numbness, and stiff neck.
An even more serious condition is Second Impact Syndrome. This occurs when a second head injury occurs before the first one has healed. Commonly, the athlete will appear stunned, stand up and then collapse soon afterwards. This is a medical emergency and you should seek help immediately.
Some screening tools such as Impact Testing and the SCAT3 tests are valuable tools for concussion assessment and return to play determination. The SCAT3 uses a combination of tests that can be administered after the injury to evaluate for concussion. The tests include questions about how the athlete feels, tests their functional ability, and response to general questions.
Return to play should be guided by your doctor, but as general guideline, the standards are between 1 week and 1 month depending on the severity of the first concussion and how quickly the signs and symptoms resolve. If there is more than one concussion during a season the timeframe for return lengthens and may be reason to end the season of play. Concussions in children usually take longer to heal and because of this, their return to play is usually delayed a bit more than in adults.
Management of concussions consists primarily of monitoring the symptoms for worsening or improvement and then slowly returning to play. Returning to play is a series of steps to reintroduce the athlete to their sport. Other steps of management include treating any neck pain or muscle injuries that may have occurred during the trauma to the head. If you think you may have a concussion, play it safe and see your healthcare provider.
Written by Dr. Chandler Turnipseed – Johns Creek Chiropractor