I’m not a medical doctor, so what you read herein are my own opinions based on information obtained from a number of resources. As a coach, and parent of a player, I want to ensure you have the resources you need to be as informed as possible, and that you know where to go for tools that can help you notice the signs of a concussion, and the steps you should take in the event it happens to one of your kids.
If you have ever been to a sporting event at any level, chances are you have seen an accident resulting in personal injury. A broken bone, busted nose, knock-out, scrapes, and bruises are all known to happen on occasion in sports, and I’m not talking about at just the professional level. These things can happen in practically any sport, and at any level. One of the most frightening things that could happen on the field would be to watch as your son or daughter take a hit to the head and not get up, or worse yet, not even move. The mere thought of it invites anxiety and trepidation. When it comes to head injuries, the concussion has taken center stage due in large part to the changes made in the NFL in the 2010 and 2011 seasons including fines imposed on players that spear or lead with their heads, or target opposing players’ heads. These changes are now finally trickling down through the NCAA, High School Sports, and into the junior programs around the country such as Pop Warner and our own AAU.
This past Saturday, I had the honor of attending a mandatory coaches clinic put on by our local Florida Youth Football and Cheer League, a member of the AAU. The entire first hour was a presentation about concussions by Chief Neurosurgeon Dr. Todd Maugans of Nemours Children’s Hospital here in Orlando. His presentation was one of the most informative and enlightening I have ever seen.
Steelers QB Ben Roethlisberger told the AP why a concussion kept him on the bench: “You can get a knee replacement or a rotator-cuff operation, but you can’t get a new brain” – USA Today
One of Dr. Maugans’ first questions to the auditorium full of a hundred or so coaches was “How many of you think a concussion means you’ve been knocked out?” I really had to think about this for a moment. Growing up as a kid, I wrestled, played football and baseball, skied, and found numerous opportunities to bump my head on something. It never really mattered how hard I hit as long as I was never knocked unconscious. I remember teachers, coaches, and my own parents telling me that’s when it’s bad. My Dad used to say, when we watched George Forman or Sugar Ray Leonard duke it out in the boxing ring, that “getting your bell rung was one thing – but when you’re out, that’s just dangerous.”
I, like many others in that auditorium, grew up thinking that a concussion meant you were knocked out. Today – that’s just not true anymore.
So what exactly is a concussion?
According to The Centers for Disease Control and Prevention (http://www.cdc.gov/concussion/sports/ ), a concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious.
According to About.com (http://sportsmedicine.about.com/cs/head/a/concussion.htm ) sports concussion are; traumatic head injuries that occur from both mild and severe blows to the head. Some head injuries may appear to be mild but research is finding that concussions can have serious, long-term effects, especially repeat head injuries or cumulative concussions. A concussion is typically caused by a severe head trauma during which the brain moves violently within the skull. The brain cells all fire at once, much like a seizure. Some studies show that patients who suffer a concussion appear to have the brain activity of people in a coma.
A concussion may result from a fall in which the head strikes against an object or a moving object strikes the head. A suddenly induced turning movement such as a blow that twists the head (like a punch to the side of the face) is more likely to produce unconsciousness. However, significant jarring in any direction can produce unconsciousness.
In 2004, data collected from the head impact telemetry system used in the NFL concussion studies found that 58 of 623 (9.3 percent) of professional football players who suffered a concussion also had a loss of consciousness.
Still yet another resource, and my personal favorite definition from the National Federation of State High School Associations (NFHS) through their Sports Medicine Advisory Committee (SMAC) define concussions as:
You’ve probably heard the terms “ding” and “bell-ringer.” These terms were once used to refer to minor head injuries and thought to be a normal part of sports. There is no such thing as a minor brain injury. Any suspected concussion must be taken seriously. A concussion is caused by a bump, blow, or jolt to the head or body. Basically, any force that is transmitted to the head causes the brain to literally bounce around or twist within the skull, potentially resulting in a concussion.
It used to be believed that a player had to lose consciousness or be “knocked-out” to have a concussion. This is not true, as the vast majority of concussions do not involve a loss of consciousness. In fact, less than 10% of players actually lose consciousness with a concussion.
What exactly happens to the brain during a concussion is not entirely understood. It appears to be a very complex injury affecting both the structure and function of the brain. The sudden movement of the brain causes stretching and tearing of brain cells, damaging the cells and creating chemical changes in the brain. Once this injury occurs, the brain is vulnerable to further injury and very sensitive to any increased stress until it fully recovers.
Common sports injuries such as torn ligaments and broken bones are structural injuries that can be seen on MRIs or x-rays, or detected during an examination. A concussion, however, is primarily an injury that interferes with how the brain works. While there is damage to brain cells, the damage is at a microscopic level and cannot be seen on MRI or CT scans. Therefore, the brain looks normal on these tests, even though it has been seriously injured.
I thought this was very interesting also – a collection of quotes about concussions taken from NFL players:
“You get a concussion, they’ve got to take you out of the game. So if you can hide it and conceal it as much as possible, you pay for it the next day, but you’ll be able to … stay in the game.” _ Washington Redskins fullback Mike Sellers.
“I’ve had times where I walked up to the line, where I know the play, but don’t know what to do.” _ Oakland Raiders tight end Tony Stewart.
“If you get a little headache or something, you’re not going to say anything. This is football, and everyone gets their heads rattled a little bit.” _ Indianapolis Colts safety Jamie Silva.
“I don’t want to come out of games. I always feel that’s some kind of weakness. Somebody hits me and takes me out of the game, I feel weak. So if something happens, I take a minute to try to re-gather myself and then go back.” _ New Orleans Saints defensive lineman Anthony Hargrove.
“I’m sure there have been guys who didn’t realize they had a concussion and just kept playing. It’s a violent game. The head injuries are the most dangerous to play with. We’re trained to play no matter what. If you can run, and you’re able to focus and know your responsibilities, you’re usually out there playing. You wouldn’t have enough players if no one played hurt. Especially if you’re, like, on special teams, you’re going to do everything you can to stay in the game.” _ Kansas City Chiefs safety Mike Brown.
Read more: fxn.ws/OzrQKe
Coming up in my next posts will include concussion tools for coaches, a guide for parents, statistics, and return-to-play protocol so stay tuned.