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A broken bone is a clear sign that you need to take a break from active endeavors. A head injury, though often not as obvious, should be treated with the same respect.

Even if head-injury symptoms seem mild, you may be placing your health at a tremendous risk unless you take some time on the sideline.

Often, athletes who "get their bell rung" will feel good enough to continue their activity. However, this decision can have long-lasting or even devastating effects.

Remember actress Natasha Richardson, who hit her head on a beginner ski slope in March and later died from an epidural hematoma? She felt fine at first, but within a few hours developed a headache, one of the telltale signs of more serious injury.

David Wilkinson, M.D., emergency medicine physician at Yampa Valley Medical Center, said Richardson's case is a good example of the importance of having an appropriate medical evaluation for a head injury. Signs and symptoms that should prompt a medical exam include changes in mental status or confusion, protracted headache, nausea or loss of consciousness.

"Clearly if they have a loss of consciousness, they need an evaluation," Wilkinson said.

"Concussion," the most commonly used term for head injury, is defined as: a jarring injury of the brain resulting in disturbance of cerebral function. Wilkinson pointed out that concussion is a bucket term that refers to every injury from a minor bump of the head to sustained unconsciousness.

"Any blunt trauma to your head can cause a concussive injury," Wilkinson said. "Even minor blows can cause concussive force."

According to Wilkinson, the most common cause of head injuries evaluated in YVMC's emergency department are related to sports or recreation: skiing, mountain biking, motorcycling and ATV riding, to name a few. The second leading cause is motor vehicle accidents.

Wilkinson said he has seen a significant decrease in the severity and number of head injuries because of the use of helmets.

He also noted that "second-impact syndrome" could be a factor for some local athletes. This occurs when someone suffers a concussion and then receives a second blow to the head while still suffering from the initial concussion. Although this syndrome could have catastrophic consequences, many people put themselves at risk by returning to activity too soon.

"It's hard in this town because we are so active," Wilkinson said. "You may bump your head mountain biking and think you are OK to kayak. One should avoid any physical activity after a concussion for 30 to 60 days."

Family physician and longtime Steamboat Springs soccer coach Jim Dudley, M.D., emphasizes that if someone is the least bit "dingy" with any symptoms at all, he or she needs to sit on the sideline. Rest is critical for preventing second-impact syndrome.

"Second-impact syndrome is a real thing," Dudley said. "People have to understand if you don't feel 100 percent, you have to steer clear of anything where you could get bumped."

Dudley said there are different guidelines for concussion management in order to prevent this syndrome. Computerized testing is being used by professional athletes and some schools.

"But all of them are in agreement, if you have any signs or symptoms, you should sit out," he said.

Dudley recommends that parents keep a close eye on youth athletes, especially in the first 24 hours. Young athletes may not always tell a coach or a parent how they really feel, or may not even realize that they are suffering any symptoms. However, parents can test cognitive ability by asking questions.

"You know your kid, ask them questions," Dudley said. "You know how they would react." If a child is not completely back to normal in thought process or in speed of thought, they should rest.

Dudley also said an injured person needs to demonstrate steady improvement, hour-to-hour and day-to-day. If there is no improvement or any worsening, the individual should be seen by a medical professional immediately.

Adults need to take the same advice. After suffering a head injury, let someone know. Then stay around other people for 24 hours so they can note any change in condition.

Take time to rest from physical activity as well as from other tasks such as work, and give your brain the chance to heal. Sit out to insure a safe return.

Riley Polumbus is communications specialist at Yampa Valley Medical Center. She can be reached at riley.polumbus@yvmc.org