Monday Medical: More than ‘just a bump on the head’
August 5, 2012
As the new school year approaches, concussions are on the minds of medical and school personnel.
No longer is a concussion considered "just a bump on the head" nor should an athlete be told to "shake it off." A concussion is a common head injury, also called a traumatic brain injury, that produces a disturbance in the normal metabolic function of the brain.
Even a mild concussion can have significant side effects for the student athlete, whose developing brain is very different from the adult brain. Symptoms could show up hours or days after the initial injury and could be long lasting. If the child or teen athlete is not evaluated and given time to rest and recover, there could be long-term problems.
It takes a team approach to get the student athlete back into the classroom and onto the playing field. A player who gets a blow to the head must be evaluated by a medical professional — physician, physician assistant or physical therapist — trained in concussion management. An athlete will not return to play until given medical clearance by a physician. This now is Colorado state law.
Scott Blair, physical therapist and assistant director of the SportsMed Concussion Management Program at Yampa Valley Medical Center, encourages parents, athletes and coaches to get a better understanding about managing concussions.
"Educate yourself," he said. "There are plenty of resources available through the Heads Up Concussion program from the Centers for Disease Control and Prevention (www.cdc.gov), the Colorado High School Activities Association (www.chsaa.org) and SportsMed (www.yvmc.org/concussion).
"We strongly encourage a team approach with not only the physicians and coaches but also school nurses, teachers, counselors and parents," Blair said. "All need to communicate and work together to decide when the athlete can return fully to the classroom and to the playing field."
The immediate focus is to reduce the potential for further injury or stress to the brain. Lance Pugh, physical therapist and concussion management program coordinator at SportsMed, explains that this means a reduction in school activity and removal from the sport.
"Concussions can be complex," Pugh said. "No two are the same, and the effects on each athlete vary greatly. This is why the athlete should be removed from play and examined by qualified personnel.
"The athlete cannot return to school until symptom free at rest. Return to physical activity typically occurs after that."
When cleared for physical activity, the athlete follows a structured return-to-play schedule allowing gradual increase of physical activity under close supervision.
Neurocognitive testing has been proven to have significant value in concussion management, especially with teenagers and especially when baseline scores are available. We are fortunate to have ImPACT testing available at YVMC SportsMed clinics in Steamboat Springs, Hayden and Walden as well as at Soroco and Steamboat Springs high schools.
Each athlete is given a preseason baseline ImPACT test, and data is kept for two years. When a concussion is suspected, a follow-up test is administered to see whether the results have changed from the baseline. This comparison helps to diagnose and manage the concussion.
More than 80 percent of concussions are resolved successfully if managed well within the first two to three weeks after the injury. That is why it is so important to understand the signs and symptoms of a concussion and follow a team approach.
Lisa A. Bankard is the wellness director at Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.