Recognizing Concussions in Teen Athletes
A concussion is the most common traumatic brain injury. Athletes involved in contact sports such as football have a 5 to 10 percent chance of developing a concussion during any given season. That’s why coaches and athletic trainers need to be aware of the signs and symptoms of a concussion and know how to react should a player experience a head injury.
What is a Concussion?
A concussion is a head injury that usually comes from a blow to the head, although concussions can also come from shaking or spinning injuries. Unlike most head injuries, concussions don’t usually show up on imaging studies like CT or MRI since the changes are primarily physiological. This means that the diagnosis is based on an exam by a health professional and an imaging study to rule out more serious brain injury. That’s why it’s important to recognize the signs of a concussion so that a teen athlete can be removed from the game and evaluated promptly.
What are the Signs and Symptoms of Concussion?
A player who has sustained a blow to the head and has a concussion may appear dazed and confused and be slow to answer questions. They may be disoriented or behave inappropriately and may not be able to identify where they are or the time of day. Some teen athletes with concussions lose consciousness, but this only happens in about 10 percent of cases.
If you question a teen with a concussion, they may report feeling dizzy or nauseous or complain of a headache. Other symptoms of a concussion are balance problems, problems focusing or concentrating or double vision. Players don’t have to have all of these symptoms to have a concussion. Headache is the most common symptom of a concussion, and it occurs in more than 8 out of 10 athletes.
What Should Coaches Do if They Suspect a Concussion?
Coaches and athletic trainers should be trained to recognize the signs of concussion and other serious head injuries and know when a player needs to be removed from the field. In some cases, a teen athlete may need immediate help. If they are unconscious or unable to answer questions, they should be transported to a health care facility as quickly as possible.
If an athlete is alert and able to respond, the coach or trainer can use a Graded Symptom Checklist provided by the National Athletic Trainers’ Association to evaluate a teen suspected of having a concussion. There are also other assessment tools such as the Standardized Assessment of Concussion available for trainers to use to evaluate teens suspected of having a concussion. Ideally, athletic trainers will have a pre-season assessment on each athlete so they can compare the scores to see if a change occurred after the injury.
Teen athletes with concussions frequently experience balance problems immediately after their injury, so athletic trainers can use a series of balance tests called the Balance Error Scoring System to check for problems in this area. Based on the results of all of these evaluations, they can make a decision whether to withhold a player from the game.
If a player describes any symptom of concussion or has any abnormality on evaluation, they shouldn’t return to the field and should be evaluated by a physician before returning to sports. With head injuries, it’s always best to err on the side of caution. In some cases, concussion symptoms won’t appear right away, which makes the diagnosis of concussion challenging. Plus, some athletes won’t accurately report their symptoms for fear of being taken out of the game.
Why is Caution So Important?
If a teen athlete with a concussion returns to the field, they run the risk of re-injuring their head. This could lead to the second impact syndrome, a catastrophic condition that occurs when a person sustains a second head injury or concussion before recovering from the first one. The second impact to the already injured brain triggers brain swelling and can lead to death. Survivors almost always have some degree of disability. Once an athlete has a concussion even a minor head bump could trigger second impact syndrome, and teens are the most susceptible age group to this type of injury.
The Bottom Line?
Coaches and athletic trainers should err on the side of caution when evaluating teen players after a head injury. If there’s any doubt, they should not be allowed to return to the field until cleared by a physician. The stakes are too high.
References:
Current Opinion in Pediatrics 18 (4): 376-382.
Sports Health: A Multidisciplinary Approach. Sept/Oct 2009. Volume 1. N. 5. Pp. 361-369.
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