Commentary: Some myths, facts about sports-related concussions
This year the NFL raised the profile of head injuries in contact sports, highlighting the prevalence of concussions on the field and kicking off concern among parents of high school and club sports athletes.
Unfortunately, some of what parents are hearing is a fumbling of the facts.
While it is vital that we work to prevent and appropriately treat traumatic brain injury in youth sports, it is important to keep in mind that nearly 80% of such injuries among children are not related to sports or recreational activities. Falls and car crashes account for far more concussions among youths than football.
The medical community would like to tackle some myths to help parents better understand concussions.
Myth: The term “concussion” refers only to a head injury that results in a person losing consciousness.
Fact: A concussion is a change in neurological function of the brain that occurs as a result of head trauma. Common symptoms of concussion are dizziness, headache and changes in vision, mood and memory. The majority of concussions do not involve loss of consciousness.
Myth: Participating in contact sports leads to dementia later in life.
Fact: Studies do not support this. Research that shows an association between sports-related head trauma and dementia has involved brain trauma with prolonged loss of consciousness or a significant cumulative trauma in professional athletes, such as boxers and football players. Their levels of trauma are orders of magnitude greater than those experienced by most high school athletes. It is also important to note that most studies involve football players from 20, 30 and 40 years ago, when safety equipment was different and there was little recognition of concussion.
Myth: You should wake up a child every one to two hours to be sure he or she is OK.
Fact: Sleep is the best treatment for concussion. Deep levels of sleep restore the brain chemistry that can be put off balance by concussion. In fact, the complex changes that can occur in a concussion patient are most notable during the first three days after injury, and sleep deprivation can make these changes worse.
Myth: If you don’t lose consciousness, you can go right back in the game or walk it off.
Fact: The most vulnerable time for the brain is within the first three days after injury, so it is important for young athletes to rest to avoid reinjury. Schools have gotten more involved in setting guidelines for “return to play” and “return to school” following concussions. Coaches, school nurses and community physicians work together to help players return to activity as appropriate. Some schools are starting to utilize software that can assess an athlete’s baseline cognition to help determine the severity of an injury and the conclusion of healing.
Myth: A child should stay home until completely healed.
Fact: While we used to recommend complete physical and cognitive rest following concussion, we now realize that isolation can actually exacerbate some of the symptoms — particularly depression — in young athletes. Instead, we now recommend keeping kids off the field but allowing them to participate in team meetings and events in which they can receive plenty of positive social feedback. While cognitive rest is crucial, finding that balance is important in aiding healing.
DR. TERYN CLARKE is a neurologist at Hoag Hospital in Newport Beach.