Teen Athletes and Concussions
|After recuperating from a concussion while playing baseball, Aaron Doster is back playing the sport he loves. Aaron followed strict return-to-play protocols designed to protect young athletes from permanent damage.
Aaron Doster remembers sliding into second base. “My helmet fell off, and I hit my head on the ground,” the Fairborn High School baseball player recalls about the game last spring.
Aaron thought he just had a bump on the head. Initially he showed no symptoms of a concussion. Aaron, who is both a pitcher and outfielder, continued to play, even scoring a run and making a few outfield plays. Then he asked for a time out telling his coach he “didn’t feel right.” His coach sidelined Aaron for the remainder of the game but kept a close eye on him.
When he got home, his parents, Kelley and Gary Doster, noticed a disconcerting change in their son. “He just didn’t seem like himself,” recalls Kelley. “Normally he is talkative, and he was just standing off by himself.”
Surprisingly, the next day Aaron didn’t remember hitting his head, scoring a run, riding the bus home or having dinner with his parents.
When his parents took him to school that day, they asked that he be evaluated by Kevin Allen, ATC, a certified athletic trainer. As part of Miami Valley Hospital’s Sports Medicine program, athletic trainers like Kevin are assigned to local schools. Throughout the school year, they work on-site, where their duties include evaluating injuries and supervising a teen’s return to play.
Kevin’s evaluation indicated that Aaron had suffered a minor concussion. The Dosters were relieved to learn that the memory loss Aaron experienced is not uncommon in cases of minor concussions.
The vast majority of bumped heads in sports don’t cause harm. However, when the head is hit hard enough and the brain suffers temporary neurological impairment, the result is a concussion, says Dusty Rhodes, DO, of the MVH Sports Medicine Center and a clinical associate professor atWright State University Boonshoft School of Medicine.
“Thirty years ago, we talked about concussions in term of whether someone lost consciousness. If they didn’t, it wasn’t considered a big deal,” says Dr. Rhodes. “We now know that cognitive functions, such as perception, memory and judgment, are affected – even when there is no loss of consciousness.”
In particular, when a player doesn’t see a hit coming, it’s more likely a serious concussion will happen. “If you’re blindsided, it takes much less force to cause damage,” explains Dr. Rhodes.
According to the Centers for Disease Control and Prevention, “Children and teens are more likely to get a concussion and take longer to recover than adults.” In addition, “Athletes who have ever had a concussion are at increased risk for another concussion.”
Treating Teen Concussions
|A balance test helps determine Aaron’s readiness to resume athletic activity.
Aaron received a follow-up evaluation from Dr. Rhodes three days after his injury.
“I tell athletes to sleep as much as possible,” says Dr. Rhodes. “The brain knows how to normalize itself and resolve chemical imbalances. Just like a cut, it will heal itself.”
Recent information about teen concussions has led to new postconcussion measures, including a ban on loud noises, cell phones and video games until the player is healed. Dr. Rhodes says about 90 percent of concussions are healed within about seven to 10 days.
Kevin says ImPact testing is another tool now used to evaluate the seriousness of concussions. This neuropsychological evaluation, conducted on a computer, measures reaction time and memory and records the patient’s symptoms.
The key to utilizing ImPact testing is comparing post-concussion results with a baseline test conducted before the season starts. In Aaron’s case, six days after his injury, this testing showed no loss of function.
Kevin says this test is only one component of evaluating a concussion. He and Dr. Rhodes rely heavily on feedback from those who know the personality of the player like a player’s parents.
Just saying he or she feels fine won’t get a teenage athlete back on the field, says Sean Convery, MD, medical director of the MVH Sports Medicine Center and clinical associate professor atWSU Boonshoft School of Medicine. Dr. Convery, like Dr. Rhodes, is conservative when it comes to letting a teen back into sports after a concussion.
|Sean Convery, MD
|Dusty Rhodes, DO
Dr. Convery says protocols for treating concussions got even more stringent after an international meeting of sports medicine experts two years ago. The resulting guidelines, known as the Zurich Criteria, have been adopted by MVH’s sports medicine program.
In addition to neuropsychological testing and the elimination of highstimulation activities following a concussion, the Zurich Criteria includes a graduated return to play.
In Aaron’s case, Kevin supervised him as he undertook light activity such as walking. Since he remained symptom free, Aaron began jogging, throwing and catching before returning to running and full workouts. Kevin says he sees fewer repeat concussions in teens as a result of the Zurich Criteria.
To share these new protocols, the MVH Sports Medicine Center participates in local meetings and symposiums designed to educate professionals in healthcare and sports about teen concussions.
Aaron is now fully recovered. He’s playing in a summer baseball league, and he plans to play baseball and golf at Fairborn High School when he returns this fall as a junior. “I’m back to where I was,” he says.
Recognizing the Signs of a Concussion
Symptoms of a minor concussion, requiring observation:
- Memory loss
- Heightened anxiety or emotion
Symptoms of a major concussion, requiring immediate medical attention:
- Severe headaches
- Impaired vision
- Nausea and/or vomiting
For more information about MVH’s Sports Medicine Center, located at Miami Valley Hospital South, call (937) 208-2111 or visit us online.