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Release Date: 8/15/2012

Sports-related concussions take toll on young athletes

William Feldner, D.O., sports medicine specialist at South County Family & Sports Medicine

More than 300,000 sports-related concussions occur annually in the United States, with more than 62,000 of those sustained in high school contact sports. Some 34 percent of college football players have had one concussion and 20 percent have had multiple concussions.

Why are so many young athletes suffering concussions?

“Athletes are getting bigger, stronger, faster and more aggressive, and contact sports today involve more contact,” said William Feldner, D.O., a sports medicine specialist at South County Family & Sports Medicine and a member of St. Anthony’s Physician Organization. “High school athletes are trying to emulate players in the NFL, and they don’t have the training or technique. Additionally, coaches today are much more aware of the signs of a concussion, so they report them more often than in the past.”

A concussion is a traumatic brain injury caused by a bump, blow or jolt to the head. It’s not true that if the victim remains conscious, it’s not a concussion – most concussions occur without loss of consciousness, Dr. Feldner said.

“A concussion causes the brain to be bruised,” Dr. Feldner said. “When you have a bruise on your leg, it is sore; a bruise on your brain might cause nerve signals to become scrambled. Different people can have different reactions to a blow to the head. For some, it can be a real problem; others, not so bad. If the athlete recovers quickly, it was a mild concussion; if it takes longer, it was more severe.”

An athlete who has suffered a concussion might exhibit any of the following symptoms:

• appears dazed, stunned, confused or forgetful;
• moves clumsily, exhibits balance problems or dizziness;
•  answers questions slowly, has a hard time concentrating;
• complains of headache, nausea, double or blurry vision or sensitivity to light or noise.

“If the player doesn’t get up right away after the play, if he has a glassy look, heads in the wrong direction or just doesn’t exhibit his usual competitiveness, there’s a good chance he may have suffered a concussion,” Dr. Feldner said. “Some athletes pretend to feel better than they do, because there’s not a single player who doesn’t want to get back in the game. In that case, it’s important that his teammates speak up.”

A good athletic trainer usually can tell if a player has a possible concussion, and he may have to resort to simply taking the player’s helmet away, Dr. Feldner said. “You tell him, ‘You may play your sport for another five to 15 years, but have to use your brain for the rest of your life.’ He may not like it, but he’ll get it.”

Most athletic teams have defined protocols that coaches routinely follow in the event of a player suffering a head injury. The first is to remove the athlete from play and check for signs of a concussion. Keep the athlete out of play the day of the injury and until he is evaluated by a healthcare professional and released to return to play.

Symptoms may not occur (or be reported by the athlete) for hours or days after the injury. While most people with a concussion recover quickly and completely, some experience symptoms for days, weeks or longer. Warning signs of a more significant injury, like vomiting or weakness in the extremities, could indicate subdural hematoma (bleeding in the brain). While no imaging test shows a concussion has occurred, a CT scan can identify a brain bleed.

In Missouri, it is mandatory for an athlete who has suffered a suspected concussion to leave the game; he must be released by a medical professional before he is allowed to return to play. (Visit this link for more information about concussions and state rules related to them.)

“Concussions may cause significant and sustained neuropsychological impairments in information-processing speed, problem solving, planning and memory,” Dr. Feldner said. “These impairments worsen with multiple concussions. Sustaining a second concussion while still having symptoms from the first – second impact syndrome – can cause the brain to swell and, ultimately, can be fatal. If a high school athlete suffers a third concussion, his high school sports career is over.”

Standard treatment for a concussion is simple brain rest, Dr. Feldner said. “The best prescription is to sit quietly in a dark room, with no physical activity and no brain stimulation,” he said. “Once the symptoms are gone, the athlete can return to school, then gradually resume light activity, more strenuous activity, then sports-specific activity and, finally, resume the contact sport. In most cases, if an athlete is hurt on a Saturday and his symptoms are gone, he can play the following Saturday.”

While you can’t always prevent injuries from occurring during contact sports, you can make sure your athlete wears the appropriate protective equipment for the sport, Dr. Feldner said. “If it’s a helmet, make sure it meets current safety standards and fits properly. Whatever protective gear is recommended or required for your sport, wear it; but be aware that even the best safety equipment doesn’t provide immunity from injury.”

Physical conditioning also is important; be fit and ready to play your sport, Dr. Feldner said. Should you have a sports physical every year? “Absolutely,” he said. “In Missouri it is a requirement. A sports physical can identify any potential problems, like a heart murmur or heart valve impairment.”

Participating in sports of any kind is fun, healthy and character-building; it also should be safe, Dr. Feldner said. “And football isn’t the only sport where concussions occur. Athletes – male and female – who participate in cheerleading, gymnastics, field hockey or soccer all have their share of concussions.

“Just remember this: Any young athlete dreaming about a college or even pro career in sports, who is tempted to pretend he/she’s not injured, should think about this: ‘How much money are you making now, playing this sport? None. Blow it now and you have no chance later.”

Dr. Feldner, who is team physician for Lindenwood University and USA Volleyball, will begin taking patients Aug. 22, at South County Family & Sports Medicine, located in Suite 104 of the St. Anthony’s Lemay Urgent Care, 2900 Lemay Ferry Road.

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