With the NFL season in full effect, and many of our young athletes in the midst of their fall sports seasons, we must all remain vigilant about the possibility of a concussion. Increased media attention has raised awareness on the importance of this issue, specifically with regard to professional football. However, there is now emerging evidence on the increased frequency of concussions in soccer, lacrosse and hockey as well. Suffering just one serious concussion may result in long-term consequences and increased susceptibility to future injury, and therefore, as parents and amateur athletes, we must recognize the signs and symptoms of a concussion, and learn what to do if one occurs.
Symptoms of a concussion are wide and varied, and often self-reported. The most common include dizziness, headache and mental clouding, only sometimes immediately after the event. Some may not experience symptoms until up to 24-hours after the event, and in many cases, the inciting event may go completely unwitnessed (the NFL and MLS are now employing spotters for these particular events). Post-concussive syndrome can also vary widely but, it is usually associated with some cognitive or concentration deficits, even if mild.
Prevention is important for all injuries but, contact sports present a situation in which prevention is not always easy. For example, proper padding and helmets should be fit-to-size regardless of the sport but interestingly, “heading” the ball in soccer, a sport that does not require helmets, can still lead to accumulated micro-injuries. Currently, leading soccer organizations are recommending that “heading” not be taught to children until the U8 level at which, the cranium is much more developed. For helmeted sports, new technology is continuously emerging though, there is no evidence of any particular type of helmet or material that best prevents concussion.
Unfortunately there is no standard treatment for concussions but, studies are suggesting baseline testing for youth athletes so if they suffer a concussion, a more efficient, complete and safer program of rehabilitation may be individualized for all. Additionally, Return to Play (RTP) states that only a medical professional, adept at monitoring improvement, can allow an athlete to resume activity. However, finalized guidelines of RTP are currently being hotly debated.
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Jeffrey M. Ciccone, MD, specialized in various forms and techniques of anesthesia and pain management. Learn about Mount Sinai’s Pain Management and Integrative Medicine at www.mountsinai.org/painmgmt.