Summit Medical Group of Oak Ridge

Awareness and Recognition of Concussions in Student Athletes – By Bridget Peterson, F.N.P., B.C.

Monday, July 7th, 2014

There has been more and more discussion in recent years regarding head injuries in athletes, especially with the National Football League (NFL) coming under fire for whether or not there has been knowledge within the NFL that repeated hits to the head in football players eventually causes brain damage. An increasing number of NFL players who have suffered concussions as a result of playing football have developed cognitive and memory deficits, such as dementia, Alzheimer’s Disease, depression, and chronic traumatic encephalopathy (CTE).

A concussion is trauma to the brain as a result of a blow, bump, or jolt to the head. The adolescent brain is at a higher risk of suffering damage because the brain is still developing. Most concussions occur without a loss of consciousness. Signs of a concussion can occur immediately after a blow occurs or may occur hours or days later. It is important that parents and guardians be observant of their athletes after an injury to the head.

In October of 2012, my son suffered a serious concussion as a 16 year old high school football player. He came into contact with another player in a typical football tackle. After the tackle, my son felt like he was in a tunnel. He tapped his helmet to signal his coaches that he needed to come out of the game, walked two steps toward the sideline, and then collapsed with a complete loss of consciousness that lasted for a few minutes. He was transported to the University of Tennessee (UT) in Knoxville for evaluation and he was found to have a concussion. He was followed by a physician at UT for several weeks who specializes in concussions and he had serial assessments by the physician who let my son return to play after approximately 9 weeks of rest from competitive practice and play. My son experienced dizziness, headaches, balance issues, and difficulty with his concentration and with recall for a solid five weeks after his concussion occurred.

The U.S. Department of Health and Human Services Centers for Disease Control and Prevention has developed signs of concussion to include:

–dazed or stunned appearance
–confusion about events
–slow verbal responses
–repetitive questions
–inability to recall events that led up to the hit or events that follow the hit
–loss of consciousness, even it is brief
–behavior or personality changes

Symptoms that an athlete may report include:

PHYSICAL
–headache
–nausea, vomiting
–feeling off-balance
–dizziness
–feelings of tiredness or fatigue
–blurry or double-vision
–sensitivity to light and/or noise
–numbness or tingling
–not “feeling right”

EMOTIONAL
–irritability
–sadness
–nervousness
–more emotional than usual

SLEEP DISTURBANCES
–drowsiness
–sleeping more than usual
–sleeping less than usual
–difficulty falling asleep

Medical attention should be sought immediately if signs or symptoms are noted in a child or teen athlete. No athlete should be allowed to play on the same day as the blow to the head has occurred. A health care professional should be involved to determine when a child or teen is ready to return to physical education classes, physical activity at recess, sports practices and games through a series of steps that track the individual’s progress in returning to his or her baseline function.

The Sport Concussion Assessment Tool-3rd Edition (SCAT3) is an objective tool that can be used on individuals 13 years and older in a resting state to establish baseline recall, balance, coordination, and cognition. This baseline test can be done along with a sports physical prior to participation in athletic play. In the event of a blow to the head, the athlete can be tested again after the injury using the SCAT3 to evaluate whether or not the athlete has changed from his or her baseline.

Summit Medical Group of Oak Ridge has partnered with area high schools to perform the SCAT3 Assessment on high school athletes as part of the pre-season preparation for football, basketball, and soccer players. With the pre-season information on athletes, if an injury does occur, the SCAT3 can be performed on the sideline by a coach or a trainer to gauge impairment to the player’s balance, coordination, cognition, and recall and to determine see if the score is different from the initial (baseline) assessment.

After first-hand experience with a serious concussion in my teenage athlete, baseline information was invaluable to have. Summit Medical Group in Oak Ridge looks forward to helping educate and protect our community’s student athletes with the use of the SCAT3 as part of high school athletic programs and part of pre-play screening.