Watching your child play a sport is thrilling. Watching them get injured? Scary. Especially if it’s a head injury.
However, doctors and athletic trainers have become much better at treating sports concussions. Researchers such as Ohio State’s Jaclyn Caccese are a big reason.
Caccese is an assistant professor in the School of Health and Rehabilitation Sciences and a researcher within Ohio State’s Chronic Brain Injury Program. She uses virtual reality to research the short- and long-term effects of concussions and how to help athletes rehabilitate in a way that ensures impairments do not worsen with age.
Below she shares tips on how parents, teams and athletes can safely address sports concussions.
All sports carry some inherent risk of injury. Although it is not possible to completely prevent sport-related concussions, there is evidence that some rule changes (such as delaying body checking in youth ice hockey), tackling technique improvement and equipment modifications may reduce the risk of injury.
Although football helmets cannot prevent a concussion entirely, some football helmets are better able to absorb forces than others.
Virginia Tech does provide helmet ratings for various sports. We, at Ohio State, are also exploring the role of neck strengthening in reducing the risk of concussion.
Although not a primary prevention mechanism, having a medical provider, such as an athletic trainer, on the sidelines at sporting events may improve concussion reporting, diagnosis and, ultimately, result in better, faster recovery after injury.
As soon as a concussion is suspected, an athlete should be removed from play and seek medical evaluation. There is emerging evidence that the longer an athlete plays after sustaining a concussion, the longer it will take that athlete to recover from injury.
Signs of concussion include loss of consciousness, balance problems (stumbling, slow to get up), disorientation or confusion, loss of memory or a blank or vacant look. Common concussion symptoms include headache, pressure in the head, dizziness, blurred vision and sensitivity to light/noise, among others.
It is a common misconception that loss of consciousness is required for concussion. Only about 10% or less of concussions involve loss of consciousness.
Medical clearance should be given before returning an athlete to a sport.
Following a brief period of rest (24-48 hours), physicians will instruct athletes to follow a graduated return to sport protocol beginning with symptom-limited activity and progressing to normal game play over a series of several days, as symptoms allow.
Recent evidence suggests light aerobic exercise early in the treatment protocol results in faster recovery.
Beyond return to sport, athletes should also consult with their doctors about returning to school, which also requires a graduated protocol, and returning to driving.
For high school sports, football, ice hockey, lacrosse, wrestling and soccer have the highest rates of concussions for boys. For girls, soccer, basketball, lacrosse and volleyball have the highest rates of concussions.
As I mentioned, some football helmet designs are better than others, but studies of headgear in other sports (such as soccer), have produced mixed results. At Ohio State, we are beginning to evaluate helmets in lacrosse, particularly girls’ lacrosse, where helmets are currently not required.
There’s a lot of misinformation regarding concussions. Most people recover from concussion within four weeks. An athlete should expect to return to all of their usual activities.
If symptoms are not improving, they should reach out to a physician who specializes in concussion care. There was one time when individuals with persisting symptoms after concussion were diagnosed with “post-concussion syndrome.” But there is no evidence that everyone’s persistent symptoms stem from one origin. In fact, it is certainly possible that the persisting symptoms may not be due only to concussion, but that does not mean that they do not need to be treated.
Athletes with concussion can improve. They need to communicate their specific symptoms and medical history to their physician. The physicians can target treatments for their specific symptoms.
One of our goals at Ohio State is to revolutionize concussion rehabilitation, and one of the ways we’re doing this is through virtual reality. We have ongoing studies, immediately following concussions, in current and former athletes with and without a concussion history.
We have a 15-foot virtual reality cave – one of the few in the country – and we use it to study how people use visual information to balance. Vision is very important for keeping us upright and to navigate through our environments. What we’ve found is that even people who have had a concussion years prior have very subtle problems with balance, which we can probe using our virtual reality cave.
What we’re hoping to do next is develop interventions to help rehabilitate some of these subtle balance impairments so they do not get worse as athletes age.