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Three things you need to know about concussions

Aug. 22, 2013 @ 12:00 AM

Sydney Crosby, Merrill Hodge, Mike Matheny, Junior Seau... Do these names sound familiar? These professional athletes have all suffered from the effects of numerous concussions. Sydney Crosby (Penguins) is still trying to play NHL hockey but Hodge (Steelers/current ESPN analyst) and Matheny (SF Giants/current ST. Louis Cardinals mgr.) were medically retired from their respective sports. Junior Seau (San Diego and New England Patriots) died in an accident that many have linked to his post-concussion issues. The media has placed much focus on concussion in recent years. Sports programs from the youth level to the pros have made it a point of emphasis. If you are an athlete or are around athletes, here are some things you need to know.

What is a concussion?

The word concuss (Latin origin "concussus") means to "shake violently." Any trauma or contact to the head/neck area can cause the brain to move inside the skull, which in turn, causes injury to the brain. The contact DOES NOT have to be direct! A sudden deceleration force (as in any contact sport or even a fall) when the neck muscles are relaxed will allow for the brain to move inside the skull. The medical community now uses the term M TBI (Moderate Traumatic Brain Injury) when a concussion is diagnosed. If someone has suffered an occurrence as mentioned above, and is experiencing head aches, nausea and/or vomiting, dizziness, lack of concentration or fogginess... they are likely to have a concussion. Loss of consciousness can be a factor as well BUT is not always present.

Who to see if a concussion is suspected?

Many coaches are now trained to recognize possible concussions. If your activity is covered by an Athletic Trainer, they have a good understanding of concussion signs and symptoms. Any time a concussion is suspected or if any signs/symptoms are present, you should seek qualified medical assistance as soon as possible. ER's are adept at ruling out severe brain injuries. CT scans and MRI's rule out the major problems but often show negative results in diagnosing concussion injury. Typically, concussions read negative on such testing and are more based on the typical signs and symptoms. If the individual is not referred to a specialist (Neurologist, orthopaedist, etc.) but is experiencing signs/symptoms, they should definitely seek out a physician trained in concussion management to further diagnose the M TBI and develop a plan of action.

Concussion is now a treatable injury

Not too long ago, an individual who had been diagnosed with a concussion (M TBI) would have been instructed to rest, stay in a dark(er) room and use pain a reliever/Excedrin if suffering a head ache. While rest is key, we now know much more about how to treat a concussion. Thanks to the efforts of the University of Pittsburgh Medical Center's Concussion Management Program, we no longer put concussion patients "in a dark room" and tell them to rest. Recent research shows prescription meds such as Amantadine can be helpful to those who suffer heightened and prolonged symptoms. A specialist who is adept in treating concussions will conduct a proper evaluation which includes an interview, a vestibular (balance and motor skills) and ocular (vision) screen, a cognitive test (such as ImPACT) and a resulting plan of care. Patient education is key in treating a concussion. The physician will make recommendations such as school accommodations, computer/technology usage, activity modifications and prescribe physical therapy to help resolve symptoms.

Physical Therapy plays a key role in returning concussion patients to their respective sport. New advances in vestibular therapy (balance and fine-motor skills) and exertional therapy (how the individual responds to increased activity) are very helpful in determining when to return to full-go activities. The PT will communicate all findings and progress to the specialist which will allow for an informed decision on when it is safe to return to sports, etc.

Kevin Burton, M.Ed., ATC, ITAT, recently earned credentialing as an ImPACT Trained Athletic Trainer. Kevin is certified in using the ImPACT Concussion Management System based on the University of Pittsburgh Medical Center model) contact: kburton@hptservices.com or call 304-525-4445.

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