Prevention

Preventing concussions is as important as treating them.

How can athletes prevent concussions? Neurologist, pediatricians, therapists and neuropsychologists share different treatment methods however in terms of prevention we have our work cut out.

The last thing you want to hear while at work is a call from the coach or school nurse to tell you your son or daughter is in the emergency room with a head injury.

Is there anything you can do to prevent that call? If you get the call, wouldn’t you be happier if you knew that the injury was due to chance rather than a reason you or the school could have prevented? As a parent, let me answer that for you. YES. Accidents do happen but there are a few things that we can all do to prevent them or decrease their severity.

The following is a parent, coach and athlete prevention game plan before sports practice.

  1. Education – Concussions can have subtle signs and symptoms and athletes may not recognize it in themselves therefore reporting an injury is as critical. More over, having a few trained eyes on the game may improve the chance of early recognition and action. Concussions are not limited to football players. Women’s soccer is the second most likely school sport to cause a concussion. Dr. Alex Gometz, DPT at Concussion Management of Ayrsley Town Rehabilitation, recommends a simple and effective video that helps students and parents understand the basics of recognition and reporting. The most common signs and symptoms include but not limited to (headache, dizziness, ringing in ears, nausea/vomiting, blurry vision, weakness), emotional (depression, anxiety), cognitive (memory problems, focus problems) and sleep disturbances (insomnia, excessive sleepiness).
  2. Baseline neurocognitive tests – Make sure the athlete gets a baseline assessment. A baseline test refers to neurocognitive functioning in normal conditions before injury and provides a snapshot of the individuals brain functioning important for system comparisons should the athlete gets a concussion. It provides objective data, which improves our medical team’s decision-making ability regarding return to play while enhancing safety. They are important provided they are valid as recommended by Concussion Management of Ayrsley Town Rehabilitation “be weary of advice.
  3. Action Plan – Make sure your coach, trainer PE teacher, parents are aware of the typical signs and symptoms of concussions and that the institution, school or club has a policy for dealing with concussions. “Know who is responsible for responding to head injuries at the game….Know what the school or organization policy is regarding head injuries (what happens on game day and when can the child return to play in the event).”
  4. Know your athlete – Parents know the athletes better and know their pre-existing conditions that can put them at higher risks or can expose them to increased complications, for example, in the cases of Attention Deficit Hyperactivity Disorder (ADHD). Ensure that ADHD treatment is adequate to prevent impulsive or distracted performance. Children who have sustained a previous concussion are up to 6 times more likely to have a subsequent concussion. For children and teens that have suffered multiple concussions, ensure that they have seen a specialist and they are cleared for full contact activity. Poorly fitted shoes, braces or with orthopedic conditions may limit their balance, perception or confidence in the field and could be at higher risks for a fall. Lastly, if they are not feeling well their physical condition can be compromised. The pressure of an important game or practice may persuade an athlete to participate in a sport in less than optimal condition. Make sure the coach and or trainer is aware of any preexisting condition
  5. Adequate training and equipment – Strong body parts can withstand higher stress at less injury rate. Strength training for head, neck and shoulders helps delivering more precise control of their bodies, possibly lessening vulnerabilities that lead to more severe injury, and potentially decreasing concussion risk. Tackling technique in football must be taught from the start, and dangerous head-on methods discouraged immediately. Heading the ball appropriately in soccer has not been shown to cause concussion if done correctly. However, the amount of force associated with some direct head hit when the ball is traveling at high speeds or altitude may not be completely documented in the literature therefore some precautions should be in place in such events. Teaching correct heading techniques is therefore as important as kicking, dribbling and game strategy. Feel free to discuss with your coach or trainer any unusual practice or game activity. Check protective equipment. Outdated, and poorly maintained equipment can put your athlete at higher risk. Ensure that athletes have a current and highly rated helmet that also has an appropriate fit. Safe helmet systems go far to prevent a concussion. Players can obtain effective helmets that greatly decrease the force of the collision. There are helmet systems for most contact sports including soccer and lacrosse. Mouth guards are important for preventing oral trauma, and may also reduce the severity of a head trauma even though not clearly demonstrated in the literature and recent studies

Recommendations:

If you suspect a head injury or been advised that the student athlete had one, follow your emergency plan.

  1. Remove the youth from sports activity immediately. Missing one game or practice is better than missing weeks of participation.
  2. Make sure to visit your primary care physician or concussion expert early identified. The doctor who knows your child might also be able to detect differences that a parent missed.
  3. Repeat your neurocognitive test within the first 48 hours for comparison with baseline tests.
  4. Follow instructions including observation and symptom reporting for flawless management.
  5. Request from your concussions management specialist, a written report with recommendations for treatment, accommodations for school work and home specific to affected systems.
  6. Returning to sports is only safe if all symptoms have subsided and rehabilitation steps under exertion are executed before re-integration, when the vestibular system is affected, and must be provided by a licensed physical therapist with such knowledge. The symptoms and signs of concussion are physical, neurologic and neuropsychological and a multi faceted approach is key to its management and treatment. Contact Dr. Alex Gometz, DPT for management tips, assistance with a certified baseline test or to recommend another management team specialist including neurologist, pediatrician and neuropsychologist with experience in concussion management in Charlotte.