Suspect a concussion? Follow the rules
Q: My son is playing high school sports. Can you explain why there is so much focus on concussions in his pre-participation paperwork?
A: Concussions are one of the more common injuries in high school sports, may not be properly treated because they do not present with obvious external signs, and can be associated with long-term problems. Additionally, kids’ brains will continue to develop until they are about 25 and a concussion can impede normal brain development. Because of these reasons, significant focus has been placed on educating athletes, parents and coaches on the prevention, recognition and proper treatment of concussions.
You may have noticed in your son’s paperwork that the NM Activities Association requires education and training to be completed before he may be cleared to participate in athletics. The NMAA is a nonprofit organization that regulates and supervises interscholastic middle and high school sports. This organization ensures that all athletes and coaches abide by Senate Bill 38 (SB38), Brain Injury Training for Student Athletes, that was signed into law in 2017. This law states that each year coaches, student athletes and parents must complete a certificate course, and sign a fact sheet on concussions and their management. It also reviews current return-to-play guidelines when a student has sustained a concussion.
What is a concussion? A concussion is a type of traumatic brain injury (TBI) caused by a biomechanical blow to the head or body that causes the head and brain to move rapidly back and forth, or in a twisting motion. This shearing motion causes stress to the cells in the brain, creating chemical imbalances that cause dysfunction. An athlete may look fine with no bruise or bump on the head, but a concussion can occur with no external signs. That is why it is so critical to understand the symptoms of concussion and how to treat it. Symptoms may include: headache or feeling of pressure in the head, change in vision, ringing in the ears, dizziness or balance problems, nausea or vomiting, sensitivity to light or noise, confusion, memory problems, emotional labil-
ity, feeling hazy or sluggish, incoherent or slow speech and appearing confused, and can be associated with a loss of consciousness. An athlete should immediately be removed from the sport or activity and seek medical attention.
Sports that carry a higher risk of concussion are football, soccer, lacrosse, basketball, hockey and cheer. It is estimated that a person’s lifetime prevalence of having a concussion is 20 percent, and the CDC reports that there are 3.8 million sports-related TBIs annually, most of those being concussions.
Once a concussion has been diagnosed, it is important to rest for two to three days without average or above-average stimuli (such as driving, screen time, homework). Try to avoid using ear buds and headphones. It is typical to miss a couple of days of school to allow for proper physical and mental rest. Acetaminophen or ibuprofen can be helpful for headaches for the first few days and is sometimes necessary to treat nausea and sleep problems, as well. Once a patient can tolerate 30-45 minutes of concentration without worsening symptoms, they are usually ready to return to school. They can start light activity, such as walking or bike riding, if their symptoms don’t return in the next 24-hour period. There are specific return-to-play criteria listed in SB38. Athletes:
1. Must be immediately removed from activity when any signs or symptoms of a concussion are present.
2. Must not return to full activity prior to a minimum of 240 hours (10 days).
3. Must be released by a medical professional to return to play.
4. Must follow the school district’s return-to-play guidelines.
5. Coaches are to continue to monitor for signs and symptoms of a concussion once the athlete has returned to activity.
Typical recovery is 2-4 weeks, but may take several months. Some students may require a 504 plan for school to enable them to have educational modifications while their concussion heals. It is critically important to avoid a second head injury before the first is completely healed as this can cause severe brain injury. Additionally, some athletes may quit their sport after sustaining three concussions due to the high risk of longterm and permanent brain damage (such as learning problems, depression and even suicide).
Prevention is best, but if your child gets a concussion, play by the rules!