SPRINGFIELD – Football season is right around the corner for both the pros and student athletes, and you know what that means. Concussions and their debilitating effects – which have received plenty of attention lately, especially in the NFL and increasingly in youth sports – will be back in the media spotlight.
“We see a lot of concussions very early into the practice season when some student athletes are out of shape,” said Dr. Julio Martinez-Silvestrini, staff physiatrist and a board certified sports medicine specialist at Baystate Physical Medicine and Rehabilitation. “If an athlete is not really fit for the particular sport he or she is playing, the risk of concussions and other injuries is higher.”
But, while football may see most of the publicity when the topic of sports concussions makes the news, other team sports such as basketball and soccer are likely to lead to injury and concussions, as well as bicycling and playground activities.
A concussion is a head injury that occurs with or without the loss of consciousness and changes how the cells in the brain normally function. Concussions – most often caused by a blow to the head or body that causes the brain to move rapidly inside the skull – may result in headaches, dizziness or balance problems, nausea or vomiting, confusion, blurry vision, sensitivity to light and noise, feeling “foggy,” and a variety of other symptoms. Children and teens are more likely to get a concussion, and take longer to recover, than adults.
“These symptoms can be prolonged and long lasting for some. Concussions, especially those that go undiagnosed, can also affect a student-athlete’s academic performance, who might be having trouble sleeping at night and is tired in school, and may be unable to concentrate and have memory problems,”, said Dr. Martinez- Silvestrini, who sees injured athletes in Baystate Medical Center’s Sports Concussions Clinic. According to a report released by the Centers for Disease Control and Prevention (CDC) last October, emergency room visits by children and adolescents for brain injuries jumped more than 60 percent over an eight-year period from 153,375 in 2001 to 248,418 in 2009.
The CDC cited part of the reason for increased visits to the emergency department as a “growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected concussion to be seen by a health care professional.” Various laws being put into place around the country, including Massachusetts, to protect student athletes are also making a difference.
Two years ago on July 8, 2010, Massachusetts adopted a “get tough” policy when it comes to concussions, when Gov. Deval Patrick signed the Commonwealth’s youth sports safety law which states that student-athletes and their parents, coaches, athletic directors, school nurses and physicians must learn about the consequences of head injuries and concussions by participating in annual concussion education. The law also requires that student athletes and their parents inform their coaches prior to the beginning of the season about any past head injuries. Even more important, noted Dr. Martinez-Silvestrini, is the fact that any youth who is injured and becomes unconscious, or is suspected of having a concussion during play or practice, must be taken out of the activity immediately. And, no “return to play” will be allowed without a written clearance from a licensed medial professional.
“I really believe a lack of awareness, especially of the serious, long-term, permanent damage just a single brain injury can cause, is to blame. But, you cannot point the finger at any one person whether coach, parent or student. There are many forces that come into play today, chief of which is the desire to win at all costs resulting in pressure from some coaches and parents to play through an injury,” said
Dr. Martinez-Silvestrini, who also noted an athlete’s own reluctance to admit injury.
The Baystate physiatrist noted the new state law has helped in some respects, especially since it requires these truly injured athletes to get the care their need.
“Yet, we are still seeing athletes coming into our clinic. I can’t stress enough the importance of taking a player out of the game immediately, whether football, soccer or other sport, if there is any suspicion of a concussion,” he added.
According to Dr. Martinez-Silvestrini, an undiagnosed concussion followed by a repeat injury before the brain heals can slow recovery and lead to long-term problems such as memory loss, psychological problems, brain damage and may be a risk factor for developing ALS or even Parkinsonian syndromes.
When it comes to preventing concussions, especially on the football field, wearing a helmet is essential, but not foolproof in protecting athletes.
“Most helmets will prevent very serious injuries such as skull fractures, but minor concussions may still happen, even if the player is not hit directly in the head. While there have been little steps in the right direction, we still haven’t seen big advances in developing even safer protective equipment to help prevent injuries,” said Dr. Martinez-Silvestrini.
“Prevention is also about good sportsmanship, such as not engaging in the dangerous practice of giving your opponent a headbutt on the football field, which can result in a concussion or neck injury. All athletes must be taught safe playing techniques, such as how to tackle somebody in football or how to hit the ball in soccer, and coaches must insist that their players follow the rules of the game,” he added.
Dr. Martinez-Silvestrini cautioned against coaches attempting to make their own diagnosis of a concussion, and leaving it to trained medical experts who have a number of tools such as SCAT2– a standardized method used by medical and health professionals in the evaluation of injured athletes for concussions.
However, the CDC has created a free online concussion training course for coaches called “Heads Up” that provides important information on preventing, recognizing, and responding to a concussion. The special concussion training program – which is also geared to parents and athletes, can be accessed by visiting www.cdc.gov/concussion.
Baystate Medical Center’s Sports Concussion Clinic offers a comprehensive program modeled after the pioneering University of Pittsburgh Sports Concussion Program. The clinic evaluates and treats injured athletes through a multi-disciplinary program involving neuropsychology, physiatry, and rehabilitation care at the hospital.
The clinic utilizes the ImPACT™ test employed by all major professional sports leagues, division I colleges, and many high schools, as part of its evaluation and management protocol. Dr. Zachary Marowitz, the clinic’s neuropsychologist, is a Certified ImPACT™ Consulant.
To schedule an appointment at the clinic, call 413-794-5555, or for more information, visit baystatehealth.org/sportsconcussion.
