Concussion rates on the rise, athletes risking health

Credit: Mikael Haggstrom via Wikimedia Commons Credit: Mikael Haggstrom via Wikimedia Commons

Concussions and concussion awareness are by far the most popular topics in sports medicine right now. In the last decade, there has been a large shift in the culture and attitude surrounding concussions and their treatment. Many high-profile sports injuries involving concussions have brought this injury to the center of attention, and with good reason: the Center for Disease Control and Prevention estimates that up to 3.8 million Americans suffer concussions as a result of accidents and sports activities every year, and the amount of concussions in the NFL rose 32 percent from 2014 to 2015. This massive increase in concussion rates has prompted large-scale discussion on the dangers of concussions. A recent movie titled Concussion details a narrative of an NFL player that experiences significant mental deterioration as a result of multiple untreated concussions. The impact of this injury on athletes has come to the forefront of the sports medicine discussion, and scientists have only cracked the surface.
Concussions sustained while playing football have been shown to be the cause of a disorder called chronic traumatic encephalopathy or CTE, which is known to lead to suicide and mentally debilitating symptoms after retirement from the NFL. For years, the NFL denied that there were long-term consequences to the frequent head trauma undergone by football players. Efforts to bring awareness to the subject began in 1994, but it wasn’t until 2014, when a study announced that in 79 autopsies of former NFL players, 76 of the them were diagnosed with CTE.

The NFL has come into many legal issues with concussions as well. In 2012, Kansas City Chiefs player Jovan Belcher shot and killed his fiancee before committing suicide in the parking lot of the Chiefs stadium. The team is being sued by the family of Belcher in a wrongful death lawsuit, claiming that the Chiefs ignored Belcher’s cries for help because of concussion-like symptoms. In 2013, five former Kansas City Chiefs players filed a lawsuit against the team, wishing to know just how much the team knew about concussions, and when they had that knowledge. The players felt they did not receive adequate treatment and thought they had the right to know that continuing to play football would put them at severe risk for disability later in life. The consequences of an untreated concussion are not to be ignored, and can potentially be fatal.

So then what is there to know about how this dangerous brain injury works, and what exactly is it? A concussion is usually a short-term brain injury caused by a jolt or sudden impact to the head, and can result in mild disturbance of brain function, usually without loss of consciousness. More rarely, concussions can cause brain swelling and permanent injury.

Symptoms of concussions include headache, dizziness, nausea, neck discomfort, difficulty thinking clearly, trouble focusing, and disturbed sleep patterns. Severe cases can include persistent vomiting, disorientation, unequal pupils, and partial or full loss of consciousness. If a person exhibits any of these symptoms, it is imperative that they receive an immediate and thorough evaluation of their symptoms by a qualified healthcare provider experienced in concussion evaluation. Without timely diagnosis and treatment, a mild concussion can potentially cause more serious complications including further brain trauma or a prolonged recovery. When treated, patients receive a standard set of instructions to manage the injury, including mental and physical rest. Generally, any activity that provokes the symptoms of the concussion should be completely avoided so as not to prolong recovery. These activities can include reading, texting, watching TV or playing video games, and physical activity. School and the work associated with it can also worsen symptoms, and accommodations are often made for students with concussions, such as increased time for assignments or test taking.

Most concussion patients return to sports or regular physical activities within three weeks after their symptoms begin. For athletes, the patient should be without symptoms for a full twenty-four hours before beginning physical activity. Once the patient has been without symptoms for a day, they begin a multi-phase progression of physical activity that may take several days if the patient has symptoms that return with increased physical activity. All athletes who sustain a concussion must pass an evaluation with specific criteria before returning to play, including final authorization from a healthcare provider that the patient is completely without symptoms.

Traditionally, athletes that play contact sports such as football, hockey, and lacrosse are at higher risk for concussions, though the majority of these injuries are a result of falls or motor vehicle accidents by non-athletes. Young athletes in particular are at a higher risk of concussion and take longer to recover than adults because their brains and bodies are still developing.
The frequency of this injury among young athletes around the country, as well as in professional athletes means that something must be done to protect the brains of these players. What needs to be looked at is exactly why concussion rates have risen so sharply in recent years, and how we can create an environment that will put young athletes at a much lower risk of serious brain damage due to contact sports. But for now, the important thing to remember is that if you experience these symptoms, or see someone experiencing these symptoms after a head injury or physical activity with contact, get them to a qualified healthcare provider immediately for an evaluation. Even a mild concussion left unchecked can result in serious brain damage. Simply knowing the signs can save someone’s mind.