Health & Safety Resources

INNOVATIVE PROACTIVE APPROACH TACKLES SPORTS-RELATED CONCUSSIONS

Sports often move at a fast and furious pace. In the pursuit of winning, accidents invariably happen. One of the most serious and common accidents is a brain concussion, which can occur during soccer, football, wrestling, hockey and other contact sports. About 15 percent of high school athletes involved in contact sports experience a concussion every year.   

Too often coaches, parents and health care professionals do not realize the seriousness of a concussion.  Terms such as “ding” and “bell rung” show that too often concussions are not afforded the concern they deserve and thus the care that they need.  This is because, generally, the longer term symptoms or effects are hard to detect or can be hidden by the athlete.  There is often no obvious sign of a concussion akin to the limp from a sprained ankle to alert caregivers that there is something wrong with a player.  Additionally, most people do not understand that there may be long term consequences if a concussion is not managed properly.  In fact, sustaining a second concussion before recovering from the first concussion can lead to more devastating impairments. High school coaches need to understand that the brain is not fully developed until the early 20’s.  Research has shown that high school athletes are more susceptible to the effects of concussion and take longer to recover from them.  Also, athletes with a history of multiple concussions (three or more) may be more likely to sustain a concussion and have a more complicated course of recovery. 

Prevention 

Symptoms

The signs of a concussion may exhibit one or several of the following symptoms: altered or varying levels of consciousness, balance problems, memory and concentration difficulties, irritability or personality changes and self-reported symptoms, such as headache, blurred/double vision, sensitivity to light and sound, ringing in the ears and nausea.

For athletes playing sports with a high risk of concussion, baseline cognitive testing is recommended. Baseline cognitive testing, such as the ImPACT program (see below), is the most reliable and validated method to diagnose and assist in treatment of concussions.  Neurological examinations and neuroimaging techniques (e.g., CT and MRI of the brain) are insensitive in detecting common sports concussions.

Monitoring the severity, duration and progression of symptoms is vital.  The duration of symptoms may help determine the severity of the concussion and it is possible that symptoms may appear or worsen over hours or days.  Record the time of the concussion.  Monitor vital signs, level of consciousness and other symptoms every 5 minutes after a concussion until the athlete’s condition improves. The athlete should also be monitored over the next few days after the injury for the presence of delayed signs and symptoms and to assess recovery.

Care

Decisions regarding return to play after a concussion should be made in consultation with the athlete’s physician, a neuropsychologist, your team’s athletic trainer, the athlete and his or her family.  For the safest outcome return to sport is based on clinical symptoms and neuropsychological testing. 

There are many guidelines for the care of concussed athletes.  The most accepted guidelines recommend that athletes who display any symptoms (including headache) at rest or after exertion 15 minutes after the initial concussion should be disqualified from returning to participation on the day of the injury.  The safest course of care is to disqualify all concussed athletes from participation until they have received neuropsychological testing and have been cleared by the athlete’s physician in consultation with the neuropsychologist.

Athletes who experience loss of consciousness or amnesia should be disqualified from participating and referred to a physician.

An athlete with a suspected concussion should be instructed to avoid taking medications, unless they are prescribed by a physician.

ImPACT Program 

As team physicians for the Detroit Tigers, Lions, and area high schools, Henry Ford is well known for its athletic medicine expertise.  

To address the special needs of these athletes, Henry Ford has developed a Sports Concussion Safety Program that can be tailored to an individual player or an entire team at the high school, college or professional level. This program is the only one of its kind in the Metro Detroit area. 

The Sports Concussion Safety Program begins with a baseline evaluation of three key cognitive functions (memory, reaction time, and speed of thinking) and level of symptoms using innovative software known as ImPACT. In the event of a suspected concussion, the player is retested. These baseline and post-injury tests are used for diagnosis, treatment and to determine when it’s safe for the player to return to the game. Testing is fast and convenient and can be administered in a group setting at the school or training camp. The program has been used at all levels of competitive athletics. Also, testing will be available on-line through www.henryford.com/concussion in September. 

“ImPACT testing is the most sensitive technique to determine when one fully recovers from a concussion. This minimizes the risk of the player receiving a second concussion before recovering from the first” said Kenneth Podell, Ph.D., ABPN a neuropsychologist and director of the program.  

Concussions can have wide-ranging injuries and effects, impacting scholastic and social relationships as well as athletic participation.  These issues are managed by Dr. Podell, sports medicine physicians, and athletic trainers at Henry Ford. They work as a team to establish a diagnosis, treat related injuries (such as whiplash and migraine headaches), tailor a rehabilitation program, and decide upon return to play.  Clinicians also conduct concussion research to look for new and improved ways of treating head injuries. 

For more information or to schedule a same-day appointment for an evaluation, please call 313.876.2526, visit our web site, www.henryford.com/concussion, or e-mail Dr. Podell at KPODELL1@HFHS.org.

Henry Ford Health System’s Center for Athletic Medicine offers a comprehensive approach to sports medicine, including surgical and non-surgical care, sports rehabilitation, injury prevention, and performance enhancement programs.  The HFHS treatment team includes sports medicine fellowship trained orthopedic surgeons, sports medicine fellowship trained primary care physicians, as well as certified athletic trainers and physical therapists.  These health care professionals are supported by the HFHS nationally recognized bone and joint research facility, including the prestigious Herrick Davis Motion Analysis Lab.  HFHS is proud to be health care providers to the Detroit area’s premier sports programs including professional, collegiate, and high school athletes.