Henry Ford Health System
Awareness about the dangers of concussions is at an all-time high. In response, athletic organizations — from Pop Warner football (a nonprofit program for kids 5 to 16) to USA Hockey — have safe-play protocols in place. But misconceptions about injury — prevention, management and return to play — are still all too common.
"It's great that parents, coaches and athletes are focused on the potential for concussions, but they also need to be aware of the complexities involved in evaluating, diagnosing and managing concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.
The best way to get the knowledge you need? Learn how to separate fact from fiction.
Separating Concussion Fact From Fiction
Here’s the truth behind five common concussion myths:
Myth #1: Concussions are only caused by blows to the head.
Concussions happen in response to force. While they often result from a blow to the head, they can also occur after a hit to the neck, shoulders or anywhere else on the body. To cause brain injury, the force of the impact only needs to cause the head to move rapidly back and forth (think whiplash from a car crash or a spill down the stairs).
Myth #2: Concussions always involve a loss of consciousness.
A very small percentage of all concussions, 10 percent or less, result in a loss of consciousness. For the remaining injuries, parents, coaches and medical providers should watch for additional symptoms such as:
· Balance problems
· Slurred speech
· Physical complaints including headache, nausea and vomiting.
Myth #3: You should keep a person awake overnight after a concussion has occurred.
It's important to observe and interact with a recently concussed person for the first few hours to recognize the potential signs of a more serious injury. However, if they are interacting normally after four hours, it’s okay to let them sleep. If you have any doubts or questions, always err on the side of caution and seek medical attention.
Myth #4: After a concussion, kids should avoid digital media until they feel better.
Unless digital activities or screen time significantly worsen symptoms, there's no reason to avoid them. "You shouldn't force people who have suffered a concussion to rest too much — or deprive them of sensory input — if they are comfortable engaging in activity," Dr. Kutcher says. What’s more, taking away activities that bring a person joy or keep them socially connected could end up prolonging their recovery by creating additional symptoms.
Myth #5: All physical activity should be avoided after a concussion.
It’s important to rest for the first two to three days after a concussion. However, you need to be careful not to rest too much or avoid all activity for too long.
Engaging in physical, mental and social activities can be beneficial. But knowing how much to do and when to take it easy can be difficult. If you have any questions, consult a sports neurologist for specific recommendations.
Ground Rules for Concussion Prevention and Management
When it comes to preventing concussion, common sense offers the greatest impact, Dr. Kutcher notes. He recommends starting with these four tenets:
- Whenever possible, limit the amount of contact in practices and games.
- Wear proper fitting and certified helmets or other head protection whenever appropriate.
- Spread contact drills out over time as much as possible.
- Practice good technique and play by the rules.
Athletes — especially those who play contact sports — should undergo an annual neurological evaluation that includes a comprehensive, focused neurological history and examination. This information provides a critical point of reference for medical professionals.
Knowing the truth about concussions — including what to watch for and what to do if one occurs — is really the best game plan.
Dr. Jeffrey Kutcher is a sports neurologist at the Henry Ford Concussion and Sports Neurology Clinic and the global director of the Kutcher Clinic.
Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.
Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.
Macomb Lutheran North freshman Emiliana Manzo has already achieved a long list of accomplishments, including a 3.8 grade-point average while juggling two sports she loves.
As a point guard, she led her basketball team to an undefeated season in its division. She is also a center attacking midfielder, sometimes playing forward, on the 2009 Nationals Girls Academy Blue soccer team, ranked No. 1 in Michigan and 14th in the country.
In June of 2022, Emiliana hit a detour on her sports journey when she was participating in a club soccer national championship in Oceanside, Calif. With a few seconds left in the game and her team up 2-1, she ran 20 yards full speed to get to the ball. Hyperextending her left knee, she felt two pops. It was the first time she experienced an injury.
“I was screaming and crying and got taken off the field on a golf cart,” explains Emiliana. The trainer felt she was OK. Fortunately, she had the next day off and her knee was feeling better. The following day she played again, and 20 minutes into the game she knew there was an issue.
“Someone hit me from behind and I heard the pop again. I knew there was a problem.”
Emiliana’s father Vince Manzo said she experienced swelling, and the athletic trainer thought she may have a meniscus injury; however, she was able to continue to walk around during the championship in California before heading home.
Finding the Right Provider
Back in Michigan, Emiliana saw a few surgeons during her evaluation to seek treatment. When she met with Vasilios Bill Moutzouros, MD, chief of Sports Medicine at Henry Ford Health, she felt she met the right match.
“He treated me like an athlete and made me feel really comfortable,” she says.
Vince adds that both he and Emiliana were also appreciative of something Dr. Moutzouros said during her evaluation: “He emphasized to Emiliana that she was an athlete before this injury, and she would be an athlete after the injury.”
A detailed evaluation by Dr. Moutzouros revealed Emiliana had a complete anterior cruciate ligament (ACL) tear and medial and lateral meniscal tears. The meniscus, a C-shaped piece of tough, rubbery cartilage, acts as a shock absorber between the shinbone and the thighbone. It is one of the most common knee injuries. The ACL, one of the strong bands of tissue that help connect the thigh bone (femur) to the shinbone (tibia), is also prone to injury during sports when there are sudden stops or changes in direction.
Emiliana required physical therapy to get the swelling down and increase mobility before surgical repair.
Dr. Moutzouros reconstructed her ACL with her own patellar tendon graft and repaired her medial meniscus.
“She handled the surgery well and has been working very hard in her rehabilitation,” he says. “Her high-level soccer experience likely helped in her recovery as her range of motion and strengthening advanced so quickly.”
Understandably, Emiliana was nervous and scared when she went into surgery but expressed appreciation for the little things from Henry Ford like hearing “great music” as she was entering surgery, which gave her a sense of calm.
“That’s when I knew I picked the right doctor,” she said.
The Road to Recovery
As part of her recovery, after surgery which took place in July of 2022, Emiliana has undergone six months of physical therapy to increase mobility and strength training to get her leg strong again.
She also participated in the Return to Sport Program at the Henry Ford Center for Athletic Medicine to optimize recovery.
“We loved it,” says Vince. “It gave us peace of mind.”
Dr. Moutzouros explains that ACL prevention and rehabilitation programs are critical, especially for women because they have a four times greater risk of ACL tear than men. He says performance training post-surgery, along with an injury prevention program for those playing cutting sports, can markedly reduce the likelihood of future ACL injury.
“At Henry Ford, we work with physical therapists across the Midwest as well as our own. They do a great job in following our Henry Ford specific post-ACL reconstruction protocol,” he says. “After therapy runs its course, we strongly encourage our athletes to undergo performance training to allow a smooth transition back to sport.”
Nick Parkinson, supervisor of Athletic Training and Sports Performance at Henry Ford Health, emphasizes that the return to sport program is designed to bridge the gap between rehabilitation and returning to full activity in your chosen sport.
“Many times, insurance limits rehabilitation to regaining activities of daily living and not necessarily rebuilding the skills needed to play a sport or return to activity,” Nick says. “This program provides an affordable option to fill this need and return athletes to competition at the highest level.”
As for Emiliana, who hopes to play soccer in college and pursue a career in the medical field, she says this experience has taught her to not be afraid of injuries and treatment. She has also used the experience to volunteer for a program through the Girls Academy which serves as an advisory board to come up with ideas to help with mental and physical issues girls her age may be facing.
“For other kids who experience injuries, I’ve learned that this does not define you,” she said. “You can push through it, recover from it and be way better than you even were before.”
To find a sports medicine doctor or athletic trainer at Henry Ford, visit henryford.com/athletes.