The clash of helmets and repeated play-by-play body slams are seasonal signs that high school football is underway. Indiana was the first state in the nation to require concussion awareness training for high school and youth football coaches and to impose a 24-hour waiting period for players suspected of suffering a concussion. Despite the efforts, concussions still happen.
Jeffrey Smithers, MD, a physician with IU Health Southern Indiana Physicians Orthopedics and Sports Medicine, with practices in Bloomington and Bedford, is an expert in concussion-related injuries, working with Bedford North Lawrence High School as its sports physician.
What is a concussion?
“A concussion can occur when there is a blow to the head or body. The brain is floating in cerebrospinal fluid, much like water, inside the skull. When there is a blow to the head or body, the brain bumps against the skull,” which may result in a concussion, or temporary functional brain injury, sometimes described as a “bruise” to the brain, Dr. Smithers says.
What are the signs of concussion?
If a student develops a concussion while playing a sport, symptoms and signs usually appear rapidly and are often recognizable by a trained health professional, such as an onsite trainer. Otherwise, it’s incumbent on friends and family to watch the athlete for symptoms and signs of possible concussion, including but not limited to: headache, dizziness, difficulty concentrating, memory problems, fatigue or confusion.
Something’s not right. Now what?
“Not every concussion is an emergency room event,” Dr. Smithers says, noting that each case should be treated individually, and an MRI or CT scan is not usually necessary for routine concussions. However, timely guidance from your primary care physician or other specialist trained in treatment of head injury is key for appropriate management and is advisable in all cases.
Is this myth or fact?
It’s sometimes said that someone with a concussion who falls asleep may never wake up. Is it true? Dr. Smithers says that in rare cases of more severe head injury beyond a concussion, including a brain bleed, signs may not be present immediately. He suggests closely watching an injured athlete within the first couple hours after the injury. If the athlete had loss of consciousness for more than 30 seconds or develops prolonged or worsening altered mental status, severe headache, focal neurologic deficits, or seizure, these are clues that an athlete may have had a more serious injury and that immediate medical attention is necessary.
How severe is it and how long will it take my child to recover?
Oddly enough, it isn’t until the child heals that the severity of the concussion is known, Dr. Smithers says, but notes that symptoms in 85-90 percent of concussions resolve within 10 days. He says recovery time is variable but is generally longer in younger athletes. There is considerable concern that repeat injury can lead to prolonged or permanent symptoms, cognitive deficiencies and even more severe outcomes. This has led to legislation requiring a 24-hour waiting period for suspected concussion and the push for appropriate cognitive treatment and physical rest until full clinical recovery occurs.
My child wants to play football. How can I protect my child from injury?
Dr. Smithers says that changes to sports rules and techniques to reduce head injuries are among the best preventative measures for concussions. Properly fitting equipment, including a helmet for football, is important for overall sport safety. Additionally, coaches are reinforcing Heads Up Football, a 2012 piloted program touting new standards in the game. The program focuses on properly-fitted equipment, good hydration, concussion awareness and heads-up tackling.
Featured IU Health Southern Indiana Physicians provider seeing patients for concussions and other sports injuries:
Jeffrey Smithers, MD