From headaches to dizziness to cognitive dysfunction and memory loss, the issue of concussions among elite athletes is real —and one reason many states, including Utah, have worked hard to create concussion awareness programs designed to improve safety for players, said Mike Henrie, D.O., a sports medicine physician at University of Utah Health Care.
Concussions are a traumatic brain injury caused by a blow or jolt to the head that causes the soft tissue of the brain to knock against the skull's bony surface. Although they range from mild to severe, they're all serious injuries that can harm the way the brain works. For many of these injuries, the athletes never lose consciousness yet still suffer significant damage. Concussions can happen to anyone participating in any sport, or in simple daily activities in some cases (falling off the monkey bars during recess, for example).
The short-term effects of a concussion can generate additional problems that may plague a person through life. When young athletes have a flawed memory, they can have difficulty concentrating in school, relating to other kids, or sleeping well, and these things can have long-term, devastating consequences.
Many athletes can be hesitant to speak up to coaches after taking a hit to the head, not wanting to let down the team or miss a minute of an important game. But it's better to miss one game than a whole season —or longer—due to a brain injury, said Greg Hawryluk, M.D, a neurosurgeon and traumatic brain injury specialist at University of Utah Health Care's Clinical Neurosciences Center.
In cases where athletes go back to the game before they fully recover from a concussion, even a mild blow can cause second-impact syndrome. That can lead to brain swelling, brain damage, and less commonly, in death. Statistics also show that athletes with a history of concussion are at six times greater risk for another concussion than an athlete with no prior concussion.
"There have been famous instances where young football players returned to play and died after a second blow to the head," said Hawryluk. "That's why education and awareness about concussion is so important – because there's so much more at stake than winning a game. Brain damage can't be undone. It is critical that concussed athletes see a physician with expertise in concussion so that they can work towards a safe return to play."
Knowing the warning signs of a concussion is the first step to getting an athlete on the road to recovery, said Henrie.
"The most common complaint that we hear after a concussion has occurred is 'I just don't feel right. Or I feel foggy or cloudy,'" said Henrie. "The coaches know these kids, the referees know them. If someone gets hit and they run to the other sideline (in confusion), it's a sign that a concussion may have occurred."
Sometimes, Henrie cautions, the warning signs can be less obvious at first and hours later an athlete may complain of a headache or dizziness. Sensitivity to light and nausea and also be signs of trouble, he said.
In Utah, policy makers including the Utah High School Activities Association have advocated for the importance of a concussions awareness curriculum designed to make athletes, parents, coaches and referees more aware of the signs of concussion and how to react appropriately when a child is injured on the field.
Laws passed in 2011 require amateur youth sport organizations to adopt and enforce a concussion policy as well as educate parents and athletes about concussions. Athletes suspected of sustaining a concussion now need to be immediately removed from play and not allowed to return until medically cleared by a health care provider.
The University of Utah is home to a sports concussion program that works with area high schools as part of an outreach mission to better educate coaches and parents on the new laws and how to enforce them. The program this month is launching a new video on concussion awareness, available here.
The video is designed to help young athletes, coaches and parents understand that concussions should be taken seriously.
"Your health is of utmost importance to us," said David Petron, M.D., an associate professor at University of Utah Health Care's Department of Orthopaedics and team physician for University of Utah Athletics.
"We care about you as an athlete, but ultimately we care more about you as an individual and both your long and short-term health."
The video comes at a time when the ramifications of concussions are frequently found in the headlines.
Last year, a group of NFL players won a historic lawsuit filed against the league claiming being tackled day after day resulted in head trauma. Approximately 4,500 of those players took their cases to court, suing the NFL for failing to disclose proper information about the long-term effects of repetitive head trauma. A $765 million settlement was awarded to players who have suffered effects of repetitive head injuries, and also to families of players who died and were diagnosed with chronic traumatic encephalopathy (CTE), a progressive degenerative disease sometimes found in people who suffered multiple concussions.
Concussions in soccer took center stage at the 2014 World Cup, when a handful of players were removed from the field after knocks to the head over several weeks, including Germany's Christoph Kramer in the final match last month.
And the topic of concussions even gained notice from President Barack Obama, who organized a one-day summit at the White House in May devoted to research on youth concussions.
Henrie noted that all concussions can be serious —from those football players incur from a tackle to those that come from a simple bump on the head in situations like hitting one's head on a shelf while climbing a ladder.
Most recoveries involve rest and time away from athletics, but in some cases different treatment options are required, said Henrie.
"Generally speaking, it's pretty uncommon that any intervention beyond cognitive and physical rest needs to be done," he said. "But a discussion with a health care provider is important to make sure a proper course of treatment is developed if necessary."
Melinda Rogers is a communications specialist at University of Utah Health Care. She can be reached at firstname.lastname@example.org or on Twitter: mrogers_utah.
Think the young athlete in your family has a concussion? The University of Utah's sports medicine program can help you on the road to recovery.