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New research suggests that athletes who are too active after a concussion — not just on the field but also at home or school — may be hindering their recovery.
And (oddly) female athletes may take longer to recover than males.
Government estimates suggest that there are between 1.6 million to 3.8 million sports- and recreation-related concussions each year
Growing evidence is showing that healing from concussion, a common sports injury, is more complicated than once thought. Experts are warning parents and education professionals as school sports programs gear up for fall.
Lauran Neergard’s article from the Associated Press quotes Kevin Guskiewisz, an athletic trainer who chairs the sports science department at the University of North Carolina: “No two concussions are the same. We need to be cautious with what we’re allowing someone to do, and at what point in their recovery they’re allowed to do it.”
Since concussions are brain injuries, they are among the most difficult of sports injuries. It’s problematic even identifying who’s had one. Many athletes never even lose consciousness, which is the obvious symptom, and the one always looked for.
And brain scans can’t diagnose a concussion; other symptoms may also not be apparent right away; players sometimes hide or minimize them. They say they’re feeling okay, and beg to be put back in the game.
There are grave risks to doing so. A second concussion before recovering from the first one can cause brain swelling that can trigger permanent damage — even death.
There is mounting evidence from studies of retired professional athletes that those who suffered multiple concussions over the years may be at increased risk for depression, memory problems and other neurological problems later in life.
The worry isn’t just another bump: an injured brain undergoes metabolic changes that affect its energy levels, meaning physical and mental exertion might add more strain.
The good news is that awareness is growing among college and professional athletes. Reports of concussions have risen 10 percent in the last three years, meaning not that more are occurring but that more victims are seeking care.
But the question that remains is how much time is needed to heal; how much activity is okay.
Researchers at the University of Pittsburgh and one of Guskiewisz’s colleagues tracked 95 high school athletes evaluated in a university-based program. They gave a battery of memory, reaction time and other cognitive tests up to a month after the athlete suffered a concussion.
Patients were grouped by activities recorded in their medical records: “no school,” “some schoolwork but no other activity,” “moderate activity,” “moderate activity plus sports practice,” or “schoolwork with some sports.”
The best recovery scores were for those with moderate activity, researchers reported in the Journal of Athletic Training. More active patients scored much worse, and of those more active patients, even those thought to have suffered “mild” concussions ultimately performed as poorly as athletes diagnosed with serious injury.
Guskiewisz says the goal is “to keep the brain stimulaed, but not enough to push it into overdrive.”
Regarding female athletes: another Pittsburgh study of 234 soccer players found that two weeks after their injuries female patients scored worse on some brain-function tests than similarly injured males. Size differences didn’t explain it, and alternate explanations did not present themselves. The gender question is being explored. Dr. Alexis Chang Colvin urges coaches and athletes to be aware that female players may need a little extra time to recover.
Professional and college athletes — but not high school — are increasingly being given preseason tests of memory and other cognitive skills. After a concussion, retesting can help athletic trainers determine when athletes are ready to return to play. Currently, Ohio State University is analyzing the only national study of high school injuries.
So — what to do? Who to turn to? A government campaign and concussion specialists urge that:
- parents, players and coaches know the symptoms — from immediate signs, such as being dazed, amnesia, moving slowly or clumsily, to later symptoms such as dizziness, sleep problems, irritability and concentration problems.
- athletes don’t return to play until cleared by a health professional.
- appropriate health officials be on site to assess concussion whether it’s Pop Warner football or soccer or high school teams.
Young players must be taught the seriousness of the problem, and that’s the challenge, says Ohio State injury specialist Dawn Comstock.
“It’s difficult for them to realize this one game Friday night is not as important as my cognitive ability the rest of my life.”
For a resource on the Net you will find government concussion info at: http://cdc.gov/ConcussioninYouthSports/default.htm
adapted from article on the AP by Lauran Neergaard on 8/11/08.
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