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Concussions: Recognizing the symptoms

Concussions have become an increasingly hot topic in the media, from the new movie "Concussion" with Will Smith to pre-game concussion talk every NFL Sunday. It is important, above all things, that the symptoms for concussions are recognized in order to keep our youth safe due adolescents being at an increased risk. Up to 3.8 million concussions occur annually in the United States, and the numbers are increasing in part due to increased awareness from coaches, parents, and medical providers.

According to the CDC a concussion is defined as a traumatic injury to the brain, as a result of a violent blow, shaking, or spinning. A brain concussion can cause immediate but temporary impairment of brain functions, such as thinking, vision, equilibrium, and consciousness. A person suffering from a concussion can experience up to 50 different symptoms including headache, fogginess, blurred vision, and dizziness. These symptoms can also be prolonged in rare cases lasting over a month in which rehab would be beneficial for these patients. However 85-90% of concussions show signs of recovery within the first 7-10 days, and early identification of impairment aids in return to activity/sport without prolonged sequelae. If needed, symptoms are ideally treated by a team of medical professionals including athletic trainer, doctor, vestibular therapist (PT/OT), neurologist, and vision therapist.

Adolescents are at a higher risk due to their "developing brain" and typically have prolonged recovery periods from concussions. Many kids also have increased likelihood of experiencing a concussion due to their exposure possible collisions in play and especially in sport. In equal sports, women are more likely than men to experience a concussion. Therefore, women playing soccer experience concussions at a higher rate than men playing soccer. Different sports also have increased incidence of concussion "per exposure." An exposure is defined as a practice or game where the athlete is at risk to experience a concussion.

Sport Rates (Per 10,000 "exposures")
Men's Wrestling 10.92
Men's Football 6.71
Women's Soccer 6.31
Women's Basketball 5.95
Men's Basketball 3.89
Women's Volleyball 3.57
*Rates from APTA website, October 2015 (rates from 2009-2014 academic years)

The next step after a student, or student athlete, has a concussion is return to school and return to the sport or activity. It is important for the athlete to maintain symptom free in order to return to the sport. The newest research suggests that prolonged rest of 5 days is not as effective as a 24-48 hour rest period and then return to school. When returning to school it is best to notify teachers, attempt half days, receive packaged notes to decrease screen time, and have no participation in any video games. New research on return to play protocol includes five steps that the athlete must complete without having any concussion related symptoms. The five steps include stationary bike riding, light activity, sport specific non-contact drills, return to non-contact practice drills, and full contact practice with no restrictions. These activities can be guided by your local physical therapist to ensure a safe return to sport to decrease further injury risk.

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