August 13, 2013

VUMC concussion expert says ‘When in doubt, sit them out’


As sports practices have resumed for the fall, physicians at the Vanderbilt Sports Concussion Center (VSCC) are already treating young athletes with concussions. They urge coaches and parents to know the warning signs of a concussion and not let athletes return to play until they have been cleared by a health care professional.

“It is critical to know the signs and symptoms of a concussion. Having a repeat concussion before the brain fully recovers can be dangerous. Catastrophic outcomes can be prevented if parents and coaches are cognizant of the signs and symptoms, the players and their condition,” said Gary Solomon, Ph.D., a concussion expert and co-director of VSCC.

A concussion is a type of traumatic brain injury caused by a bump, blow or jolt to the head that can change the way the brain normally works. Young athletes are more susceptible to the effects of a concussion because their brains are still developing.

According to the American Association of Neurological Surgeons, sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents.  The Centers for Disease Control and Prevention (CDC) estimates that at least 300,000 sport-related concussions occur annually in the United States.

“It is important to remember that most concussions happen without a loss of consciousness,” Solomon said. “When I was playing sports we called it ‘getting your bell rung,’ but that is actually a concussion.”

Solomon said no player with a suspected concussion should return to play that day.

“When in doubt, sit them out. That’s the mantra,” he said.

Concussions can occur in any sport, so all athletes, coaches and parents should know concussion signs and symptoms and have an action plan if a concussion occurs.

Concussion signs and symptoms:

  • Headache
  • Pressure in the head
  • Neck pain
  • Nausea or vomiting
  • Dizziness
  • Blurred vision
  • Balance problems
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling slowed down
  • Feeling like “in a fog”
  • “Don’t feel right”
  • Difficulty concentrating
  • Difficulty remembering
  • Fatigue or low energy
  • Confusion
  • Drowsiness
  • Trouble falling asleep
  • More emotional
  • Irritability
  • Sadness
  • Nervous or Anxious

What to do if you suspect a concussion:

  • Remove the athlete from play.
  • Do not let the athlete return to play, even if they insist they feel fine.
  • Have the athlete evaluated by a health care professional experienced in evaluating concussions.

Most concussion symptoms resolve within a relatively short period of time, but some take months to recover. Once athletes have been cleared to return to activity by a medical provider, they should follow a stepwise progression to activity, gradually adding in more strenuous exercise.

Solomon also recommends athletes have pre-concussion baseline testing every two years. The 20-minute computerized test measures factors including reaction time, memory and attention span. After a concussion, athletes can retake the test to evaluate if they have recovered to baseline.

VSCC offers baseline testing to all community athletes at three locations around Middle Tennessee. Out-of-pocket cost is $50 for the test (which also includes a neurological history and a balance examination), and it can be scheduled through the VSCC hotline at 875-VSCC.