According to the Center for Disease Control and Prevention, there are approximately 1.6 to 3.8 million sports- and recreation-related cases of mild traumatic brain injury (MTBI) or concussions in the United States each year. New attention regarding the evaluation, management, and prevention of these injuries has greatly increased awareness of the problems associated with concussions. Media reports tend to highlight the worst-case scenarios and oftentimes provide dramatic examples that draw attention away from the positive recovery trajectories that typically occur after these injuries.
A concussion is best defined as a mild traumatic brain injury as a result of a blow to the head or body which causes the brain to move rapidly within the skull. This injury causes alterations in brain function due to physiologic and chemical changes in the brain, which can result in a variety of symptoms such as a brief loss of consciousness, headache, nausea/vomiting, dizziness, vision changes, light/sound sensitivity, loss of balance, mood/personality changes, poor concentration or mental slowness, lethargy, and changes in sleep patterns. Not all symptoms will be present after a concussion, and it is important to note that only 10 percent of persons with a concussion experience a loss of consciousness. The signs and symptoms of a concussion can vary in terms of severity and duration, but for most individuals a gradual pattern of recovery is noted over a period of several weeks to two to three months. Research shows that most people (95 percent or more) fully recover from uncomplicated concussions in three months or less (McCrea, 2008 – Mild Traumatic Brain Injury and Post-concussion Syndrome, Oxford Press, New York).
The key to successful recovery is proper management, including a brief period of rest followed by a gradual return to activities as symptoms improve. Health care providers, such as physicians or neuropsychologists, trained in the evaluation and management of concussion can be very helpful in determining the best recovery/rehabilitation treatment for individuals who sustain a concussion. Early intervention is important so that appropriate education, support, and medical/rehabilitation interventions can be provided as needed. No athlete should return to athletic activities until he/she has fully recovered from a concussion. Returning to play prior to complete recovery increases the chances for prolonged post-concussive symptoms and additional, possibly catastrophic, injury.
Prevention of concussions is an important step in reducing the frequency and severity of injuries. While no product has been developed that will eliminate the risk of concussion in sports, the use of certified helmets in football, lacrosse, hockey and other sports is vital. In addition, teaching and coaching proper tackling, checking, heading and other contact activities is crucial, along with general fitness training. Education and training for coaches, athletic trainers, athletes and parents for all age levels helps in the early identification of potential risk factors and injuries on the field.