Managing Concussions: An ever-changing science

The NFL Draft is this week, which means my favorite part of the NFL season is about to happen- everyone booing Roger Goodell!  Should I be so excited about that? Probably not, I just have not been a fan of many of the choices he has made as the NFL Commissioner, especially when it comes down to his involvement of hiding research about traumatic brain injuries and football.  But that's a whole different topic...

We do have some interesting research coming out about concussions though.  Now with the eyes of the world watching the NFL and other sports on how they handle head injuries, it's really important that we pass on this information to the collegiate, high school, and adolescent sporting communities.  I want to spend some time talking about how to manage a concussion and some of the misconceptions about head injuries.

1. Not every doctor or athletic trainer is qualified to diagnose or manage a concussion.

This is both from a training and legal standpoint.  First, let's discuss training.  Medical doctors (MDs), regardless of their speciality or training, are allowed to diagnose and sign off on return to play.  That means your general physician, who probably has not had a neurology course since med school, can dictate how a concussion is treated.  Not I am not saying that you should not go to your GP for a head injury, but it is important to know if you medical professional knows what the latest consensus says about head injuries (FYI, it is the 2016 Berlin Consensus, we should be expecting another one this year in 2018).

Last year, the consensus released the SCAT5, which should be the guideline for sideline assessments at a sporting event.  If your trainer is using a SCAT3, I would kindly suggest asking them to updated their repertoire.

2. You have to be hit in the head to have a concussion

This is EXTREMELY false.  Many concussions happen from blows to the neck or upper body.  Direct head contact is not required to be considered a head injury.  The force of the neck whipping can send the brain into an acceleration-deceleration vector and cause concussion-like symptoms.  

3. I didn't lose consciousness, so I didn't have a concussion

Another gross misconception.  Loss of consciousness (LOC) is not a requirement to be diagnosed with a concussion.  In fact, a majority of concussions do not have LOC as one of the symptoms; however, LOC is a very important symptom of a possible traumatic brain injury and should be treated very seriously.  Parents, you can go to our Forms Page and download the Concussion Recognition Tool version 5 to have available and if your child has any of those symptoms during or after a sporting event, get them checked out by a medical professional.

4. There is nothing that can be done about a concussion except time

Not exactly true.  While we don't have any definitive research to support an exact treatment on concussions, there is a lot of evidence showing the efficacy of multiple different types of treatment.  New research actually shows that returning to aerobic activity sooner can have a positive outcome on returning to sport/school/work.  There is a consensus on the timeline of when to introduce different activities and levels, but the treatments during this time can be varied, from vestibulo/oculo motor training to low level laser to hyperbaric chambers and so on.  Not one treatment is the only one that can work for concussions, but each treatment can be successful in it's own right.

Concussions are near and dear to me because I had a bad experience with a concussion when I was in high school.  Head injuries are very serious and can have long term consequences if not treated appropriately.  We do manage concussions here at Victory* and would love to be a part of helping you or an athlete you know return back to activity and soon and safely as possible.

*in the state of Texas, Dr. Blake cannot diagnose a concussion, due to scope of practice laws.  We can manage and treat concussions with co-current treatment with your medical doctor.  We can work with your medical doctor on creating a treatment plan that is beneficial for you or your child to allow a more integrated and successful treatment.  Give us a call if you have any questions on how this can work.