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  • Concussions on the rise

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    • About Concussions
      Concussion safety is an issue in football from the National Football League to youth organization Pop Warner. In just five years, 49 states and the District of Columbia have passed laws...
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      About Concussions
      Concussion safety is an issue in football from the National Football League to youth organization Pop Warner. In just five years, 49 states and the District of Columbia have passed laws intended to ensure proper treatment of concussions in youth athletes. Here is some information on the medical side of concussions.

      Question: What is a concussion?

      Answer: A mild traumatic brain injury that disrupts the function of the brain.

      Q: How do concussions occur?

      A: From a blow to the head or an impact elsewhere on the upper body that transmits to the head, causing the soft brain to slam into the inside of the skull. The brain also can twist and stretch from what is called rotational force, which is believed to cause more severe brain injury than straight-on linear force.

      Q: What are the immediate effects?

      A: Concussions vary drastically. The most common symptoms are headache, dizziness, difficulty concentrating and confusion. Estimates show that less than 10 percent of concussions include loss of consciousness. Symptoms have been known to surface days later.

      Q: What are the long-lasting effects?

      A: Research continues into concussions' long-term effects. Full recovery from a single, isolated concussion can be expected with proper recognition and management, although suffering one concussion seems to increase the likelihood of another. Repeated concussions can cause permanent and progressive brain damage.

      Q: How long does it take for concussions to heal?

      A: Hours, days, weeks, months - it varies. Symptoms usually will resolve in seven to 10 days. Research suggests younger athletes take longer to recover from concussions than adults.

      Q: How are concussions diagnosed?

      A: Concussions are diagnosed using signs and symptoms. Baseline testing, in which cognitive function is measured at the start of a season and then retested after a concussion, is an objective measure in assessing brain injury. But it is not a diagnostic tool. CT scans and MRIs contribute little to evaluating concussions.

      Q: How are concussions treated?

      A: Mental rest is extremely important. This may require missing school or reducing classwork. Activities such as watching TV, playing video games, using a computer and texting may be discouraged. Resting the body also is important, since physical activity can exacerbate symptoms and prolong recovery. Some concussions require observation at a hospital.
      Charting concussions

      Concussions in high school football are increasing. This chart shows national estimates on the number of concussions in high school football, total participants in the sport and percentage of players who suffered a concussion.

      Year         Concussions*     Participants*     Percent

      2011-12         140,057         1,097,597     12.8

      2010-11         117,173         1,109,836     10.6

      2009-10     100,928         1,110,527     9.1

      2008-09     70,672         1,113,062     6.3

      2007-08     70,929         1,109,511     6.4

      2006-07     60,136         1,105,585     5.4

      2005-06     55,007         1,072,948     5.1

      *Concussion estimates from the High School Sports-Related Injury Surveillance Study. Participation estimates from the National Federation of State High School Associations.

  • High school football players increasingly are bigger, faster, stronger - better.
    The level of medical care awaiting them on the sideline has not kept pace.
    While professional and college football teams have physicians, athletic trainers and other specialists at their disposal, medical support is spotty at the high school level.
    For those who think new state laws aimed at proper treatment of concussions and prevention of long-term brain injury are just a first step, improving medical support is high on the list of suggested next steps.
    Usually, the best a high school football team can hope for is one full-time athletic trainer at games and practices, and maybe a physician at games.
    Estimates vary of how many U.S. high schools have access to an athletic trainer. Jim Thornton, president of the National Athletic Trainers Association, puts that estimate at "a little over half."
    As head athletic trainer for NCAA Division II Clarion (Pa.) University, Thornton has himself, four other full-time athletic trainers and a student staff to take care of about 400 athletes.
    "You go down to the local high school, and it's one athletic trainer taking care of 400 athletes in six different venues," Thornton said.
    He cites budget constraints at high schools for the lack of athletic trainers.
    A full-time athletic trainer in a high school typically will make around $40,000 per year.
    Dr. Robert C. Cantu is a neurosurgery professor at the Boston University School of Medicine and medical director of the Sports Legacy Institute, an organization that strives to advance the study, treatment and prevention of brain trauma. He talked about the "uneven playing field" at the prep level. A well-funded private school might have multiple athletic trainers on staff while roughly half of the public schools across the country have none.
    "That's unfortunate, and certainly not where you'd like to see it," Cantu said. "It's a work in progress."
    Diagnosis of concussions is the job of a qualified physician. But from coaches to physicians, most people agree that when it comes to properly assessing and treating concussions and other head injuries during competition and practice, an athletic trainer is the most qualified and feasible option for high schools.
    People become athletic trainers through accredited undergraduate or graduate programs, and must pass an exam for national certification. Athletic trainers focus on emergency care, injury prevention, clinical diagnosis, and therapy and rehabilitation for injuries. They generally work closely with physicians. More than 70 percent of certified athletic trainers hold at least a master's degree.
    "The modern athletic trainer is the gatekeeper between making a decision on concussion symptoms and proper referral of that student-athlete on the day and the moment it happens," Thornton said.
    Proper treatment relies on spotting concussion symptoms quickly and removing the athlete from play. The potential consequences of an athlete returning to play before a concussion heals include more severe concussions, long-term brain damage and death.
    Page 2 of 2 - At those high schools without an athletic trainer, the responsibility for spotting concussion symptoms and pulling an athlete from play falls to coaches, officials, teammates and parents.
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