Jan. 19, 2018 - Researchers have identified evidence of early chronic traumatic encephalopathy (CTE) brain pathology after head impact — even in the absence
of signs of concussion.
Unfortunately, many teens and parents are unaware
of the signs of concussions and may forgo medical attention because they don't know that a concussion has happened.
Not exact matches
With the NFL's new
concussion protocol rules, players must be taken to the locker room if they show
signs of a
concussion.
Team personnel and officials are responsible to know how to identify the potential observable
signs of concussions.
Knee and ankle injuries, along with a 2015
concussion, spelled the end
of his tenure in the nation's capital, and his star had dimmed so much he was reduced to
signing a one - year deal to compete for the Browns» starting quarterback position.
Since 2010, any athlete who exhibits
signs of concussion must be removed immediately from the game.
If a player is suspected
of having a
concussion, or exhibits the
signs or symptoms
of concussion, they will be removed from participation and undergo evaluation by the medical staff in a quiet, distraction - free environment conducive to conducting a neurological evaluation.
In this forum would be lucky to show only
signs of concussions.
More than 90 %
of all cerebral
concussions fall into this mild, or Grade 1, category, which, under my brain injury guidelines is characterized by only a brief (less than 30 minutes) period
of post-traumatic amnesia (PTA) or other post-concussion
signs and symptoms.
What I learned from working with the Newcastle team, and with youth football programs across the country over the years is that traditional
concussion education in which athletes, coaches, and parents are taught the
signs and symptoms
of concussion, and the health risks
of concussion and repetitive head trauma, isn't working to change the
concussion reporting behavior
of athletes.
Anecdotal evidence from NCAA Division I football programs suggests that the
signing by athletes
of pledges acknowledging their responsibility to report
concussion symptoms increases the rate
of reporting by athletes, both
of their own symptoms and those
of teammates.
Unfortunately, there has been during this same period, and especially in the last five to ten years, a substantial increase in the number
of reported cases
of second impact syndrome (SIS), which occurs when an athlete who sustains head trauma, i.e. a traumatic brain injury - often a
concussion or worse injury, such as a cerebral contusion (bruised brain)- sustains a second head injury before
signs of the initial injury have cleared.
They still need to be present and ever - vigilant in watching for
signs of concussion or heavy hits that could cause
concussion.
For instance, many do not require that coaches receive training in recognizing the
signs and symptoms
of concussion, or require that parents be notified when their child is suspected
of having suffered a
concussion, and few penalize those who violate their provisions.
37.7 %
of the athletes indicated that they had continued participating in a practice or game at least once while experiencing
signs and symptoms
of concussion.
Pressure to play needs to be taken off kids in order for them to feel comfortable reporting their
signs and symptoms
of a possible
concussion,» says Tamara Valovich McLeod,, PhD, ATC, FNATA, Professor in the Athletic Training Program and Directors
of the Interdisciplinary Research Laboratory and Athletic Training Practice - Based Research Network in the Department
of Interdisciplinary Health Sciences at A.T. Still University in Mesa, Arizona, co-author
of the attitude study, and lead author
of an earlier study [3] on attitudes on
concussions among high school students.
Educating parents, players, coaches, and health care professionals on the
signs and symptoms
of concussion and the long - term health risks if
concussions are not identified early and treated conservatively, and the importance
of creating an environment in which athletes feel safe in reporting
concussion symptoms;
What are the
signs of a
concussion?
To begin with, the
signs of concussion are often either subtle or non-existent, so they escape detection by sideline personnel.
[1 - 9] As a 2013 research paper [7] and a number
of other recent studies [12 - 15] show, education alone (or at least that which focuses on educating athletes about the
signs and symptoms
of concussion and not changing attitudes about reporting behavior) does not appear capable
of solving the problem, because the reasons for under - reporting are largely cultural, [2,3,9,10, 12 - 15] leading the paper's author to conclude that «other approaches might be needed to identify injured athletes.»
The bad news is that
concussion education
of athletes and parents was much less extensive, with about a third
of athletes and more than half
of parents not receiving any
concussion education beyond
signing a
concussion and head injury information sheet.
Add in the possibility that sideline personnel responsible for monitoring athletes for
signs of concussion, such as team doctors and athletic trainers, or coaches and parent volunteers, may be away from the sideline attending to other injured athletes when a player sustains a high force blow, or, even if they are watching the field / court / rink, may miss significant impacts because they occur away from the play, and one can see why better
concussion detection methods are needed.
Because «parents
of high school athletes attend their games, watch their child closely during game play, and are accutely attuned to changes in their behavior... [e] ducating parents about
signs and symptoms,» they said, «could potentially decrease the likelihood
of athletes playing with
concussion symptoms.»
The critical point to always keep in mind about impact sensors is that they are just another tool in the
concussion toolbox or, put another way, another set
of eyes, with which to identify athletes who (a) may have sustained impacts
of sufficient magnitude that (b) may have resulted in some cases in
concussions, so that they (c) may be monitored for
signs of concussion, or (d) may be asked to undergo a balance, vision, and / or neurocognitive screen / assessment on the sideline or in the locker room, the results
of which (e) may suggest a removal from play for the remainder
of the game and referral to a
concussion specialist for formal evaluation away from the sports sideline, which evaluation (f) may result in a clinical diagnosis
of concussion.
The emerging model
of sport
concussion assessment now involves the use
of brief screening tools to evaluate post-
concussion signs and symptoms on the sideline immediately after a
concussion and neuropsychological testing to track recovery further out from the time
of injury.
Question: How can an athletic trainer on the sideline keep his or her eyes on athletes on the field to watch for
signs of concussion if the AT has to be constantly monitoring the data coming from the sensors?
While all but three states now have laws requiring immediate removal from play
of athletes with
concussion signs or symptoms and prohibit same - day return to play for those with suspected
concussion, some are concerned that such laws may have the perverse effect
of making the under - reporting problem even worse, fearing that an athlete is going to be even less likely to self - report experiencing
concussion symptoms and more likely to hide symptoms from teammates, game officials and sideline personnel if they know that a suspected
concussion may sideline them for the rest
of the game.
Impact sensors don't depend solely on athletes to remove themselves from games or practices by reporting
concussion symptoms, or on game officials or sideline personnel to observe
signs of concussion.
One way, I believe, to address the problem
of under - reporting and increase the chances a
concussion will be identified early on the sports sideline may be to rely less on athletes themselves to remove themselves from games or practices by reporting
concussion symptoms (which the most recent study shows occurs at a shockingly low rate, [9] or on game officials and sideline observers to observe
signs of concussion and call for a
concussion assessment, but to employ technology to increase the chances that a
concussion will be identified by employing impact sensors designed to monitor head impact exposure in terms
of the force
of hits (both linear and rotational), number, location, and cumulative impact, in real time at all levels
of football, and in other helmeted and non-helmeted contact and collision sports, where practical, to help identify high - risk impacts and alert medical personnel on the sideline so they can consider performing a
concussion assessment.
Parents and coaches will benefit from reduced reliance on honest self - reporting
of concussion symptoms by athletes and
of the less - than - perfect observational skills
of sideline management in spotting
signs of concussion;
When I presented the next year in Atlantic City to recreational department directors gathered for the annual meeting
of the New Jersey Parks and Recreation Directors» Association, I spoke to the critical role they could play in improving sports safety by proactively exercising the power
of the permit to require youth sport coaches to receive more training in first aid, CPR, and the
signs and symptoms
of a
concussion.
Contrary to some media reports, impact sensors used in this fashion are not intended to replace sideline observers, game officials, coaches, and teammates, who, if they observe an athlete exhibiting
signs of concussion, can trigger a sideline screening for
concussion using one or more assessment tools (eg.
My experience with the Newcastle football team in Oklahoma leads me to believe that, as long as impact sensors are strictly used for the limited purpose
of providing real - time impact data to qualified sideline personnel, not to diagnose
concussions, not as the sole determining factor in making remove - from - play decisions, and not to replace the necessity for observers on the sports sideline trained in recognizing the
signs of concussion and in conducting a sideline screening for
concussion using one or more sideline assessment tests for
concussion (e.g. SCAT3, balance, King - Devick, Maddocks questions, SAC)(preferably by a certified athletic trainer and / or team physician), and long as data on the number, force, and direction
of impacts is only made available for use by coaches and athletic trainers in a position to use such information to adjust an athlete's blocking or tackling tec hnique (and not for indiscriminate use by those, such as parents, who are not in a position to make intelligent use
of the data), they represent a valuable addition to a program's
concussion toolbox and as a tool to minimize repetitive head impacts.
It does not measure other critical brain functions that can be adversely affected by head trauma, such as balance and vision, which is why expert groups [1] recommend a «multifaceted approach to
concussion management that emphasizes the use
of objective assessment tools aimed at capturing the spectrum
of clinical
signs and symptoms, cognitive dysfunction, and physical deficits... that are more sensitive to the injury than using any one component alone.»
A coach may not allow a member
of a school athletic team to participate in any athletic event or training on the same day that the member (1) Exhibits
signs, symptoms or behaviors consistent with a
concussion following an observed or suspected blow to the head or body, or (2) Has been diagnosed with a
concussion.
The statute requires that each year, before beginning a practice for an interscholastic or intramural sport, each high school student athlete and their parent
sign an information sheet about the risk
of concussion or head injury.
Concussion and Sports Related Head Injury: Code 280.13 C requires the Iowa high school athletic association and the Iowa girls high school athletic union to work together to distribute the CDC guidelines and other information to inform and educate coaches, students, and parents and guardians of students of the risks, signs, symptoms, and behaviors consistent with a concussion or brain injury, including the danger of continuing to play after suffering a concussion or brain injury and their responsibility to report such signs, symptoms, and behaviors if t
Concussion and Sports Related Head Injury: Code 280.13 C requires the Iowa high school athletic association and the Iowa girls high school athletic union to work together to distribute the CDC guidelines and other information to inform and educate coaches, students, and parents and guardians
of students
of the risks,
signs, symptoms, and behaviors consistent with a
concussion or brain injury, including the danger of continuing to play after suffering a concussion or brain injury and their responsibility to report such signs, symptoms, and behaviors if t
concussion or brain injury, including the danger
of continuing to play after suffering a
concussion or brain injury and their responsibility to report such signs, symptoms, and behaviors if t
concussion or brain injury and their responsibility to report such
signs, symptoms, and behaviors if they occur.
The student athlete may return to play if, as a result
of evaluating the student athlete on site, the athletic trainer, physician, physician assistant or nurse practitioner determines that they do not have any
signs or symptoms
of a
concussion or brain injury.
Parents and / or guardians shall be provided with information as to the risk
of concussion and / or traumatic brain injuries prior to the start
of every sport season and they shall
sign an acknowledgement as to their receipt
of such information.
Requirements for the information sheet are outlined in the policy (E) Maintain all documentation
of the completion
of a
concussion recognition and head injury safety education course program and
signed concussion and head injury information sheets for a period
of three (3) years.
Concussion and Sports - Related Head Injury: Administrative Code 14:303 (2011) requires the Delaware Interscholastic Athletic Association to work in collaboration with the Department of Education to adopt rules and regulations applicable to member schools regarding the appropriate recognition and management of student athletes exhibiting signs or symptoms consistent with a c
Concussion and Sports - Related Head Injury: Administrative Code 14:303 (2011) requires the Delaware Interscholastic Athletic Association to work in collaboration with the Department
of Education to adopt rules and regulations applicable to member schools regarding the appropriate recognition and management
of student athletes exhibiting
signs or symptoms consistent with a
concussionconcussion.
Students participating or desiring to participate in an athletic activity and their parent or guardian must
sign and return an acknowledgement
of and receipt and review
of a
concussion and traumatic brain injury information sheet on an annual basis.
(3) A student athlete shall be promptly removed from play if the athlete is suspected
of sustaining a
concussion or exhibits
signs or symptoms
of concussion until completion
of assessment by a qualified healthcare professional or medical clearance.
The policy does not specify anything regarding removal from play, forcing concussed student - athletes to receive medical clearance before returning to play, or requiring the parents or guardians
of student - athletes to
sign a
concussion information form before their children can participate in interscholastic athletics.
(2) Annual educational session for coaches and athletic trainers about the
signs and symptoms
of a
concussion
The program must address the
signs and symptoms
of a
concussion and require that an official must remove a student from competition and an athletic trainer must remove a student from practice, training or competition if (1) a student reports any
sign or symptom
of a
concussion, (2) an official, coach or athletic trainer determines that the student exhibits any
sign or symptom
of a
concussion, or (3) an official, coach or athletic trainer is notified that the student has reported or exhibited any
sign or symptom
of a
concussion by a licensed, registered or certified health care provider.
The policies must (1) Require the student athlete and their parent or guardian to annually review and
sign information on
concussions, (2) Require that a student athlete suspected by their coach, athletic trainer or team physician
of sustaining a
concussion or brain injury in a practice or game be removed from the activity at that time.
If at any time during the return to full participation in school activities the student exhibits
signs and symptoms
of concussion, the student must be removed from the activity and be re-evaluated by the treating licensed health care provider trained in
concussion management.
The policy must require that the student and their parent or guardian
sign an information form at least once each year about the nature and risk
of concussion.
It is the responsibility
of staff members involved in school activities and trained in the
signs and symptoms related to
concussion or other head injury, to act in accordance with this policy when the staff member recognizes that a student may be exhibiting such
signs and symptoms
of a
concussion.