Concussions are certainly THE hot topic in sports today. Almost every media outlet that has anything to do with sports is running a special about concussions. There is so much noise about concussions that many tend to disregard the reports as a type of sensationalism. Despite the uproar, many Christian school athletic departments lack the sense of urgency needed when dealing with concussions.
The book Concussions and Our Kids: America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe by Dr. Robert Cantu is a must-read for athletic directors. Cantu is considered by many to be the leading expert in concussions and treatment. So much valuable information will be gleaned from reading this book.
Before reading Cantu’s book, I had a fairly good grasp of concussions and how to treat them. However, as I read the book, I found there were tremendous gaps in my understanding of concussions. It was then that I was reminded of a statement I once heard from a wise man in my church,
“It’s not what you know that gets you in trouble; it’s what you think you know.”
I thought I knew how to handle concussions in sports, but I was not as fully prepared as I thought I was.
The goal of today’s post is to aid the Christian school coach and/or athletic director in recognizing and responding to concussions.
Cantu defines concussions in the simplest terms possible:
“Concussions are … a shaking of the brain inside the skull that changes the alertness of the injured person.” (p. 2)
Obviously there is a wide variety within that definition. Concussions can result in a mild feeling of dizziness, or they can cause the victim to lose consciousness.
But think about it; if a concussion is just a shaking of the brain, how often does the potential for concussions arise in sports (both contact and non-contact)? Answer: very often.
Cantu goes on to point out the two types of “accelerations” that produce concussions. The first type is linear. Linear acceleration is basically a collision that produces back and forth motion (think of whiplash or head-on hits). The second, and more dangerous, type of acceleration is rotational. Rotational accelerations occur when there is an off-center hit that causes the brain to rotate inside the skull. (p. 4-5)
Symptoms of concussions include more than just dizziness, nausea, or lack of consciousness. Cantu divides all concussion symptoms into four categories: somatic, emotional, sleep disturbance, and cognitive.
Here is a complete list each type of concussion system and their category:
- balance/visual problems
- sensitivity to light and noise
- sadness to the point of depression
- suicidal thoughts
- sleeping more/less than usual
- trouble falling asleep
- difficulty concentrating
- troubles with memory
- feeling mentally slow or “in a fog” (p. 8)
Any of these symptoms indicate a possible concussion. Everyone involved in your athletic department needs to know all of them.
Your coaches also need to recognize plays that can produce concussions in athletes. Any sequence, in any sport, that can result in a blow to the head needs to be evaluated. So often we only watch for helmet-to-helmet contact or heads slamming against the court. However, concussions can result from the most routine athletic plays, like heading the ball into the goal in soccer.
Cantu also provides some simple sideline tests that coaches can administer to players who are exhibiting concussion symptoms.
If you suspect an athlete might have a concussion, ask these questions:
- “What was the play you were injured in?”
- “What was the color of the jerseys of the opposing team?”
- “What quarter is it?”
- What is the score?” (p. 16-17)
These questions can be used to identify obvious concussions, but beware: correct answers do not necessarily mean your athlete is concussion-free.
After having your athlete answer questions, Cantu advises the following tests:
“I give them six digits and ask them to repeat them, then to repeat them backwards. Then a simple balance test: Can the player stand firm with their feet together, in heel-to-toe tandem position, and on one foot, eyes open and then closed; with hands on hips, eyes open and then closed?” (p. 17)
If a parent suspects that their child has an unrecognized concussion, Cantu also gives a simple test that can be administered in the car on the way home:
“Ask a kid to choose four unrelated words — such as object names or colors. Ask the child to repeat the list. Then say, ‘I’m going to ask you to repeat that list again in three or four minutes.” (p. 118)
Review these symptoms and tests with your athletic department. Educate the coaches, parents, and players! Research shows that injured athletes typically do not think that they have a concussion. If they know what symptoms to report, then hopefully they won’t put themselves in a dangerous situation.
Responding to Concussions
Obviously, emergency medical services should be called right away if if there is an immediate medical emergency such as loss of consciousness.
However, the most appropriate response to a suspected concussion is to sit the player out of athletic competition until a medical professional has cleared him or her for activity.
Cantu is also the author of the famous When in Doubt, Sit Them Out policy. This policy places the future well-being of the athlete ahead of the immediate needs of the team. This is something that, unfortunately, not every coach and athletic department is willing to do.
Depending on the severity of the concussion, the athlete may need to sit out for several weeks. If an athlete suffers multiple concussions in a season (severe or not) then they may be advised to sit out for the remainder of the season.
The athlete’s mental load needs to be reduced as well. Sitting in class, taking tests, or even watching tv can all hinder or completely reverse the healing process. Cantu doesn’t expect everyone to sit in an empty room with the lights off, but a brain injury requires brain rest. This includes mentally stimulating activities.
“Rest is the hallmark of concussion therapy. The best we can do for patients is to shut things down physically and cognitively.” (p. 10)
According to Cantu, an athlete can return to their sport once they are free of symptoms. The key to this statement, though, is that they need to be symptom free while exercising as well. For instance, if a football player has no more symptoms after a few days off but then experiences concussion symptoms after his first practice back, then he did not rest long enough and his brain is not fully healed.
Ultimately, athletic programs in general need to consider how they recognize and respond to concussion symptoms. We must treat every questionable situation with the appropriate gravity in the best interest of our athletes and their future.