Head Injuries: Perspective

Head Injuries: Perspective
Posted on 05/12/2022

Head Injuries: Perspective


Sue Tymkew, MS, ATR/R

Head Athletic Trainer 

Chaparral High School


Sports are gearing up for another season.  No matter what the sport, head injuries are a very real part of the equation.  The literature is out there.  Access to it is abundant.  Almost without exception, education is the key to making decisions that are appropriate for the individual and their families.  As more and more studies become available, there is no denying that head injuries can have catastrophic consequences if one chooses to ignore the facts.

There is really no such thing as a “mild” concussion or head injury.  Of course they are classified in various categories but if your brain is disrupted, it can be very serious.  Certainly, life wouldn’t be very interesting if we lived in bubbles.  However, in the unfortunate event of a head injury, there must be steps in place to achieve the best possible outcomes.

It seems that there are some who would like to dismiss or deny the severity of a head injury.  “It’s just a ding”.  “They barely bumped heads”.  “They’ve been hit harder than that before and were just fine”.  These are a very short list of examples of common statements following a head injury.  One person may run into a brick wall and show little or no signs.  Another barely gets bumped and they are very symptomatic.  There is no amount of force that can be the magical determinant of severity.

It is quite possible that ignoring signs and symptoms of a head injury can turn even more serious.  Second impact syndrome is an extremely serious situation.  The athlete denies or minimizes their reporting of symptoms, returns too quickly, receives another blow to the head and now they may be out indefinitely.  At a minimum, several months.  Those subsequent months are agonizing.  Recurring headaches, light sensitivity, memory loss, nausea, lack of concentration, or even death, just to name a few of a very long list.

Missing a few days or even three to four weeks seems to be the end of the world for some athletes.  The importance of brain healing time cannot be underestimated.  Days or weeks seems a short amount of time when the topic is the brain.  We each have only one brain.  It cannot be splinted or taped to return to practice or a game.  It is a difficult concept because we cannot see the brain as we would a swollen ankle, etc.

The “old school” of thought is still alive and well even though the literature proves otherwise.  Prevention, proper equipment and techniques are a key component in reducing head injuries.  It will not stop all of them.  The portion that is very much in control is a sound “return to learn and play” protocol.  There is no practice or game so important as to take such a big risk with one’s brain.  It cannot be stressed enough the importance of reporting a head injury and symptoms.  If there are symptoms, it’s the brain and body’s alert that there is something not right.  There will be another practice and/or game but never another brain.  Please give thoughtful consideration to any potential head injury.  Better to be safe and take the appropriate healing time so when it is time to return, it’s at 100 percent, full go.

The State of Colorado has a law requiring removal of an athlete suspected of having a head injury.  Douglas County School District in conjunction with Panorama Orthopedic and Spine Center have procedures and protocols in place in order to protect the athlete with a potential head injury.  These cannot be varied under any circumstances.  “Return to Learn” is the focus which goes beyond simply returning to play.  There is a recognition that this must be a multi-faceted approach.  The student component is just as, if not more, important than the athlete component.

  

Please refer to the information below for important definitions, laws, protocols and best practices with regard to head injuries.  This is a brief overview.


What is a concussion?

A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious.


A concussion cannot be seen on a CT scan or on an MRI.


A concussion does not require a loss of consciousness. If an athlete sustains a jolt to the head or body and then experiences signs or symptoms, a concussion has occurred.


Signs and symptoms can be evident in four areas: Physical, Cognitive/Thinking, Emotions/Mood and Energy/Sleep.









Colorado’s Concussion Law SB 11-040 requires that you:  REMOVE the athlete from play for “suspicion” of concussion.

(for coaches, certified athletic trainers and other medical personnel)


*Colorado legislation HB19-1208  - 2019.  The act adds licensed physical therapists with training in pediatric neurology or concussion evaluation and management to the definition of “health care provider” for this purpose.  They may authorize youth athletes’ return to play following concussion.


DCSD in Conjunction with Panorama Orthopedics and Spine Center will follow the Graduated Return to Sport Strategy following a physician diagnosis and/or clearance.



Resources:

https://www.cdc.gov/headsup/basics/concussion_whatis.html

Panorama Orthopedics and Spine Center Policies and Procedures Handbook, appendices

https://www.cde.state.co.us/healthandwellness/concussionguidelines7-29-2014-0

https://leg.colorado.gov/bills/hb19-1208
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