From the alluring smell of concession stand snacks to the sounds of the marching band, Friday nights in the fall are full of excitement surrounding an all-American tradition: football. But the sport has gained increasing attention in recent years more for the injuries it can cause than for the game itself.
Doctors at the University of Alabama at Birmingham say concussions are a brain injury caused by a hard hit, and they are not to be taken lightly. As many as 3.8 million athletes suffer a concussion each year in the United States, according to the Centers for Disease Control and Prevention.
“Concussions are significantly more of an issue than originally thought. If you have one concussion you are more likely to suffer from subsequent concussions,” says Jim Johnston, M.D., assistant professor of surgery in the Division of Neurosurgery at UAB.
Physicians and athletic trainers in the UAB Sports Medicine department at Children’s of Alabama say concussion should be suspected in the presence of one or more symptoms, such as headaches, blurred vision, nausea or vomiting, cognitive impairment, abnormal or erratic behavior, drowsiness or slurred speech.
“It can be any instance of trauma that causes these, and it doesn’t have to be a direct blow to the head – it can be a direct blow to the body that sends a strong enough force up to the head,” explains Marshall Crowther, M.D., assistant professor of pediatrics in the Division of Orthopedic Surgery at UAB.
Nearly 30 states have passed concussion laws in recent years, with Alabama following suit in June 2011. In 2010, the Alabama High School Athletic Association (AHSAA) put new rules into effect that stated if a student athlete exhibited concussion symptoms they must be held out until a physician clears them to return. See their concussion information form here.
“We saw a threefold increase in concussions in the emergency room last year because of the rule change,” says Drew Ferguson, M.Ed., director of UAB Sports Medicine and an athletic trainer for more than 40 years. “Probably 90 percent of the ones we see clear up on their own, especially if it’s their initial concussion and the guidelines we give them are followed.”
An athlete diagnosed with a concussion can expect to be out of the game for a minimum of a week. As with many aspects of this sports-related injury, everybody reacts differently, and you never can tell what the outcome will be.
Players should be removed from the game immediately and have a medical assessment if any symptoms develop.
“If you return to play too early you are much more likely to have a subsequent concussion and longer duration of symptoms with those concussions. It is like injuring your knee, if you go back too early instead of missing a month, you may miss a season, and we need to start thinking of concussions in the same way,” says Johnston.
“We still don’t know a lot about long-term ramifications of concussions, why some people tend to have more prolonged problems or symptoms, so that’s still being researched,” says Crowther.
To help parents and athletes get through the recovery process, UAB Sports Medicine is opening a Concussion Clinic at Children’s of Alabama.
“We anticipate Mondays will be the busiest for concussions as we’re trying to capture the Friday night injuries that happened. Sometimes symptoms may not show up right away, it may be a couple days before they appear, so ideally we’ll see more acute injuries two to three days from the football game,” Crowther says.
The concussion clinic staff consists of athletic trainers, nurses and physicians. In addition to treating concussions, they will work to educate parents, trainers, coaches and athletic directors about the prevention, diagnosis and treatment of concussions.