The Hidden Epidemic

By Bobby Jean Lee, PT, DPT, SCS, CSCS, USAW
Sports Physical Therapist and Certified Concussion Specialist, Ben Hogan Sports Medicine

Over the past 20 years the incidence of Sport-Related Concussion (SRC) has doubled. This increase may be due in part to improved methods of detection, as well as higher participation in youth sports. A concussion is defined as a mild traumatic brain injury that is induced by biomechanical forces on the brain, such as a collision with another player, the ground or ball. Concussions often result in physical, cognitive, emotional and somatic symptoms that affect daily life and sports participation.

Common Symptoms Include:

• Headache = #1 symptom • Dizziness = increased risk for prolonged recovery
• Blurry vision
• Sensitivity to light and sound
• Difficulty concentrating
• Fatigue
• Balance problems
• Nausea/vomiting
• Neck pain

Detection of a concussion is of utmost importance for the athlete’s safety and proper treatment. Returning to play with a concussion, or prior to full recovery, increases an athlete’s risk for Second Impact Syndrome (SIS). SIS occurs when a subsequent concussive episode closely follows a first episode that has not yet resolved. This rarely occurs but can lead to swelling of the brain, paralysis, and even death.

In the past, athletes who sustained a concussion were told to rest, often times in a dark, quiet room, until symptoms resolved. However, new research recommends only 1-2 days of rest followed by integration into activities that are sub-symptomatic under guidance of a medical professional. Physical therapy has been shown to be effective in helping with symptom resolution. It can help address visual, vestibular, exertional, and physical symptoms of a concussion. Physical therapy intervention can begin within 1-2 days following a concussion.

It is critical that all members of the sports team are educated on the detection and proper management of SRC for each individual athlete’s success and safety. It is up to the medical staff, coaches, family, athletes and YOU to properly identify the signs and symptoms of a concussion and to take the appropriate action.

References: Covassin T, Elbin RJ, Larson E, Kontos AP. Sex and age differences in depression and baseline sport-related concussion neurocognitive performance and symptoms. Clin J Sport Med. 2012; 22(2):98-104.

Centers for Disease Control and Prevention (CDC). Concussion in sports. http://www.cdc.gov/concussion/sports/recognize.html. (Accessed 1 January 2015)

Hootman JM, Dick R, Agel J. Epidemiology of collegiate inuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42:311-319.

Lovell MR, Collins MW, Iverson GL, Field M, Maroon JC, Cantu R, Podell K, Powell JW, Belza M, Fu FH. Recovery from mild concussion in high school athletes. J Neurosurg. 2003;98:296-301.