SalemNews.com, Salem, MA

February 19, 2014

Column: The seriousness of concussions

Melinda Adam
The Salem News

---- — Not too long ago, experiencing a concussion was not considered such a big deal. But these days, people are now paying attention, thanks largely to the constant stream of media attention surrounding the injury. Every day, we hear about another football or hockey player who has to miss games because of head trauma. In just the last few months, Bruins players Dougie Hamilton, Daniel Paille and Loui Eriksson have missed games due to concussions, along with Patriots players Danny Amendola and Kenbrell Thompkins.

Professional athletes aren’t the only ones affected by concussions. According to surveys submitted to the state by about 360 public and private schools, students across Massachusetts suffered more than 4,400 concussions or other head injuries while playing school sports during the last school year. This includes many injuries on the North Shore: 23 from Danvers High, 14 from Gloucester High, 19 from Manchester Essex Middle-High School, 31 from Peabody Veterans Memorial High School. And these are just the numbers voluntarily reported by schools.

Concussions — and more specifically, repetitive concussions — can have a serious impact on health and cognitive function. After suffering a head injury, some people experience chronic headaches, difficulty multitasking and dizziness for weeks after the initial impact. In more serious cases, the brain’s ability to regulate blood volume is damaged, and pressure in the brain can increase rapidly, causing death. Multiple head traumas can even cause the brain to atrophy, or waste away, leading to dementia and increased violent behavior in athletes, according to research from Boston University’s Center for the Study of Traumatic Encephalopathy.

There are steps parents, athletes and coaches should take to ensure that people who experience this injury receive the care they need and do not return to play before they’re ready. Comprehensive treatment programs, like those at Beverly and Addison Gilbert Hospitals, both members of Lahey Health, can be effective tools for diagnosing, treating and managing patients with concussions. These programs include four components: education, baseline testing, management and return-to-play guidelines.

Education is critical to ensuring that injuries are managed properly. It’s important that all adults working with student athletes have a full understanding of what concussions are, how to detect them, what to do after a player experiences a head injury, and how to determine when it’s safe for a player to return to full-contact activity.

Baseline testing plays an important role in detecting head injuries. It can be used to determine if and when an athlete who has been injured can play again safely or should receive further treatment for a concussion. On the North Shore and Cape Ann, Beverly and Addison Gilbert Hospitals recently partnered with Beverly, Gloucester, Danvers and Ipswich high schools to establish a baseline against which they can compare a student athlete’s cognitive function if the student suffers an injury and exhibits symptoms.

Once athletes experience a concussion, how it is managed plays an important role in their recovery. Taking a break is the most important step athletes need to take. The brain needs to rest — physically and cognitively — which means activities like reading, watching TV, listening to music and playing video games should be limited.

Knowing when it is safe to return to play is also crucial for preventing further complications and injury. As part of Beverly Hospital’s concussion program, hospital staff work with schools to develop “back to play” protocols so student athletes are not returning too soon and placing their health at greater risk. Athletes should wait at least five days to return to play after a concussion, and they should be able to successfully complete a series of tasks without experiencing symptoms for 24 hours. First, the athlete should go a full day symptom-free at rest, meaning no headache, dizziness or fatigue. After this stage, a medical professional can clear the patient to progress to light cardiovascular exercise, then sports-specific exercise and one hour of non-contact training drills. If an athlete completes each of these stages with no symptoms for 24 hours afterward, a medical professional can clear the athlete to return to full-contact play.

Concussions are not something to take lightly. It’s certainly a move in the right direction that professional sports associations, schools and medical professionals are beginning to take an in-depth look at concussions, recognize how serious they are and treat them with the seriousness they deserve.

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Melinda Adam is the director of rehabilitation and sports medicine at Beverly and Addison Gilbert hospitals.