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Sport Concussions

Concussions are getting more and more national attention. Why? A growing trend suggests that athletes are returning to their sport or exercise too soon after suffering a concussion – a decision that can cause brain damage.

Texas Health is leading the way in concussion management across North Texas. Using the ImPACT™ assessment test and engaging physicians who specialize in concussion management, Texas Health Ben Hogan Sports Medicine is giving athletes a tool to reduce the damage a concussion may cause.

If you have ever had a concussion, you know that the symptoms can be debilitating and often times require special attention and care. You will also find a concussion toolbox for coaches, athletic trainers and teachers in this section.

Concussion Centers

Dallas
Professional Building 3
8230 Walnut Hill Lane, Suite 514
Dallas, TX 75231
Phone: 214-345-2929
Fax: 214-345-2905
Map
Fort Worth
Ben Hogan Center
800 5th Ave., #402
Fort Worth, TX 76104
Phone: 817-250-6870
Fax: 817-250-6871
Map

Texas Health Ben Hogan Concussion Centers in Dallas and Fort Worth are leading the way in concussion management. As the only dedicated, multidisciplinary sports concussion clinics in North Texas, our staff includes physicians, neuropsychologists and certified athletic trainers.

The center’s comprehensive approach to concussion care includes:

  • Diagnosis and treatment for concussion
  • Interpretation of neurocognitive baseline and post-injury test results
  • Interpretation of balance testing with the latest technology used by professional players
  • Education on concussion for athletes, athletic trainers and parents

What is a Concussion?

A concussion is a type of mild traumatic brain injury (mTBI), caused by a bump, blow, or jolt to the head that can change the way your brain normally works. According to the Center for Disease Control and Prevention, approximately 3.8 million sports-related concussions are reported in the U.S. every year.

Concussions can 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. Many people assume that if an athlete does not lose consciousness then they did not suffer a concussion. This is not true.

Athletes who sustain repeat concussions are also at a higher risk for brain swelling permanent damage and even death. (www.cdc.gov)

Did you know?

According to the University of Pittsburgh Medical Center, 10 percent of all contact sport athletes sustain concussions and 63 percent of all concussions occur in football players.

  • An athlete who sustains a concussion is four to six times more likely to sustain a second concussion.
  • “Bell ringers” account for 75 percent of all concussions.
  • The effects of a concussion are cumulative in athletes who return to play prior to complete recovery.
  • Concussion headaches are the No. 1 reported symptom, usually described as a “pressure sensation” which worsens as the day progresses.
  • Eighty percent of all concussions get better within 3 weeks and 20 percent of concussions take three weeks or longer to recover.
  • Second impact syndrome (SIS), which results from a rapid swelling of the brain, can occur if an athlete suffers an additional concussion before symptoms of the initial concussion have subsided.
  • Adolescent athletes are more susceptible to second impact syndrome.
  • Second impact syndrome is more likely to occur within 14 days of the initial concussion.

What is really going on in the brain after a concussion?

A metabolic imbalance occurs in the brain after a concussion. Therefore increasing blood flow to the brain during recovery may slow down the recovery process and worsen the symptoms of concussion. Many patients with concussions have a hard time concentrating or focusing on a task.

Recent research by the University of Pittsburgh Medical Center indicates that females typically have more concussion symptoms than males. Also, younger athletes (aged 18 and younger) typically have longer recovery times after a concussion.

How does a concussion impact your ability to learn and concentrate?

Both physical exertions and cognitive exertion, or thinking, are usually difficult for an athlete who has suffered a concussion. Cognitive exertion and the added stimulation of the school environment can significantly increase concussion symptoms, even during the recovery period. An athlete with a concussion will frequently find that background noise, lighting, changing classes, group work and testing can all exacerbate their symptoms.

Physicians may prescribe a modified learning environment or school schedule for athletes who have suffered a concussion. Do you want to know more about academic accommodations? Visit our toolbox or make an appointment with a physician on our medical staff before your child returns to school.

ImPACT™ Assessment Test

The Concussion Management Program at Texas Health Ben Hogan Sports Medicine begins with a computerized baseline test that establishes an athlete’s neurocognitive function. After a concussion, an athlete takes the test again, allowing the computer system to calculate if there’s been a change to his or her cognitive efficiency. Called the ImPACT™ test, the online testing program was created by the University of Pittsburgh Medical Center and is used by the majority of teams in the NFL, NBA, MLB, NHL, as well as college sport programs and more than 3,000 school districts across the nation.

Since 2008, more than 45,000 North Texas student athletes from 150 local schools and clubs have received ImPACT™ baseline testing through the Concussion Management Program at Texas Health Ben Hogan Sports Medicine.

Of those, approximately one in 15 have returned to be retested after suffering a concussion. The online tests help athletic trainers and physicians determine when it is safe for athletes to return to the field. Sitting out during recovery from a concussion prevents dangerous repeat head injuries that can cause severe, long term brain damage.

Symptoms of a Concussion

An athlete who has experienced a head injury or concussion may have signs and symptoms that do not become apparent until hours after the initial traumatic event.

Signs and symptoms may present differently from individual to individual.

At the time of injury, hospitalization may not have been required. However, you should be alert for possible signs and symptoms in the athlete. Seek medical attention immediately if you observe any changes of these symptoms:

  1. Headache (especially one that increases in intensity) or headache that is persistent
  2. Any period of loss of consciousness
  3. Seizure activity
  4. Dizziness
  5. Nausea or vomiting
  6. Drowsiness, lethargy or sleepiness
  7. Memory deficits
  8. Mental confusion/disorientation or inability to focus attention (easily distracted)
  9. Emotions out of proportion to circumstances
  10. Delayed verbal and motor responses or slurred speech
  11. Feeling “foggy”
  12. Gross observable lack of coordination (such as changes in gait or balance)
  13. Vacant stare (puzzled facial expressions)
  14. Blurry or double vision
  15. One pupil larger than the other from right to left eye, or dilated pupils
  16. Bleeding and/or clear fluid from the nose or ears
  17. Ringing in the ears

The best guideline is to note symptoms that worsen and behaviors that seem to represent a change in you or your loved one. If you have any question or concern about the symptoms you are observing, contact your family physician for instructions, or seek medical attention at the closest emergency department.

Special Attention and Care of a Concussion

The appropriate care of your concussion will help you get back on the field quicker. Texas Health Ben Hogan Sports Medicine has provided some simple “do’s” and “don’ts” while caring for your concussion. Please remember that these are guidelines that do not replace the instruction you receive from your physician.

Things you may “DO” when you have a concussion:

  1. Take acetaminophen (Tylenol®) for your headaches**
  2. Use an ice pack on the head and neck area as needed for comfort
  3. Limit food intake
  4. Sleep
  5. Rest and refrain from strenuous activity and sports
  6. Listen to your body and ease back into normal everyday activities
  7. Inform your school and teachers of your concussion and ask your doctor about academic accommodations for your concussion
  8. Follow-up with the school’s athletic trainer
  9. Get physician-clearance before you return to athletics
  10. Take an online assessment to assess your neurocognitive state and provide safe return-to-play timelines
  11. Slowly and gradually return to activity after your physician has cleared you

** You should not take any medication without consulting your physician first.

 

Things you should “NOT DO” when you have a concussion:

  1. Take ibuprofen, aspirin, naproxen or other non-steroidal, anti-inflammatory medications
  2. Drink alcohol
  3. Drive when you have symptoms of a concussion
  4. Exercise or lift weights
  5. Use a computer or send text messages
  6. Watch television for long periods of time
  7. Listen to loud music or conversations
  8. Attend dances, parties, music concerts and sporting events where there is loud noises and light stimulation
  9. Take hot baths
  10. Engage in heated or emotional discussions

The 3 “R”s of Concussion Management

  1. Remove players with concussion symptoms from athletics and competitive sports
  2. Restrict athletes from competition until symptoms completely resolve
  3. Return to play gradually when you are without symptoms

Concussion Toolbox for Coaches, Athletic Trainers and Teachers

While some individuals who have had a concussion may be able to attend school without increasing their symptoms, the majority will probably need some modifications depending on the nature of the symptoms. The student, coach, athletic trainer and teacher may need to work on a “trial and error” basis to discover what the student can and cannot do. Some helpful return-to-class guidelines may include:

  1. The parent should notify the school of the students’ concussion when it occurs.
  2. The parent may request “Academic Accommodation” or a modified school schedule in accordance to physician recommendations.
  3. When a student athlete returns to school after a concussion, they should check-in with the school nurse as well as with the Athletic Trainer.
  4. If the student is unable to attend school for an entire day without symptoms, they might try a half-day. Some students may only be able to attend for one period, some not at all, due to severe headaches or other symptoms.
  5. The student may require frequent breaks with rest periods in the nurse's office. Many students benefit from alternating a class with a rest period.
  6. Students often complain of more symptoms during Math class than any other class.
  7. Depending on their symptoms, some students may need to be driven to school to avoid walking and should be given elevator passes to avoid stairs. They should not attend gym or exercise classes.
  8. The student may benefit from reduced homework loads and frequent breaks during homework. If possible, the teacher should postpone term papers. The school should consider offering the student with pre-printed class notes and tutors to relieve the pressure of schoolwork.
  9. If the student is suffering with concentration and/or memory problems, tests, quizzes, PSAT and SAT tests and final exams should be delayed or postponed. Extra time or untimed tests may be necessary initially when the student resumes taking tests.
  10. As the recovery process occurs, the student can gradually attend more class and begin to gradually resume athletics following their physician’s guidelines.  

 

Sports Concussions Contact

Kenneth Locker

KennethLocker@texashealth.org