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House Calls: Concussions in student athletes

The Arkansas Activities Associations, the governing body of school athletics, has made the recognition and treatment of concussions a top priority this year.

A concussion is a brain injury caused by a blow to the head or it can be caused when the body moves too quickly and moves the brain inside the skull. A concussion prevents the cells of the brain from working correctly.

“Getting a ding” or “getting your bell rung,” are common phrases used when referring to concussions. Concussions can be caused when players collide or when they hit the ground.

Signs and symptoms of concussions are headaches, nausea, vomiting, dizziness, blurred vision, feeling foggy, memory problems, or confusion. The coach or parent may notice the player being forgetful, moving clumsily, answering questions slowly, seeming dazed, or having trouble recalling the hit or fall.

If a concussion is suspected, the athlete should be removed from the game immediately. If consciousness is lost, one pupil is bigger than the other, speech is slurred, or the player experiences vomiting or seizures, the player should be taken to the emergency room immediately. In rare cases a blood clot in the brain can form when a player has a concussion.

A CT scan may be ordered by the emergency room physician if you have any or all of these symptoms. The player should not return to the sport or practice until cleared by a physician or certified athletic trainer. Appropriate diagnosis, referral and treatment are key steps in helping an athlete with a concussion. These steps will help in providing a safe and speedy recovery.

Rest and limited activities are important in an athlete’s recovery. Most people fully recover after a concussion. Speed of recovery depends on age, health, how early recognition occurred, and treatment after the concussion. More than 70 percent of concussion victims heal spontaneously within the first five days after injury. A concussion patient should be symptom free for 24 hours before returning to light aerobic activity. This should include walking, jogging, or biking for no more than 10 to 15 minutes at a time. There should be no weight lifting or running during this first step in recovery.

If the athlete tolerates the first step, he or she can advance to more moderate exercise, including brief running and moderate weight lifting. These activities should be less rigorous than the normal training regimen.

If this step is tolerated then non-contact exercise and more intense work out can be added. At this point the player can return to normal running and weight lifting activities. The next step is returning to full contact practice and the last step is returning to competition.

Each one of these steps should be monitored for 24 hours. If symptoms return during any of these steps do not progress activities. If symptoms resume, the athlete may be pushing too hard. Many steps may take days to accomplish without symptoms. It is very important to be patient and go slow when going through recovery after a concussion.

Multiple concussions can cause brain swelling and it may take longer to recover with additional concussions.

Always contact your healthcare worker if concerning symptoms occur or if you have any questions. A mental status exam or a brain imaging test may be needed to assess the recovery or further progression of the problem

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