Be Aware Of Concussion As Winter Sports Season Gets Under Way

Featured Article
Main Category: Sports Medicine / Fitness
Also Included In: Neurology / Neuroscience;  Pediatrics / Children's Health
Article Date: 29 Dec 2011 - 0:00 PST


Every winter, hundreds of thousands of sport enthusiasts, many of them teenagers and young adults, head out to ice and ski slopes to practise, enjoy and compete in many kinds of winter sport. Winter sports are a great way to develop fitness and stay healthy, and they also help develop important life skills such as team-building and leadership. But it is vitally important to remain aware that accompanying these benefits is a potentially serious risk: concussion as a result of injury or fall.

The serious risk of concussion is something many athletes out to push the limits of speed, strength and endurance fail to appreciate, much to their disadvantage, especially as when a person has concussion, they are also less likely to appreciate their own limitations.

A concussion is a traumatic brain injury (TBI) brought on as a result of a bump, blow or jolt to the head or body that causes the head and brain to move rapidly back and forth in such a way that the brain bounces around or twists in the skull. This sudden movement can stretch and damage brain cells, bring about chemical changes in the brain, and cause bleeding in the brain.

Most people with concussion recover quickly and fully, but others can have symptoms for days or weeks, and more serious cases can linger for months and even years.

Prompt treatment following concussion can save lives.

Perhaps one of the most well-known examples of where delaying treatment may have cost a person their life, is that of British film actress Natasha Richardson, who died from "epidural hematoma" (bleeding into the skull) due to "blunt impact to the head" according to an autopsy conducted the day after she died on 18 March 2009. Her death was ruled an accident.

45-year-old Richardson was skiing on a nursery slope in Canada when she fell and hit her head. Apparently she had refused an ambulance and medical treatment after the fall. It wasn't until three hours later, after developing a headache, that she went to hospital.

The unfortunate thing with concussion is that even when the injury is serious, the person can feel fine for a while because it takes time for the symptoms of bleeding into the brain to emerge.

Experts suggested at the time that if Richardson had had a CT scan immediately after her fall, it could have detected bleeding, bruising or the start of swelling in the brain.

The condition is very treatable, if you are aware of what the problem is and the patient can be taken to hospital quickly, but there is not much time and you have to act quickly.

Dr. Edward Aulisi, neurosurgery chief at Washington Hospital Center, told the Associated Press at the time that:

"If there's any question in your mind whatsoever, you get a head CT. It's the best 20 seconds you ever spent in your life."

The US Centers for Disease Control and Development (CDC) have teamed up with the National Football League (NFL), USA Hockey, the US Ski and Snowboarding Association, and developed an awareness campaign to alert young athletes and their parents, coaches and teachers about the risk, symptoms and signs of concussion and what to do.

Created through the CDC's "Heads Up" educational campaign, the initiative includes resources for high school and youth sports coaches and other professionals. The kit includes materials to help spot concussions and what immediate steps to take if you suspect someone has a concussion. Click here to see a list of materials and links to resources.

The resources include a poster that the sponsoring organizations ask parents, coaches, and school professionals to display in team locker rooms, competition and tournament sites, gymnasiums, ice rinks, and schools all across the country.

So before you strap on your skates, skis or snowboard this winter, set aside some time to learn about concussion, its symptoms, danger signs, potential long-term symptoms, and how to reduce the risk of injury in the first place. It could save a life.

Here are some tips from the CDC on how to prepare and prevent concussion and other injuries, on and off the ice and ski slopes:

• Make safety your number 1 priority: there is no such thing as 100% concussion- or injury-proof equipment, but there are measures you can take to minimize the risk.


• Wear only approved and properly fitted protective equipment. Make sure it is well-maintained and always wear it consistently and correctly.


• In hockey and other sports, enforce and follow rules such as "no hits to the head" or other types of dangerous play.


• Practise safe playing techniques, and encourage all participants to follow the rules of play.


• Learn about concussion. Get the facts and carry the "four step action plan" with you, not just to practices and competitions, but also when out with family and friends just having fun with winter sports.

The Four-Step Action Plan

The CDC recommend that parents, teachers and coaches in charge of young athletes learn about concussion and carry this "four -step action plan" around with them all the time they are supervising young people doing sport:

1. Remove the athlete from play
   Look for signs of concussion if they have had a bump on the head or a blow to the head or body. If in doubt, keep them out of play.


2. Get a professional evaluation
   Make sure a health care professional who knows about concussion evaluates the injured person: don't try to judge the severity of the injury yourself. Have the following information ready to give to the health care professional: cause of injury; force of blow; any loss of consciousness, if so for how long; any loss of memory immediately after injury; any seizures immediately after injury; any previous concussions?
3. Inform parents/carers, family
   Make sure whoever is caring for the injured person at home knows about concussion. Give them a fact sheet (eg from the CDC educational resources mentioned above). Make sure they know the person has to be seen by a healthcare professional who knows how to evaluate for concussion, if this has not been done already.


4. Keep them out of play
   Don't let the person get back into the game or return to play sport until the healthcare professional says they are symptom free and it's OK to do so. Experiencing a repeat concussion before the brain has recovered from the earlier one, for instance within hours, days or weeks, can slow recovery and raises the chances of developing long-term problems. Failing to do so, albeit in rare cases, can lead to brain swelling or edema, permanent brain damage, and even death.

The CDC also offers free online training on concussion for coaches and health professionals. Click here to see the course for coaches.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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