Understanding Sports Concussion Injuries

Contact sports, like football and hockey, are violent by nature. Yet accidents can happen even during non-contact sports like baseball and long distance racing. Players collide with each other, they trip and fall, or some other mishap occurs that leads to an injury.

Concussions are among the most common — and most serious — injuries that athletes sustain. This article will help you understand the nature of concussions that occur during participation in sporting events.

What is a concussion?

A concussion is a traumatic brain injury that changes the way the brain functions. Concussions are typically caused by a blow to the head, but they can also be produced by violent movement or spinning that causes trauma to the brain. During sporting events, concussions usually occur when players collide with each other, when a player runs into a fixed object like a wall or pole, or when a player's head strikes the ground.

Some concussions cause a player to lose consciousness. More often, they produce temporary symptoms that include headaches, disorientation, poor balance, dizziness, memory loss, and impairment of concentration. Most symptoms resolve after a few minutes but in some cases the symptoms persist for longer periods, sometimes indefinitely. The worst concussions result in permanent brain damage.

How often do concussions occur?

According to the Center for Disease Control, more than 170,000 sports-related concussions send children under the age of 19 to emergency rooms each year. That statistic fails to account for the substantially larger number of athletes who experience a concussion but do not visit an emergency room. In addition, the CDC estimate only counts injuries that arose from organized sports in which the primary diagnosis was a traumatic brain injury. The American Academy of Neurology estimates the total number of sports-related concussions sustained by minors to be between 1.6 million and 3.8 million annually. Half of all sports concussions go unreported.

The risk of a concussion is greatest in football and other contact sports. Protective gear provides some degree of protection but a helmet cannot prevent movement of the brain within the skull when the head experiences a sudden impact.

Football is not, however, the only sport in which concussions occur. No sport is risk-free. Any time an athlete is running or jumping, the possibility exists of inadvertent contact with another player or of falling to the ground. Concussions happen to players during games of basketball, soccer, volleyball, and all other athletic competitions. They happen to high school and to college players, to males and to females. Concussions have been called a "silent epidemic" in athletic programs because of their pervasive nature.

Are there different kinds of concussions?

Although medical experts have developed different classification schemes, they all grade concussions by severity. The American Academy of Neurology guidelines divide concussions into three levels. The most serious, sometimes called a "classic concussion" or a "Grade 3 concussion," results in a loss of consciousness. The least severe is a minor or "Grade 1" concussion. It typically produces disorientation, dizziness, or other symptoms that last no more than 15 minutes. If the symptoms persist for more than 15 minutes, the concussion is classified as moderate or "Grade 2."

It is critical to be evaluated by a doctor after sustaining a Grade 3 concussion. It is wise to seek medical care even after a minor or moderate concussion. Brain injuries are not easy to diagnose. Only observation by a trained professional can provide assurance that bleeding or swelling in the brain is not endangering the life of an athlete who sustained even a minor concussion.

"Second impact" concussions are a special category of brain injuries. They derive their name from the brain's vulnerability after a concussion occurs. Until the brain heals — a process that may take days or weeks — a second concussion could be devastating. An impact that might cause only minor injury to a healthy brain could cause permanent damage to a brain that has not healed from an earlier concussion. Second impact concussions often take months or even years to reach a maximum state of healing.

"Post-concussion syndrome" is the name given to conditions such as chronic traumatic encephalopathy (CTE). Brain injury patients are diagnosed with a post-concussion syndrome when symptoms of a concussion persist after a typical healing period ends. At least 17 percent of individuals who sustain repetitive concussions develop CTE. Athletes with post-concussion syndrome are sometimes forced to retire from competition because headaches, dizziness, concentration lapses, and other symptoms impair their ability to play their sport.

Who should diagnose a concussion?

Any time an athlete sustains a blow to the head, a trained professional should evaluate the player for symptoms of a concussion. A number of sophisticated tools, including symptom checklists and sideline tests, have been devised to help trainers and medical staff look for evidence of a concussion.

If a concussion is suspected, a more thorough evaluation should be conducted by a licensed health care professional. While that is the best practice to follow whenever a concussion might have occurred, it is particularly important when the symptoms of a traumatic brain injury persist for more than 15 minutes.