Concussions in Sports
Most concussions go unreported because the symptoms aren’t understood by parents, coaches, or players. Youth, college, and professional sports organizations now have concussion protocols that are mandated to follow. Even so, sport concussion statistics are both startling and serious.
What are Concussions?
Concussions are traumatic brain injuries, known as TBIs. These TBIs tend to be mild injuries that allow recovery over a period of days or weeks. However, repeated concussions can seriously harm the brain causing long-term aftereffects. Left untreated, concussions can result in brain damage that affects a person’s quality of life, and in rare cases, they can be fatal. 2
Concussions may also affect brain function. Someone suffering from a concussion may not be able to think, concentrate, or react well when faced with situations that involve rapid decision-making, like driving. Both working and long-term memory may be impaired.
Concussions may affect emotions. This could manifest itself in depression and mood swings. Personality changes may also be evident.
Concussions may affect a person physically. They may suffer from headaches, light sensitivity, dizziness or vertigo, sleep issues beyond excess fatigue, or seizures. Most concussions do not cause unconsciousness.
Although common, concussions always require medical attention. However, over half of concussions go undiagnosed, meaning that 50 percent of all concussions aren’t getting the needed medical attention.
The NCSS and Sports-Related Concussions
While true that not every bang on the head or body slam will result in a concussion, athletes will play sports under a national concussion protocol. This protocol was implemented when The Traumatic Brain Injury Program Reauthorization Act of 2018 was signed into law on December 21, 2018.5 The National Concussion Surveillance System (NCSS) allowed the Centers for Disease Control (CDC) to determine how many children and adults receive a concussion and how they receive it.4
The NCSS provisions include gathering the following sports-related concussion data:
- National estimates regarding concussions among youth inside and outside organized sports and monitor concussion trends.
- Establish whether current sports-related concussion protocols and prevention efforts are working, including identifying return to work or return to sports recovery needs that are not being met.
- Give healthcare providers, and hospitals insights about the patients seeking care for concussions and their recovery needs to minimize barriers to care.
The NCSS also collects data on concussions outside of sports, traumatic brain injury, and resulting disabilities. Current data only covers 1 in 9 concussions throughout the United States in any given year, which is a crucial reason for concussion protocols and data gathering.
Youth and High School Athletes
- The ER rate for youth ages 8 to 13 with concussions doubled.
- Teens 14 to 19 years old have seen a 200 percent rise in diagnosed concussions.
- High school football accounts for nearly half of all high school sports-related concussions. One-third of those concussions happen during practice.
The good news in this is that more concussions are beginning to be diagnosed and that the symptoms of concussions are being more recognized. That fact aside, 1 in 5 athletes playing a contact sport will get a concussion this year. Youth and high school football see around 300,000 concussions each year, while girl’s soccer and girl’s basketball rank second and third in high school contact sport concussions.
- 34 percent of college football players have suffered a concussion
- 30 percent of college football players have suffered more than one concussion
- 12.2 percent have suffered a concussion through a tackle injury
The NCAA has put together an NCAA Concussion Fact Sheet to help athletes understand and recognize the symptoms of a concussion in both themselves and their teammates, as well as concussion protocols and return-to-play requirements.9
Many professional athletes, especially in football, have been diagnosed with chronic traumatic encephalopathy (CTE).10 CTE has gotten much attention recently as several high-profile football players have been diagnosed with the neurodegenerative disease. Those players suffered from repeated concussions during their careers. They develop CTE later in life, exacerbating mental health disorders and the onset of diseases like ALS (Lou Gehrig’s disease) and Alzheimer’s.
Professional football players who died from CTE in recent years include well-known running back and sports commentator Frank Gifford.6 CTE is just one reason the medical and sports communities have come together to educate health professionals, athletes, and their families about early concussions and the cumulative effects of multiple concussions.
How are Sports Concussions Diagnosed?
Contrary to popular belief, concussions aren’t brain bruises. Bruising means bleeding somewhere inside the brain, causing the bruise. Concussions do not cause the brain to bleed.
Concussions change how brain cells function on a microscopic level. While imaging is helpful to ascertain whether surgery after a concussion is needed, for instance, it won’t show microcellular brain damage. Neurological and cognitive testing will be more helpful in diagnosing both mild and severe concussions.
The ACE Concussion Form
Evaluations will include:
Injury characteristics: description of the injury and how it occurred, loss of memory (amnesia), loss of consciousness, seizures, early signs of concussion observed by others
Symptom checklist: the four symptom categories are physical, cognitive, emotional, and sleep. Part of the symptom checklist is if symptoms worsen upon physical or cognitive activity or if the injured individual is acting differently than usual. The symptom scores are rated as a “0” for symptoms, not present and a “1” for symptom present. The symptom checklist score ranges from 0 to 22.
Risk factors for recovery include a history of concussions, headaches, developmental disability, and psychiatric history, including medications and other co-existing disorders. This category serves to identify risk factors that would negatively affect recovery.
Red flags of neurological deterioration include SUDDEN ONSET of symptoms that merit acute emergency attention, such as slurred speech, repeated vomiting, seizures, worsening headaches, and loss of consciousness.
Diagnosis with insurance coding, also known as ICD diagnostic codes:
- Concussion with no loss of consciousness
- Concussion with less than one-hour loss of consciousness
- Concussion that is unspecified or unclear
- Other diagnoses that emanate from a traumatic brain injury
Follow-up action plan, which may include patient monitoring or specialist referral.
The ACE concussion form plays a vital role in holistically evaluating mild traumatic brain injury or concussion, as symptoms are notoriously difficult to recognize and assess.
Recognizing the Symptoms of Sports-Related Concussions
It can be challenging to recognize the symptoms of a sports-related concussion because, often, the symptoms don’t appear immediately following contact, although some signs do. Confusion is one of those symptoms that may happen immediately after hard contact.
The player may appear stunned or dazed, not seeming to know where they are, who they are playing, remembering plays, or the score. They may need help to think clearly and answer questions slowly. They may also need help knowing what day it is or knowing their name.
Other symptoms include:
- Short-term memory loss
- Vision disturbances and light sensitivity
- Balance issues, dizziness, or clumsiness
- Headache or ringing in the ears
- Nausea and vomiting
- Sensory issues like loss of smell or taste
Each of these symptoms, whether singly or together, merit sitting out and getting checked out by a physician or trainer. These symptoms tend to go away quickly or in a few hours. However, some may last a few days or weeks after contact, whether or not a concussion has been diagnosed.
Post-Concussion Syndrome Symptoms
Sports Concussion Treatment
It’s imperative to get medical care following any kind of head injury. First and foremost, the athlete should be immediately removed from current play. Concussion protocol prohibits returning to play until cleared by a physician or neurologist.3
Concussion treatment includes rest and the monitoring of symptoms.1 Ask your doctor about pain relievers for headaches, as over-the-counter medications like ibuprofen or aspirin can increase the risk of a brain bleed.
If the concussion is severe or an athlete exhibits symptoms of post-concussion syndrome, further treatment may be necessary. This may include both physical and occupational therapy. Mental health professionals may be needed for psychological or psychiatric support.
Treating Post-Concussion Symptoms in the Brain
So, in addition to traditional concussion and post-concussion treatments, advances in neurobiology can use that increased communication between neurons to treat post-concussion symptoms in innovative, non-invasive, drug-free ways using TMS.
Sports Concussion Treatment With Brain Therapy TMS
Most patients experiencing a concussion will feel better or asymptomatic within three months. Up to a quarter, however, may experience post-concussion symptoms beyond that three-month threshold, many being symptomatic for years.
Headache is the most common symptom that hangs on beyond the initial concussion. There’s no cure for post-concussion symptoms, but there may be help available with brain therapy, most notably transcranial magnetic stimulation (TMS), also referred to as repetitive transcranial magnetic stimulation (rTMS).
What is TMS?
How Does TMS Work?
By placing a magnetic coil over the scalp, repetitive magnetic pulses flow through the coil and enter the brain, targeting the prefrontal cortex. This is called neuromodulation therapy, a drug-free therapy. The brain’s neurons are activated in ways that either increase or decrease electrical activity that may alleviate post-concussion syndrome symptoms over time.
One current clinical trial explores whether rTMS significantly improves post-concussion symptoms.11 Still in the recruitment phase, the study will work to determine the relationship between brain function and certain rTMS treatment markers that predict treatment responses for such post-concussion symptoms like depression.
The U.S. Food and Drug Administration (FDA) approved TMS treatment for depression in 2008. Since then, patients have found relief for symptoms of treatment-resistant depression through TMS treatment. Advances in TMS therapy for post-concussion signs continue to be researched.
The Future of TMS Therapy is Now
Brain Therapy TMS Can Help
Concussions can affect an athlete’s quality of life for years. TMS doesn’t treat the concussion itself, but the symptoms of concussion can significantly affect an athlete’s activities of daily living. By rendering electrical impulses to the brain’s core that harbors the signs, Brain Therapy TMS offers post-concussion patients targeted relief that, for many, is a game-changer.
Brain Therapy TMS is a recognized leader in TMS therapy in Southern California. We treat depression, dementia, chronic pain, and other mental health disorders. If you’ve suffered the often debilitating aftereffects of a concussion, contact us to schedule a free consultation.
- American Brain Foundation Staff. (2022, January 7). Concussion symptoms and treatment. American Brain Foundation. Retrieved December 14, 2022, from https://www.americanbrainfoundation.org/diseases/concussion/
- Brainline. (2018, July 30). Concussion and sports. BrainLine. Retrieved December 14, 2022, from https://www.brainline.org/article/concussion-and-sports
- CDC Staff. (2020, October 2). Responding to a concussion and action plan for coaches. Centers for Disease Control and Prevention. Retrieved December 14, 2022, from https://www.cdc.gov/headsup/basics/concussion_respondingto.html
- CDC Staff. (2021, May 12). National Concussion Surveillance System. Centers for Disease Control and Prevention. Retrieved December 14, 2022, from https://www.cdc.gov/traumaticbraininjury/research-programs/ncss/index.html
- Congress. (2018, December). H.R.6615 – 115th Congress (2017-2018): Traumatic Brain Injury Program. Congress. Retrieved December 15, 2022, from https://www.congress.gov/bill/115th-congress/house-bill/6615
- Fox, K. (2020, July 21). A tribute to the NFL players who suffered CTE Brain Injury. Legacy.com. Retrieved December 14, 2022, from https://www.legacy.com/news/culture-and-history/a-tribute-to-the-nfl-players-who-suffered-cte-brain-injury/
- Gioia, G., & Collins, M. (2006). Acute concussion evaluation – centers for disease control and prevention. cdc.gov. Retrieved December 15, 2022, from https://www.cdc.gov/headsup/pdfs/providers/ace-a.pdf
- Hazell, T. (2022, September 23). Post-concussion syndrome: Causes, symptoms, and treatment. Patient.info. Retrieved December 14, 2022, from https://patient.info/brain-nerves/post-concussion-syndrome
- NCAA. (2020). CONCUSSION SAFETY. NCAA.org. Retrieved December 14, 2022, from https://www.ncaa.org/sports/2021/5/24/sport-science-institute.aspx
- Rahman, M. (2021, August 31). Understanding CTE in NFL concussion cases. Expert Institute. Retrieved December 14, 2022, from https://www.expertinstitute.com/resources/insights/understanding-cte-in-nfl-concussion-cases/
- University of Calgary. (2022, December 12). Treatment of post-concussion syndrome with TMS: Using FNIRS as a biomarker of response – full text view. Full Text View – ClinicalTrials.gov. Retrieved December 14, 2022, from https://clinicaltrials.gov/ct2/show/NCT04568369