reduced the number of sports-related concussions. After the National Collegiate Athletic Association made the use of the head when tackling illegal in 1976, the annual number of head and neck injuries in football declined by about 50%. The required use of helmets in many contact sports and advances in helmet design also have resulted in fewer head injuries. Improved conditioning of young athletes, especially strengthening of neck muscles, may also help to prevent concussions. Although injury prevention begins with proper equipment, there is no such thing as a concussionproof helmet or mouth guard. Young athletes must be trained in safe sports techniques and how to follow the rules of the game. In addition, rule changes should be considered in sports where force is delivered head first. This not only promotes fair play, but also protects both participants. In order to get back into the game, most athletes will downplay their symptoms. Understanding the long-lasting consequences of repeat concussion is an important part of prevention. Several medical and sports organizations have recently developed concussion awareness programs for athletes, coaches and parents. These educational programs play a critical role in helping to recognize concussions and prevent repeat injury. If despite all precautions, a concussion does occur, the key to healing from a concussion is complete physical and mental rest. Reading, computer work, playing video games, even watching television are all activities that should be limited until all symptoms have resolved. This typically takes 7 to 10 days, although some people have symptoms for weeks or months after the injury. Once the patient is free of symptoms, the individual can gradually return to physical and mental activity. It is important to slowly return to daily activities because being symptom-free does not mean the brain injury has fully healed. Your doctor may recommend a step-by-step program: first add an activity, then monitor your symptoms. If symptoms do not return, the patient can continue 42
Health, Beauty & Fitness
Spring 2016
increasing the challenges. This slow, steady approach typically reduces the time spent away from school, work and athletics because it provides sufficient time for the injury to heal. It is important to note that diving back into activities as soon as symptoms have resolved can bring them back on and require a return to complete rest. If a child sustains a concussion, parents should seek appropriate medical care. They should request a description of symptoms indicative of worsening brain injury and of common post-concussive symptoms, as well as guidelines for return to play and for medical follow-up. For athletes who experience persistent difficulties after a concussion such as headaches, difficulty concentrating, irritability, sleep disturbances or dropping grades, an effective treatment plan will often combine education, cognitive rehabilitation, psychological support and, in some cases, medication. Getting back into the game too soon puts an athlete at risk for another concussion. If he or she suffers a repeat concussion before the first concussion has healed, it may take much longer for symptoms to resolve and there may be long-term problems, such as learning difficulties or chronic headaches. Although it rarely happens, repeat concussion can cause permanent brain damage and even death. In 2010, the American Academy of Pediatrics recommended that young athletes with concussions be evaluated and cleared by a doctor before returning to sports. The American Academy of Neurology issued a similar statement, and stressed that doctors who clear athletes for return to sports should be trained in managing and assessing sports concussions. Dr. Michael Gross, the founder and director of Active Orthopedic and Sports Medicine, is the section chief of sports medicine and the orthopedic director of the Center for Sports Medicine at Hackensack University Medical Center, as well as medical director of Active Center for Health and Wellness.