What coaches, players and parents should know about concussions

July 14, 2011 at 12:00a.m.

Fast facts

Signs and symptoms

A concussion is a brain injury. All concussions are serious and can occur in any sport. Recognition and proper management of concussions when they first occur can help prevent further injury or even death. Here are indications that someone has had a concussion:

Loses consciousness (even briefly), although someone does not have to lose consciousness to have a concussion.

Appears dazed or stunned

Headache or pressure in head

Confusion

Nausea or vomiting

Balance problems or dizziness

Double or blurry vision

Sensitivity to light or noise

Moves clumsily

Answers questions slowly

Feels sluggish, hazy, foggy

Shows behavior or personality changes

Can’t recall events before hit or fall

Does not “feel right”

Source: Centers for Disease Control and Prevention

Parent tips

Every sport is different, but there are steps your children can take to reduce the risk of concussions:

Ensure that your child follows the coach’s rules for safety and the rules of the sport. “Talk to the coaches to make sure they understand proper technique,” said Jeffrey Kutcher, the director of Michigan NeuroSport and the head of the Concussion Program at the University of Michigan. “Make sure there is a culture of safety with the team. If somebody sees a player who is wobbly, it’s not OK to just hide him for a few plays and tell him what to do. That happens a lot.”

Encourage your children to practice good sportsmanship at all times.

Make sure your children wear the right protective equipment for their activity (such as helmets, padding, shin guards and eye and mouth guards). Protective equipment should fit properly, be well-maintained and be worn consistently and correctly. “Preferably, you want a new helmet, not a refurbished one,” Kutcher said. “If it is going to be refurbished, you want it to be certified. The only problem with that is certification is not real strenuous. If I’m a parent, I want to know from my school system, where is my helmet coming from? If they are reconditioned, who is doing it? What’s the reputation? You can talk to them on the phone.”

Learn the signs and symptoms of a concussion.

Source: Centers for Disease Control and Prevention

Detroit Free Press

DETROIT

What should you do if your son comes home from football practice with a headache that seems to be getting worse?

What if your daughter bonked heads with another player at soccer practice and complains about feeling nauseous or becomes irritable a few days later?

The answers — seek medical attention immediately — can be found in a new online tutorial about concussions at www.MichiganNeuro-Sport.com.

“The big point is learning to recognize the injury,” said Jeffrey Kutcher, the director of Michigan NeuroSport and the head of the concussion program at the University of Michigan.

The tutorial is available just in time for coaches, parents and students who are getting ready for high-school football and soccer practices to start in a few weeks. It takes about 20 minutes to complete.

“It’s a common misconception that a concussion is caused by one big, dramatic hit like we see on ESPN, but that’s not the case,” Kutcher said. “I think the biggest misconception goes back to the general concept that all concussions are alike — that the number of concussions that a person has had is the most important thing, not the circumstances or situation or duration of symptoms.”

Symptoms of a concussion include a headache or feeling pressure in the head; temporary loss of consciousness; confusion or feeling as if in a fog; dizziness, nausea or vomiting and sensitivity to light.

“A concussion is not always the loss of consciousness, the loss of memory or somebody not being able to walk,” Kutcher said. “It can be more subtle. We are trying to get the message out that this is an individual injury. You have to be seen by health-care professionals who have experience examining nervous systems and dealing with this type of injury.”

After an athlete suffers a concussion, Kutcher said, it is important to get the player out of a game or practice and have him or her evaluated to prevent more injury. He said there is no set formula for how long a player should sit out after a concussion.

“It is a very individual injury,” Kutcher said.

“It must be managed individually. You can’t just have a set way to do it. It requires some pretty hands-on management. It’s when injuries are mismanaged that you can have a problem.”

Kutcher said that one of his patients, Spencer Helgren, is the perfect example of what can happen when an athlete returns to the field too quickly after a concussion.

Spencer, a 16-year-old from Ely Township, Mich., suffered a concussion last fall in a high-school football game and was sent to a neuropsychologist. After a 90 minute evaluation, Spencer was cleared to play in the next game, just six days after his injury. “Other than a headache, he seemed to be OK,” said his mother, Jill Koski.

In the next game, Spencer took another hit to his head and suffered another concussion.

“He obviously wasn’t healed enough from the first one,” Koski said.

After his second concussion, Spencer developed several problems. He had a severe headache that lasted for months. He was extremely sensitive to light. He was irritable and had concentration issues, even though he was an honor-roll student.

Five months later, Spencer was taken to Michigan NeuroSport for an evaluation.

“Spencer had a concussion that was pretty obvious to us, in retrospect,” Kutcher said. “If that had been managed differently, I would predict a much different outcome.”

Spencer has improved dramatically under Kutcher’s care, which included medication to help him sleep despite the pain in his head.

Kutcher said there is an important lesson at the center of Spencer’s story.

“The biggest lesson, by far, is the upfront recognition and management of concussion,” Kutcher said.

Whose responsibility is it to keep an eye out for concussions?

Amy Teddy, the injury-prevention program manager at the University of Michigan C.S. Mott Children’s Hospital, said it is everybody’s job: players, teammates, coaches, trainers, teachers, parents and medical personnel.

“It takes an entire team,” Teddy said. “That’s my strongest message. This is not just the parent’s problem, or the coaches’ problem, or the trainer’s problem. Everyone has a role in managing this issue and has the opportunity to prevent something that could be a tragedy.”

Over the last 30 years, 1,827 athletes under the age of 21 died, according to a study published in this month’s issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics. About 14 percent were caused by head trauma. The largest number was in football with 148 deaths, including 17 high school athletes who sustained concussions shortly before they died.

“Concussions aren’t just about getting your bell rung,” Teddy said. “It’s not like it was when our parents were athletes. We know more now than back then.”

Teddy said that someone should go to the hospital immediately if symptoms include seizure, persistent vomiting, trouble recognizing people or places, weakness in arms or legs, slurred speech or other signs that appear to be a stroke.

“There may be a bleed taking place,” Teddy said. “That is like a ticking time bomb.”

But sometimes, people who have concussions don’t realize they are experiencing symptoms.

“A lot of times,” Kutcher said, “athletes on the sidelines will say, ‘I’m fine.’ And later, they will say, ‘I’m messed up.’

“They just didn’t realize it.”