Sports Safety IQ

Concussion Update, Part IV: Legislation to Protect your Melon

Lawmakers in Washington state are putting through a bill to help minimize the potential for traumatic brain injuries in sports. Washington has approved the country's strictest law governing the return to play of youth athletes who are suspected of having a concussion. The law, which is informally known as Zackery Lystedt's Law, state that any athlete under 18 who shows signs of concussion will be barred from returning to play until he or she has been evaluated by a physician and cleared to resume sports activities. The purpose of this law is to prevent what is known as second impact syndrome. The law also has an educational component, requiring athletes and parents to sign a concussion and head-injury information form.

The law is named for Zackery Lystedt, who suffered a traumatic brain injury in 2006, during a middle school football game. Zackery, then 13, took a hard hit in the end zone that put him out of the game for 15 minutes. He then went back in the game, where he collapsed on the field a few minutes later. His last words to his father before losing consciousness were, "Dad, I can't see."  Zackery was then taken to the hospital where doctors operated on the hemorrhage in his brain. Three years later, he is still in a wheel chair, although he has mostly regained his sight and speech. It took Zackery 9 months after the injury before he could speak again.

Concussion Update, Part III: Head Injuries ~ Looking for Signs and Acting Quickly

Adding to the wealth of information in the media recently regarding head injuries, the NY Times joined in with an article on the importance of acting quickly to get head injuries checked out (view "Head Injuries" article).

While serious head injuries are rare in sports (when compared to total numbers of participants each year), when they do happen, every minute counts. In some circles, brain trauma specialists refer to the time between the injury and getting treatment as "brain minutes" with each minute potentially being the difference between life and death.

The NY Times article touches on a number of critical points:

• Helmets do not always prevent concussion, but they are almost 100% effective in preventing skull fractures.
• The evidence in Natasha Richardson's case suggests she fractured her skull during the fall,  causing an artery tear and the subsequent brain bleed that led to her death.
• Concussions -- which are the result of a quick acceleration and deceleration (or shaking) of the brain -- are not always caused by head-to-head or head-to-object contact. In some cases, a body-to-body tackle or hard check can cause a concussion as well.
• Anyone who suffers a head injury or exhibits symptoms of concussion should ALWAYS be checked out by a doctor.

Coming up next: In Concussion Update IV, see what lawmakers in the state of Washington are doing to protect kids from Second Impact Syndrome.

Concussion Update, Part II: More Brain Injury Prevention & Awareness for Parents & Coaches

   During National Brain Injury Awareness month, what do you as a parent or coach need to know about brain injuries that can occur during sports activities? First on the list is that concussions are on the rise in youth sports. Players are more aggressive, hitting harder and playing tougher, sometimes to their own detriment. And I'm not just talking about boys. Concussions among female athletes are soaring, with head injury rates among female soccer players, for example, rising to the level of those in the NFL. The competitive nature of sports, coupled with the competitive nature of parents these days (pushing kids to excel at all costs) and the added lure of college scholarships and lucrative pro contracts, all point to a driving sports culture that is not going to change any time soon. In this culture, injuries to kids are going to continue to escalate.

How, in this race to the highest levels of sports, can we prevent concussions and head injuries?

Concussion Update, Part I: Natasha Richardson's Death and Brain Injury Awareness Month

Part One in the "Concussion Update" series    

It is a terrible coincidence that actress Natasha Richardson's death on the ski slopes from a traumatic brain injury occurred during Brain Injury Awareness month. Each March, the Brain Injury Association of America sponsors events and publicity to raise awareness of brain injuries and their effects. This year, the association's focus -- and part of their year-long campaign -- is Sports & Concussions. What a tragic way of underscoring the seriousness of prevention and awareness of head injuries for athletes than to have the whole country focused on Natasha Richardson's story.

New Diagnostic Testing for Concussions

Despite the bleak reports on concussions to athletes in the media lately, there is good news on the horizon. A new diagnostic tool has been developed by doctors at the University of Pittsburgh Sports Medicine Concussion Program, called ImPACT, or Immediate Post-Concussion Assessment and Cognitive Testing (visit ImPACT here). The program uses computerized tests to measure brain function and appears to be just the thing to overcome subjective (and sometimes uninformed) sideline management of concussions.

Most parents and coaches are probably not aware of this new mechanism for evaluating the effects of concussions -- and that's why I'm writing about it here.

Sports Concussions: Don't Ignore the Dings

Concussions to athletes have been getting a lot of press lately. The news itself has been grim, particularly the stories coming out of the NFL about players like Ted Johnson, whose countless hits to the head have caused permanent impairment and chronic depression; or like Andre Waters, and most recently, Justin Strzelczyk (see USA Today story), whose deaths have been linked to permanent brain damage caused by repeated concussions during their playing careers.

I hope this publicity will increase awareness of the dangers of concussions among all players and coaches -- amateur and pro alike. Dings and bell-ringers are no longer something to be brushed off.

What parents, coaches and players need to know about concussions:

• A concussion is usually defined as a bruising of the brain after a traumatic injury to the head. Basically, the brain is shaken from the impact and is bruised from hitting the inside of the skull.