Head and Spinal Cord Injury
Serious head, spinal, and neurological injuries
“Be a man!” “Tough it out” When an athlete is injured, many coaches use these types of phrases to encourage their students to push themselves through pain. But recently, the actress Natasha Richardson died of what seemed to be a mild head injury she sustained after skiing (Hitti 2009). The actress fell down on a ‘bunny slope,’ and talked and laughed about her mishap afterwards. Within, she was in a coma, and soon died from bleeding on the brain. Aggressive monitoring and treatment of head injuries is essential to prevent such tragedies occurring on the playing fields of youth sports, where such injuries are all too common, particularly in contact-heavy sports like football, hockey, and soccer.
It is essential that coaches, school staff, and parents do not dismiss the signs of concussion or other serious head trauma. Unfortunately, the symptoms of headaches and dizziness, mood swings, and general lack of mental focus are easy to dismiss unless adults and teammates are vigilant (O’Brien 2009). Also, schools must abandon the idea that ‘getting on with it’ and ‘pushing past the pain’ are something to be cheered on.
Given the increased concern about head injuries in young athletes and the lasting trauma that can occur: “High school athletes in Massachusetts are currently required to have their doctor’s or a trainer’s permission before resuming activity in contact sports after having a concussion. Some medical professionals recommend staying out of any sports activity for at least a week after a concussion or head injury” to avoid repeat trauma (Safety, 2009, Brain and spinal cord.org). “There is an increased risk of suffering subsequent concussions after a first concussion” (Goodlett & Lemack 2009). Repeated blows to the head have been linked to dementia in professional boxers and football players.
Prevention
Prevention, of course, is the best cure. In football, players should be discouraged from ‘head butting’ or battering other players with their heads. Remember: the helmet is a protective device, not an implement to use against opponents. Players under age ten in soccer should not use their heads at all, and head contact should be limited for all ages. Officials can play an important role in enforcing rules: zero tolerance for checking from behind or head checks in hockey and lacrosse, for example. In baseball, “The American Academy of Pediatrics suggests reduced-impact safety baseballs for young players, the elimination of the on-deck circle, and placing screens to protect dugouts and benches from errant balls or bats” (O’Brien 2009).
Players as well as coaches should all be educated in an age-appropriate fashion to look doe the signs of concussion or more serious trauma in their friends — education sessions should be conducted at the beginning of the season, through trained sports professional athletic trainers or medical professionals, not through a cursory handout. Video or hands-on mandated safety courses may be necessary. Players may be able to spot that ‘something is not right’ in their friends before an adult. And players should be able to self-monitor as best as they can, after a hit. However, this is no panacea, given that symptoms may be delayed, or masked by the adrenaline of a game.
First aid
Signs and symptoms of serious problems include: Loss of consciousness or memory, a headache that worsens or won’t go away, confusion, mood swings, drowsiness, numbness, weakness, slurred speech, vision changes and changes in the pupils’ size, shape, and reaction to light, dizziness, vertigo, difficulty standing or walking, nausea and vomiting (Safety, 2009, Brain and spinal cord.org).. After any forceful blow to the head, the coach or referee should ensure that the game is stopped, and the player should be told to not to nod or shake his head during the assessment, but to say yes or no. If conscious, the player should be asked if he or she is aware of the day and time, his or her location, what quarter or part of the game he or she is playing, and other questions to assess his or her bearings. If a serious injury is suspected, the student should be taken to a doctor immediately. Depending on his or her mobility an ambulance may need to be called.
Any athlete with even a minor head injury should be closely supervised for any of the tell-tale symptoms. If an athlete loses consciousness, the injury “must be treated as a suspected head, neck, or back injury” (Goodlett & Lemak 2009). If the athlete does not regain consciousness, he or she should be kept stable until medical professionals arrive: “The only instances in which an athlete’s helmet and shoulder pads should be removed is when a medical authority believes that it is necessary for the care of the athlete, or if the equipment interferes with the rescuers’ ability to provide required CPR” (Goodlett & Lemak 2009).
Suggested activities:
Role-play a scenario in which an athlete has sustained a minor head injury but seems to be alright. What types of questions should you ask the athlete? What should you NOT do (ask the athlete to shake his or her head, for example). What types of symptoms should you look for?
Then role-play a scenario in which an athlete looses consciousness, but then says that he or she is fine. Remember that it is not uncommon for an athlete to insist that he or she is ready to get back to playing, yet still have a concussion. Again, run through the types of questions that might be asked of the athlete.
Finally, role-play the first aid that must be undertaken when an athlete has a full loss of consciousness. What should be done until the ambulance arrives?
References
Goodlett, Michael D. & Lawrence J. Lemak. (2009, March 11). What youth football coaches should know about concussions. USA Football. Revised October 19, 2009
Retrieved November 6, 2009 at http://www.usafootball.com/articles/displayArticle/6669/7328
Hitti, Miranda. (2009, March 18). Natasha Richardson dies after brain injury. Web MD.
Retrieved November 6, 2009 at http://www.webmd.com/brain/news/20090318/natasha-richardsons-fatal-brain-injury-faq
O’Brien, James. (2009, July 30). Heading off serious injury. The Boston Globe. Retrieved November 6, 2009 at http://www.boston.com/news/local/articles/2009/07/30/school_sports_programs_west_of_boston_pay_closer_attention_to_concussions/
Safety recommendations for concussion Prevention: A hot topic. (2009, August 13). Brain and spinal cord.org. Retrieved November 6, 2009 at http://www.brainandspinalcord.org/blog/2009/08/13/safety-recommendations-for-concussion-prevention-a-hot-topic/
Serious head injury. (2009).Revolution Health. Retrieved November 6, 2009 at http://www.revolutionhealth.com/conditions/first-aid-safety/first-aid-location/head/signs-head-injury
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