The Center for Disease Control estimates that 1. 6-3. 8 million concussions occur annually (qtd in NATA 1). A concussion is a mild traumatic brain injury that causes a disturbance in cerebral function (BIAA 1). Rates have tripled over the course of seven years in teens (CDC 1). There are a variety of ways the injury can be prevented. Similarly, if one is thought to have a concussion there are several ways to evaluate and treat it. Not only does injury to the brain affect student-athletes physically, many students are affected mentally as well.
Teachers should be aware of the aftermath students experience and curriculum may need to be modified for students due to concussions and the inability to focus and perform as well academically. A concussion, also known as a TBI is typically induced by trauma to the brain, this includes a blow or jolt to the head, face, and or body (CDC 1). This blow or jolt to the head causes the brain to move rapidly, causing the brain to hit the skull and cause damage to the brain cells.
This causes the one to become hypersensitive to certain surroundings such as stress, light, sound, and motor skills (CDC 1). These signs and symptoms are also known as neurological impairments. When these impairments do not resolve on their own, one should then be referred to see a physician to determine if they are suffering from a concussion. The severity of neurological impairments can vary on the severity of the concussion. Concussions can be graded anywhere from a slight concussion to a severe concussion.
A slight concussion one could be out for maybe a week. But if the student-athlete has a severe concussion one could be out for months. The difference between a slight concussion and a severe one can be determined by some specific scanning or testing and by the appearance of ones mental status and physical signs. Before the concussion occur or before the ones season starts one may take some baseline tests. There also may be some baseline tests during the pre-season of sports. Baseline tests are used to assess an athlete’s balance and brain function.
This includes memory recall such as asking the score of the game or last weeks opponent (CDC 1). The baseline testing also checks for the ability to pay attention and how quickly the student-athlete thinks and can solve problems, as well as checking for and physical signs (CDC 1). Baseline testing is important because if a concussion occurs to the student athlete during the season. The results from the baseline test can be taken and compared to a similar test. For example, to see if the student-athlete has a concussion, the student can take the baseline test a second time.
The test would be given after the athlete suffers from a head injury to see how the new results compare to his/her results during the preseason. Another important reason to take a baseline test is if a concussion is sustained and the student-athlete takes the baseline test again. The health care professional can look back at the first baseline test and can tell if the student-athlete has gotten that part wrong on the test before without having a concussion. When the concussion occurs a qualified health professional will do some testing to check and see if there are no skull fractures, or cerebral hemorrhaging.
When a student-athlete suffers from a blow to the head or been jolted in any unsafe way he/she may suffer from a concussion, immediately an assessment will be given on the field or on the sideline. First the responding health care professional needs to be checking for breathing and consciousness and also for spinal injuries to make sure the student athlete is safe to move. Then sideline assessment will begin including tests for cognitive status, balance, coordination and observation of any physical signs of injury (Mayo Clinic 1). Testing for the cognitive status will include things such as memory testing.
An example would be asking if the student-athlete can remember the last opponent played or if the student-athlete can remember walking off the field. Cognitive testing also includes testing ones’ ability to recall information and concentration. Some neurological examination will also occur; this examination includes testing of ones’ vision, hearing, reflexes, coordination, balance, strength and sensation (Mayo Clinic 1). If a student athlete has suffered from cerebral hemorrhaging or a skull fracture, one will be taken to the emergency room right away after being checked for consciousness and spinal injuries.
A Commuted Tomography scan may also be taken or better known as a CT scan (Radiologyinfo 1). A commuted tomography scan uses a special x-ray machine to help detect a variety of diseases and conditions (Radiologyinfo 1). The scanning is fast, painless, noninvasive and accurate (Radiologyinfo 1). In cases of emergency a CT scan which is needed if a skull fracture occurs and may be used to detect bleeding in the brain, or a hematoma, or even brain swelling (ASNR 1).
Once the scan is complete depending on what has happened specifically the student-athlete may have surgery on their brain to release swelling or maybe to even cauterized blood vessels to stop bleeding. After the surgery is complete depending on what the patient had surgery if one ven needed surgery at all there are going to be some signs and symptoms of a concussion. The student-athlete may experience different types of symptoms such as somatic, ocular, cognitive, and emotional symptoms. Somatic symptoms include headache, dizziness, nausea or vomiting, the sensitivity to light and noise, balance problems and fatigue (Brainline 1).
Ocular symptoms are symptoms that refer to ones eyesight, such as seeing double vision or blurred vision and also eyestrain (Brainline 1). Also cognitive symptoms include feeling foggy, impaired concentration, memory loss, sleep disturbances, dysregulated sleep, appetite, slowed down, and having difficulty remembering (Brainline 1). There may be emotional symptoms too such as feeling more emotional than normal, or feeling sorry or angry, maybe even irritated more than normal (Brainline 1). Treatment for a concussion should begin promptly so one can get back to optimal health.
Treatment for a concussion should begin immediately. Once the student-athlete has been diagnosed with a concussion, rest is needed but not too much rest is necessary. The studentathlete should rest for the first day or two depending on how severe the concussion is (Auger, Reynolds 1-2). Rest is needed during the early stages because the brain is most vulnerable during the early stages of recovery. Rest is also needed during the recovery because rest decreases the potential for reinjury (Auger, Reynolds 1-2).
Although rest is needed, too much rest is also bad for the student-athlete (Auger, Reynolds 1-2). Too much rest cause increased behavioral dysregulation and mood changes (Auger, Reynolds 1-2). Social isolation, Due to the social isolation and inherent child-parent conflicts with this method, such as arguments over the use of technology, playing outside, and so forth-athletes’ moods may decline. Removing the student-athlete from established routines, like attending school, may also add stress that can prolong or aggravate symptoms (Auger, Reynolds 2).
When resting student-athletes have a lot of down time to think about how they are feeling resulting in an increased awareness of symptoms and exacerbated overall fatigue (Auger, Reynolds 2). Some treatments to help with ocular symptoms are vision therapy, prescribed glasses with a prism lens to help redirect wayward eyes, and going on a daily walk or a daily bike ride(Auger, Reynolds 2). Mood changes mostly occur because ones’ schedule is disrupted so it is important to re-establish a routine such as a meal plan,an increase in fatty acids that are EPA, DHA, and ALA can help aid ith recovery.
Oils are a good source of getting these fatty acids. If one is feeling nauseous, a bland diet is important to help stop nausea such as eating rice, toast, bananas, and applesauce. Incorporating an exercise plan may also help ones’ condition and eating small meals throughout the day. For helping with cognitive symptoms one should not take naps, should regulate ones sleep schedule, and incorporate physical activity. Once the student-athlete is done resting for the first day or two and symptoms are improving, one should begin the returning to school with accommodations.
The student-athlete can’t just jump back into school right after the concussion has occurred so if and when one returns to school there should be some accommodations. More than eighty percent of student-athletes with a concussion complain of academic difficulties, so now there is a process to getting back to school. There are five phases to returning to school after sustaining a concussion. The first phase is when the symptoms are high and when one should not return to school, so this is right after the concussion occurred and when one should be resting (OHSAA 1).
Phase two of returning back to school is when symptoms have decreased to a manageable level, one should attend school for a half day of school with accommodations, and homework should be reduced or eliminated (OHSAA 1). During the third phase of returning to school, the student-athlete should attend a full day of school with accommodations even though the student-athletes symptoms by this time have decreased or are no longer present (OHSAA 1). Symptoms can still be worsened at this phase, although symptoms are present homework can gradually increase (OHSAA 1).
In the fourth phase of returning to school is when the student athlete attends a full day of school without accommodations; By this time the one won’t have any signs or symptoms (OHSAA 1). The fifth phase is the same as the fourth phase except now the student-athlete can return to physical activity such as gym class or extracurriculars (OHSAA 1). During these phases it is important for the student-athlete to stay in touch with ones parents, teachers, health care providers, and also the school nurse.
There is also no certain time to be spent in each phase one may be in phase three but the studentathletes symptoms may worsen and may be set back to phase one or two. These accommodations during these phases may include sitting away from the window, wearing a hat or sunglasses, having a note taker or a test reader for classes, and maybe extending due dates on homework. This research shows that concussions are not a joke and that hundreds of thousands of people are concussed every year. Many people think that cognitive rest or laying in bed all day is good, which it is but only up to a certain point.
A daily walk or some light physical activity is very important to help with symptoms and mood changes of a concussed student-athlete along with maintaining a diet and regulating ones sleep schedule. Teachers can also help with simple things such as dimming the lights or allowing the student-athlete to wear a hat or sunglasses. Teachers should be aware of the aftermath students experience and curriculum may need to be modified for students due to concussions and the inability to focus and perform as well academically.
