Seventeen year old running back, Tony, goes down hard, helmet first into the ground, after a 25 yard run to the end zone. Dizzy and nauseated, he manages to collect himself giving high fives to teammates on his way back to the sideline. It is the start of his senior season and he is one of the top prospects in the state, so he tells the coaches, “I’m okay.”  Tony continues play unaware he has a concussion.  He takes another hard hit, but this time the impact leaves him with permanent brain injury.  In an instant, his hopes and dreams of college and professional football are gone.  

While most concussions are not as dramatic or severe as Tony’s, it is an increasing occurrence amongst younger athletes across the U.S.  The CDC reports as many as 3.8 million sport-related traumatic brain injuries (TBI) occur annually. Children and teens make up approximately 70% of all sports-related concussions seen in emergency departments and another 50% may go unreported. Concussions occur in a variety of sports, but the highest incidence occurs in high contact sports like football.

What is a concussion?

A concussion is synonymous with a mild TBI.  Head trauma due to high-force contact damages the brain tissue by causing chemical and metabolic impairments within the brain cells. Symptoms of concussion vary, but include confusion and disorientation, headache, memory difficulties, imbalance, and vomiting. Initial evaluation should take place on the sideline by a medical professional. Afterwards, the player’s primary care physician may manage them or, as necessary, specialists like neurologists or sports medicine physicians along with athletic trainers.  

Treatment of concussions focuses on avoidance of further head injury.  This may require removal from competition or other restriction of physical activity and the time of any return to play may vary from patient to patient. Current research implies that active rehabilitation may be beneficial though physical and mental rest remain the primary interventions.  

Why are concussions increasing?

Experts suggest that the rise may be due to the increasing number of available sports and the intensity of play. Others hypothesize the increase is due to increased awareness and reporting of sports-related head injuries including the long-term brain damage resulting from them.  The consequences of those injuries that are now evident in many professional athletes stresses even further the importance of protecting our younger athletes from debilitating, long-term consequences.

What’s the price of winning?

Sports activities provide physical, metal and social benefits far beyond the field of play.  It may be thought they outweigh the risks of serious injury, but, if so, it becomes the responsibility of parents and all attending adults to consider true the cost of winning as they protect our children from repeated brain injury.  Athletes and parents of athletes who suspect a concussion that has not otherwise been treated should consult their primary care physician.