By Brandon HENSLEY
The odds of an athlete having another concussion after sustaining a first one are four to six times more likely, said Dr. Gregor Harutunian of USC Verdugo Hills Hospital. Harutunian, a neurologist, spoke to a crowd of mostly adults at the hospital on May 28 along with orthopedic surgeon Loren Geller as part of a Health Talk seminar designed to educate the audience about sports injuries for people of all ages.
Harutunian discussed the dangers athletes, especially kids playing sports such as football, face when dealing with their first concussion. Those high odds of an athlete sustaining another one are called Secondary Impact Syndrome, or SIS.
“And it doesn’t have to be a very big impact for the second one [to occur],” Harutunian said.
If SIS occurs, the brain can have increased swelling, herniation and can even result in death. Concussions have been a hot topic recently, especially in the Nation Football League, where the league has changed rules on how to tackle, and former players have sued the NFL over negligent treatment.
In high school, Harutunian said 250,000 football players sustain a concussion per year. ESPN reported last year football had the highest rate of concussions for boys’ sports, while soccer had the highest rate for girls’ teams.
It is important to identify the signs of a concussion to properly manage the athlete’s next step, said Harutunian. Immediate symptoms include a vacant stare, delayed motor responses and slurred speech. If the player has memory loss, it’s going to be of the short-term variety.
“They’re not going to forget who their mother is or what they’re name is,” Harutunian said. “They’re going to forget things that happened in the last week.”
As for post concussive syndromes, “Headaches are big,” he added. “Headaches can last.”
Vomiting can also be a problem, and if that persists, it means the brain could be bleeding, which would require immediate care.
How to know when a player is ready to get back to playing? It really depends, Harutunian said. There’s the old adage, “When in doubt, sit them out,” but there’s also multiple tests doctors or trainers can use, such as the SCAT, or Sport Concussion Assistant Tool. These tools evaluate a player’s physical and cognitive ability moving forward.
As Harutunian noted, though, “There’s really no set guide line.”
Gellar’s part of the seminar focused on the severity of certain injuries and how to deal with them. In the upper body, the most common dislocation occurs at the shoulder. Because it’s the most mobile joint, it’s the most common to come out of the socket. It can be put it back in place on the playing field, but if it takes too much time and muscle spasms occur, the player could need to be sedated.
Recurrent dislocation may require surgery.
In the knee area, Geller identified a common injury, a tear to the anterior cruciate ligament. The ACL runs diagonally in the middle of the knee. It can be torn with a direct blow, or when an athlete makes sudden stops or pivots.
ACL tears mostly require surgery, especially for serious athletes.
“A full tear in somebody who wants to play sports or cut and make pivots … that needs to be repaired surgically or else the knee will continue to be unstable,” Geller said.
Geller talked about ways people of all ages can keep their bodies from potential injuries. It’s important to warm up before going full speed on a work-out. It’s also good to cool own when the exercise is over.
For injuries such ankle sprains, which is one of the most common injuries around, or tendinitis, Geller gave an acronym for treatment, R.I.C.E., which stands for Rest, Ice, Compression and Elevation.
First, rest the injury, and then ice it for 15 to 20 minutes (never put ice directly on the skin for too long. Use ice packs instead). Then use braces or wraps to compress the area.
“It helps reduce inflammation. It also typically reduces the motion of the joint which helps with rest,” Geller said.
Finally, elevation, which also helps reduce swelling.
Geller also gave advice to not concentrate on one sport for too long. Instead, try multiple sports throughout the weeks or months or seasons. Go from jogging to riding bikes to something else.
“It’s going to minimize the risk of an overuse injury,” he said.