Originally published April 1, 2010

This story was named a national winner in the 2011 Quill and Scroll Writing and Photo Contest.

Head injuries gain increased awareness

Studies show that ignored concussions can be life-threatening; new state-wide program treats injuries

“I just felt out of it. It hurt initially but then I just felt loopy and nauseous,”  junior Jana Halstensgard recalled.

“There were a couple seconds left in the game and there was a loose ball,” said Halstensgard. “A player from Hill Murray was diving for the ball as I was and she flew on top of me. My head slammed against the floor.”

Halstensgard laid on the gym floor for a couple of seconds and then got up and was taken to the bench where she felt like she was going to get sick. Halstensgard had sustained a mild concussion. Reported concussions have been on the rise due to the fact that coaches, athletes, parents, and trainers are being more cautious when it comes to head injuries.

Concussion Awareness

Throughout the year 2009 and into 2010, there has been rising awareness to the problem of concussions and head injuries in athletic events. The growing awareness has led to more intense studies and research of the problem.

Injuries at the professional level have also brought the topic into the spotlight. During the 2009 professional football season Kurt Warner, the quarterback of the Arizona Cardinals, sustained a concussion. Another athlete, Justin Morneau, a first basemen for the Minnesota Twins, sustained a concussion in 2005 when a pitch hit him near his temple. He missed 13 games. Professional athletes are affected by head injuries with a more developed brain than young adults. Student athletes are at risk due to their age.

“The biggest concerns in juveniles is that their brains are still developing,” said athletic trainer, Rebecca VanderWerf. “Getting people to act on the awareness is important.”

Causes and Symptoms

A concussion is a brain injury that can be caused by a blow, jolt, or bump to the head. Most concussions occur when an athlete hits an immovable object such as a gym floor, the ice, or a football field. A concussion can range from mild to severe and it can change the way the brain normally functions. An athlete does not need to lose consciousness in order to sustain a concussion.

The symptoms of concussions vary widely. Some include: nausea, dizziness, fuzzy or double vision, sensitivity to light or noise, headache, feeling sluggish, concentration or memory problems, and confusion. If an athlete is experiencing symptoms they may have a concussion.

ImPACT

Programs are being set up to test the extensiveness of a head injury and prevent athletes from returning to action too soon. The most prominent of these programs may be the ImPACT program (Immediate Post- Concussion Assessment and Cognitive Testing), which Minnehaha Academy uses, as does the National Football League, Major League Baseball, Major League Soccer, the U.S. military academies, the U.S. Olympic teams and more than 1,500 high schools across the country. These programs’ main concern is to bring attention to the danger of athletes returning to play before they are without symptoms.

The ImPACT program is a research-based computer test. Athletes take the test at the beginning of a season as a baseline. If an injury occurs, then the athlete will take the test again and the results from that test will be compared to the baseline to see if there are any changes.

The test takes approximately 20 minutes. It measures the athlete’s attention span, working memory, attention time, response variability, non-verbal problem solving, and reaction time. An example of the reaction time portion of the test would be three colored squares, which are flashed in front of the test taker. The word of a color is above the squares. Then the athlete would have to click on the box that is the correct color corresponding with the word as fast as possible.

Tests like ImPACT are at times more helpful than radiological tests such as x- rays, CT scans, and MRIs, because these cannot identify the functional effects of concussions. They can, however, identify skull fractures and bleeding in the brain. ImPACT and tests similar to it are very important in recognizing the dangers of a concussion.

Returning to play while still having symptoms could cause serious problems in the short- term as well as the long- term. Returning to play can cause an even more serious injury.

“Second Impact Syndrome is a very very serious injury,” VanderWerf said. “It’s getting a second hit after already receiving a concussion.” In some cases this further injury can cause life-altering effects and sometimes death.

“[The] Biggest reason why I want to know of their first hit is because I might not know if their ‘first hit’ is [really] their second hit, and I would treat it differently,” VanderWerf said. For athletes that means it is very important to tell coaches and medical staff about a head injury.

“Coaches understand when we have pain the body is sending a message,” VanderWerf said.

Athletes often don’t mention a headache or a head injury that they sustained because they want to keep playing.

“I would hope that my coach or trainer only allows me to be put back into play if I am not at risk for further injuring myself or have recovered from the previous concussion,” said senior Taylor Hanson.

MSHSL Guidelines

The Minnesota State High School League follows a set of guidelines from a document written by the MSHSL when a concussion is suspected. Number one: the player should not be allowed to return to play in the current game or practice. Number two: the player should not be left alone over the initial few hours after injury. Number three: the player should be medically evaluated after the injury. Number four: returning to play must follow a medically supervised, stepwise process.

The MSHSL has not made ImPACT testing mandatory. The testing will help prevent further injury and damage to the brain.

Lasting Effects

Later in life, studies from the National Football League have connected dementia and Alzheimer’s to the reoccurrence of multiple head injuries over time. Researchers think that repeated concussions lower the age that people show signs of dementia and the risk of Alzheimer’s is increased.

“Repeated concussions may have an effect similar to having multiple strokes or insults to the brain, albeit sometime subtle,” said Dr. Sheldon Burns from Edina Family Physicians.

Dr. Sheldon Burns is used to seeing athletic injuries. He works with primarily the Vikings and also other professional athletic teams in Minnesota.

“Large segments of your brain that process things, such as memory, can be affected,” Burns said. “The biggest parts of the brain can be the most affected, one of the largest parts of your brain has to do with reasoning and personality.”

A concussion is a serious injury that should not be ignored.

“When you do get a concussion, and you are a young person, you do need to pay special attention and extra time to give your brain time to heal,” Burns said. “There are only so many brain cells and if they are damaged you have to do everything you can to maximize repair because they are fragile and cannot be replaced.”

Athletes need to be aware of the danger and understand the risks of sustaining too many concussions. The choice may be either miss a game or miss a season.

“Pain is a gift, it helps us know what’s wrong,” VanderWerf said. “A headache isn’t a headache anymore.”