The first week of September - high school football is in full swing, college football has just begun, and the NFL is taking off this weekend. Over the past few years the sport of football has become practically synonymous with the dreaded word “concussion.” The media is in a frenzy about whether it is even safe to play this classic, beloved sport. As an athletic trainer, I hear the term “he just got his bell rung” from coaches, parents, and other players more often than I would like. I hear the arguments exclaiming that, back in the day, all you had to do was be able to declare that you see the two fingers being held up in front of your face, and you’re good to go! With advances in medicine and technology, the medical field is bringing light to the nature and side effects of concussions, and it is not a pretty story. The good news is, there are many steps that can be taken to prevent the occurrence of a concussion.
The most important form of prevention is education. Without knowing how a concussion can occur or what a concussion feels like, it is difficult to know if you, indeed, have a concussion or not. The difficult part is that a concussion is not like a broken bone; you cannot get an x-ray and say definitively yes or no, you have a concussion, like you can with a fracture. Concussion diagnosis is primarily subjective, based upon reports from the patient about how they are feeling or what might have happened. Symptoms include a headache, nausea, dizziness, double vision, sensitivity to light or noise, and feeling off balance. More severe symptoms may include vomiting, memory loss, or loss of consciousness (blacking out). Sometimes this can be difficult for a younger individual to differentiate, but I have found that to err on the side of caution will always produce the best possible outcome. As a coach, parent, or player, if a significant hit to the head is witnessed, either from head to head, head to ground, or even whiplash, then that athlete should be removed from play and evaluated by the athletic trainer or team physician.
Teaching the correct tackling techniques can be extremely helpful in preventing concussions. Many football players, especially those more inexperienced, will put their head down and lead into a tackle with just their head. Some will even purposefully do this, known as a “helmet to helmet” hit. This is incorrect and very dangerous! The head should be up, and the tackle should be made by wrapping arms around the other player. Referees have recently become more aware and have been helping to eradicate this type of tackling. Learning to land when being tackled is also a useful technique to practice, and can prevent many other injuries as well. Always be sure that all equipment, especially the helmet, is fitting appropriately and doing its job to protect you.
Many institutions are now utilizing baseline testing, which performs a cognitive evaluation of the athlete and can be used post-concussion to compare results and ensure that the individual is ready to return to play. This is not used on its own, but in combination with a variety of other diagnostic tools such as the SCAT3, symptom check, and balance error scoring system (BESS). If diagnosed with a concussion, it is important to seek appropriate medical help from a physician, specifically a concussion specialist who has experiencing managing these types of injuries. It is absolutely possible to return to playing football after suffering a concussion, however it is important to follow the return to play protocol provided by your school’s athletic trainer and to be certain of full recovery. With efforts to educate parents, players, and coaches, simple modifications can be applied to make the sport of football safer while still enjoyable.