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MUSC Health Blog

Keyword: sports

Guest Post by:
T. Ryan Littlejohn, ATC
Athletic Trainer
MUSC Health Sports Medicine

Have you heard the buzzword concussion in todays sports world? Most people would agree they have heard all the hype about concussions and it is a big deal. There is good reason for this attention to head injuries, they can be serious and need to be managed appropriately. A concussion is an injury to the brain and currently there is no way to completely prevent them from occurring. According to the centers for disease control, there are 3.8 million concussions per year, in the U.S. alone. A concussion occurs when the brain is bruised from hitting the inside of the skull and it can occur from a whip lash or a direct blow to the head. This can lead to concussion symptoms, headache, dizziness, and nausea, which tend to be the most common. If you or someone you know is experiencing problems from a head injury, it is essential that a medical provider trained in concussion management is consulted, before returning to any type of physical activity.

Some research suggests that certain strengthening exercises may help reduce the prevalence or severity of a concussion by reducing or better absorbing the applied force. Specifically, neck strength is something that can be addressed and might help lessen the chance of receiving a concussion. The rationale behind this is simply a stronger neck could help stabilize both the head and neck movement. So take action, implement these simple and easy exercises into your sports program today.

Shoulder Shrugs:

Standing with weight in both of your hands and arms by your side slowly shrug your shoulders upward. Control the weight in both directions - lifting and lowering the weight. Perform for 3x10.

Upright Rows:

Standing with arms in front of you holding a dumbbell or bar, have the palms facing outward. Raise the weight to chest level then slowly lower the weight back to the starting position.  Perform 3x10.

Four Way Isometrics:

Place two hands on back of your head and then push into your hands for isometric resistance. Perform in all four directions - front, back, left and right side of your head. Make sure you feel the resistance in your neck, but keep your head straight.  Perform 1x10 each direction holding for 5 to 10 seconds.

Towel Resistance:

Place a towel behind your head and hold the ends of the towel. Perform resistance against the towel keeping your head straight and pushing backwards. Then change the position and push against the towel going forward. Perform 1x10 reps holding for 5 to 10 seconds.

Resources and Additional Information:

Google search results for concussion

PubMed Abstract on neck strength as a factor in concussion

Mom's Team:  Stronger Necks May Reduce Concussion Risk


Guest Post by:
Avery L Buchholz MD MPH
Resident Physician
Department of Neurosurgery
Medical University of South Carolina

Sports related concussions have become an increasingly important topic. Research has shown a steady increase in the rate of concussions in high school athletes. This along with a better understanding of the injury has added increased importance to the proper management of these athletes. South Carolina has recently passed legislation regarding education and management of concussions. The exact bill passed in South Carolina can be seen using the following link:

In summary, the South Carolina concussion policy states that

1. Local school districts will develop guidelines based on recommendations from the South Carolina Department of Health and Environmental Control.

2. Each year coaches, student athletes, and their parents/guardians will receive information on concussion education and the school must have documented receipt and understanding of this information prior to practice of competition.

3. Any athlete suspected of sustaining a concussion must be removed from play immediately and evaluated prior to returning to play. A player may return to play that same day if the on-site and qualified athletic trainer, physician, physician assistant, or nurse practitioner determines there are no signs of concussion.

4. Players thought to have a concussion will need written medical clearance by a physician prior to returning to play.

As of January 2014, all 50 states have passed concussion laws focusing on various topics including coach training, parent/athlete education, return-to-play (RTP) restrictions, and medical clearance. It is important to recognize that as both players and parents these are now required tasks and having a solid understanding of concussions and proper management will help keep play safe.

Loss of consciousness is not required for the diagnosis of a concussion. In fact most concussions happen without loss of consciousness. Concussions can result from a hit to the head or body resulting in a force causing a disruption of the brain. The most common symptoms of concussion are headaches, nausea, vomiting, dizziness, loss of balance, and blurry vision. Additional symptoms can include emotional changes, irritability, depression, sleep disturbance, poor concentration, sensitivity to light and memory impairment. These later symptoms are often not recognized immediately which is why it is important for players and parents to be properly educated and be able to recognize these symptoms when they occur. If these symptoms are identified it is important to suspect a concussion and seek medical advice. Do not allow continued participation if you suspect a concussion.

Once a concussion is identified it will need to be managed appropriately. Coaches, trainers and team personal should all have undergone training about how to safely get an athlete back into competition after having a concussion. In addition to having medical clearance from a physician prior to resuming athletics an athlete will need to have successfully completed Return to Play Guidelines (RTP). RTP is a graduated return to play strategy consisting of five steps with increased activity in each step. Each step is 24-hrs long and as long as the athlete remains asymptomatic after each step they may advance to the next. If the athlete becomes symptomatic at any point they must stop, rest, and start back at the first step when completely asymptomatic which would be the following day at the earliest. It is also important for athletes to be off all medications which may hide symptoms. The details of allowed activities for each step can be viewed using this link:

Concussions happen and are a part of being active. As players and parents it is important to recognize them when they occur and avoid any activity until the athlete is completely asymptomatic. This can mean both physical and mental rest. Once asymptomatic coaches and trainers will be following return to play guidelines and it is important for you to understand these guidelines as well so you can participate safely.


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