CONCUSSIONS IN FOOTBALL

RANDY FOX ATC-R

MULVANE HIGH SCHOOL

ANATOMY

·         BRAIN IS SURROUNDED BY TOUGH SET OF LININGS CALLED MENNINGES, BRAIN MATTER ITSELF IS VERY FRAGILE

·         CEREBROSPINAL FLUID ALLOWS THE BRAIN TO “FLOAT” INSIDE THE SKULL WITH THE ONLY ATTACHMENT TO THE REST OF THE BODY BEING THE BRAIN STEM

MECHANISM

·         CONCUSSIONS OCCUR BECAUSE OF A VIOLENT FORCE APPLIED TO THE HEAD               

·         MOST COMMONLY DIRECT CONTACT SUCH AS A BLOW TO THE HEAD OR JAW

·         MAY OCCUR AS A RESULT OF A WHIPLASH TYPE OF FORCE, MOST COMMONLY FOUND IN AUTO ACCIDENTS

                THE INJURY MECHANISM IS ONE OF TWO TYPES:

1.        COUP – BRAIN STRIKES THE SKULL IN THE AREA OF THE IMPACT

2.     CONTRACOUP – BRAIN STRIKES THE OPPOSITE SIDE FROM THE IMPACT

SIGNS AND SYMPTOMS

          MAY INCLUDE ANY OR ALL OF THE FOLLOWING:

                                DISORIENTATION                             VACANT STARE

                                SLURRED SPEECH                             L0SS OF BALANCE

                                MEMORY DEFICITS                          LOSS OF CONSCIOUSNESS

                                HEADACHES                                      CHANGES IN VISION

                                UNEQUAL PUPIL SIZE                    COGNITIVE CHANGES

                                NAUSEA                                                             RINGING OF EARS

                                SEIZURES                                                           NO PUPIL RESPONSE

                                FLUID FROM EARS, NOSE                PARALYSIS

CONCUSSION SEVERITY SCALES

                             DR. CANTU

                                                COLORADO MEDICAL SOCIETY

                                                AMERICAN ACADEMY OF NEUROLOGY

                MUCH DISAGREEMENT BETWEEN THESE THREE SCALES

• CMS, ANS TREAT ANY UNCONSCIOUSNESS AS THE MOST SEVERE CONCUSSION
• CANTU SCALE IS THE MOST COMMONLY USED

CANTU SCALE

                GRADE 1 CONCUSSION (MILD):

                                POST-TRAUMATIC AMNESIA (PTA) LESS THAN 30 MIN.

                                NO LOSS OF CONSCIOUSNESS (LOC)

                GRADE 2 CONCUSSION (MODERATE):

                    PTA MORE THAN 30 MINUTES, LESS THAN 24 HOURS

                                LOC LESS THAN 5 MINUTES

                GRADE 3 CONCUSSION (SEVERE):

                                PTA GREATER THAN 24 HOURS

                                LOC GREATER THAN 5 MINUTES

RETURN TO PLAY CRITERIA ACCORDING TO CANTU

GRADE 1               (FIRST) MUST BE ASYMPTOMATIC FOR ONE WEEK (SECOND) RETURN TO PLAY IN TWO WEEKS IF ASYMPTOMATIC FOR ONE WEEK

                                (THIRD) TERMINATE SEASON, MAY PLAY THE NEXT YEAR

GRADE 2               (FIRST) MAY RETURN TO PLAY AFTER ONE ASYMPTOMATIC WEEK

                                (SECOND) OUT MIN. OF ONE MONTH IF ASYMPTOMATIC FOR ONE WEEK

                                (THIRD) TERMINATE SEASON, MAY PLAY THE NEXT YEAR

GRADE 3               (FIRST) OUT MIN. OF ONE MONTH IF ASYMPTOMATIC FOR ONE WEEK

(SECOND) TERMINATE SEASON, MAY PLAY THE NEXT YEAR

IN EVERY CASE THE ATHLETE MUST BE ASYMPTOMATIC AND CLEARED BY A PHYSICIAN BEFORE BEING ALLOWED TO RETURN TO ACTIVITY

SECOND IMPACT SYNDROME

• OCCURS TO AN ATHLETE THAT HAS SUSTAINED AN INITIAL HEAD INJURY AND RETURNED TO PARTICIPATION BEFORE THE SYMPTOMS HAVE RESOLVED.

• CAN OCCUR FROM SEEMINGLY MINOR HIT

• BECAUSE THE BRAIN HAS NOT HEALED FROM INITIAL TRAUMA, IT LOSES ABILITY TO AUTOREGULATE THE BRAIN’S BLOOD SUPPLY

• THIS CAUSES BRAIN TO HERNIATE, AFFECTING THE BRAINSTEM

• AVERAGE TIME FROM SECOND IMPACT TO BRAINSTEM FAILURE IS 2-5 MINUTES!  THIS LEADS RESPIRATORY FAILURE WHICH LEADS TO DEATH 
• SECOND IMPACT SYNDROME PROTECTION

          PREVENTION, PREVENTION, PREVENTION

NO ATHLETE MUST EVER BE ALLOWED TO PRACTICE OR COMPETE WHILE THEY HAVE POST-CONCUSSIVE SYMPTOMS

PREVENTING CONCUSSIONS

·         NEW HELMETS PROVIDE A GREAT DEAL OF PROTECTION TO TODAY’S FOOTBALL PLAYER.

·         ORIGINALLY DESIGNED TO PROTECT THE HEAD FROM LACERATIONS

·         NOW HAVE THE LATEST DESIGNS AND MATERIALS PROVIDING PROTECTION FOR THE PLAYER

·        MUST BE FITTED AND MAINTAINED CORRECTLY TO OBTAIN THE OPTIMUM AMOUNT OF PROTECTION

          RULE CHANGES

CHANGES THAT MADE SPEARING ILLEGAL HAVE SIGNIFICANTLY LOWERED INCIDENCE OF HEAD AND NECK INJURIES

IMPROVED BLOCKING/TACKLING TECHNIQUE HAVE ALSO DRAMATICALLY DECREASED INCIDENCE