Tuesday, May 17, 2011

Really? A Concussion?

This is an essay written by Aub Harden, a fellow Under-14 soccer coach. It has an important message. Concussions are not just the province of professional football players, and they are not always obvious.

It’s Monday morning and we’ve just received a call with the verdict: "Yes, your daughter definitely has a concussion from her soccer game on Saturday."

Really? A concussion?

Actually, by this time the diagnosis was not really a surprise. After the game my daughter complained of a mild headache which continued to come and go all weekend. On Sunday, when she was trying to do her homework on the computer, it got bad enough that she really couldn’t work. When my wife volunteered to type for her, she had problems concentrating and would repeat herself. This last bit in particular was enough to think that maybe she had been concussed.

My daughter is fortunate enough to go to a school that administers ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) and has a detailed policy for working with students after a concussion. All the students take the ImPACT test in the fall, which provides a baseline for later comparison. So this morning, she went to the school nurse to take the test again. The results of this test were compared with her baseline results from the first test. Concussion. Now she’s home for a couple of days to rest. No schoolwork. No reading. No TV or computer. No soccer tomorrow, this weekend, and maybe the rest of the season. No crew for the rest of the season. (And, the school nurse told her, depending on how things progress, maybe no final exams! She’s not too disappointed about that one...)

The scary thing was how easy this would have been to miss.

Why didn’t her coach pick up on this at the game? Oh, wait. I’m her coach.

Just before the end of the first half, my daughter was pushed from behind— pushed hard enough that her head snapped back. I was talking with my players on the bench, so I didn’t see it happen. A minute or two later, she got hit in the back of the head with the ball. I did catch that, but it didn’t seem bad and she just grinned and kept playing.

Really not much to pick up on.

Hindsight and a Monday afternoon interrogation revealed some additional information that I wish I had known earlier. When she was pushed from behind, the whiplash was enough that she felt light-headed for a moment or two. When she came off the field for half-time, she didn’t eat any of the fruit because she was afraid she would throw up. When we started the second half, she asked not to start— not because she was tired (as I assumed, playing as we were with just a few subs), but because she still felt a bit nauseous.

There were some other signs— some uncharacteristic fights with her younger sister. A bit more tired than usual. Her headache was ‘different’ from others- not necessarily worse, but different.

Now we know.

My daughter will be fine. As far as concussions go, it wasn’t a serious concussion. She just needs to take the time to fully recover.

I’ve written this to encourage coaches and parents to let their players and children know what the warning signs for a concussion can be.

My 7th grade daughter didn’t know that her moment of light-headedness or her vague nausea were significant. As a coach and as a parent, I can’t act on information I don’t have, and when there’s no obvious collision or fall, I wouldn’t have thought to probe any deeper than a general how-do-you-feel.

Be sure that I will be taking the time with my players to let them know that they need to tell me about anything that’s ‘not right’. Whether the cause is a concussion, muscle strain, or heat exhaustion or whatever, it’s usually information that they provide that enables coaches (and parents) to help them.

Concussion information

Concussion information sheet for parents and athletes


Tom Keegan said...

Great info Paul and good for all to keep in mind, I will be sure to get this in front of the coaches I know and also the AD of my town's HS.

Also, I have shared this through Twitter. I am new to Twitter (just joined a few days ago), but I will get it out to my followers.

Tom Keegan

Frenchy said...

You will find Keith Primeau's Concussion iPhone App helpful, it is available on Apple's iTunes AppStore at http://itunes.apple.com/us/app/concussion/id418559920?mt=8

Anonymous said...

Hi Paul,

This is a great post and such an important topic. As a young hospital administrator I enjoy your blog in many regards, but as a former Certified Athletic Trainer I thought I'd give you and your readers some more access to pertinant information. Certified Athletic Trainers are trained in the management of concussions and are on the front lines for many young athletes. I've included a couple of pertinent links that you may want to include as well.





cate brennan said...

The Youth Sports Safety Alliance encourages youth coaches to become educated on how to identify concussion, signs of heat illness and stroke, cardiac and other acute injuries and illnesses. The CDC has great resources, along with NATA. But one of the best ways to protect your child is to be sure the facility has a certified athletic trainer on staff.