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Careful observation needed when an athlete sustains a suspected concussion

Even when the player says ‘I’m fine, coach’ after a blow to the head, University of Minnesota Health physicians say careful observation for signs of a concussion is warranted.
When student athletes suffer a head injury, coaches and parents should pay close attention, watching for telltale signs of a concussion or brain injury.

Good athletes, by definition, are tough. But “toughness” shouldn’t mean ignoring a potentially serious injury, such as the trauma an athlete’s brain can undergo when colliding with a player from the opposing team.

The National Football League recognized this when it set rules to determine whether an athlete who’s taken a powerful hit is benched. The guidelines include checking players for symptoms of a possible concussion—attention, memory and balance—right away.

Parents of student athletes, and coaches of amateur teams, are well advised to take the same cautionary approach. We spoke with Family and Sports Medicine Physician David Olson, MD, who serves as a University of Minnesota Gopher sports team physician, about recognition and treatment of concussions. Olson also sees patients at the University of Minnesota Health Sports Medicine Clinic.

What is a concussion?
A concussion is a brain injury that can happen when an athlete receives a blow to the head or has his or her head “whipped” back and forth violently. This alters normal function of the brain. A variety of symptoms can result.

What are the symptoms of a concussion?
Signs and symptoms of a concussion are broken down into three groups: physical, cognitive and emotional. Physical symptoms can include headache, upset stomach or vomiting, dizziness or balance problems, tiredness, blurry or double vision and sensitivity to light or noise. Cognitive issues include confusion and memory loss, difficulty concentrating, feeling slow or sluggish with thinking and repeating questions or comments. Emotional signs can show up as irritability, sadness or nervousness. Not all of these signs and symptoms are present in every concussion.

Many parents may say these are all signs of being a normal teenager. The key is to note when these symptoms and signs seem excessive.

What steps should I take if I believe an athlete or child has suffered a concussion?
The first step is to remove the athlete from play, then observe the athlete for the signs and symptoms listed above.

If you suspect a concussion, the most important thing for the injured athlete is rest—not just physically, but mentally, as well. Cognitive rest can be challenging, as it may mean minimizing use of or removing cell phones, tablets/computers and TVs. School activities can be challenging. Many students are driven by grades and attendance, but the mental challenges (and emotional stressors) of school can be detrimental to healing after a concussion.

When should I see a doctor about a concussion?
Immediate medical attention should be sought for any of these conditions:

  • One pupil larger than the other
  • Convulsions or seizures
  • Slurred speech
  • Weakness or numbness in the arms or legs
  • Loss of consciousness
  • Repetitive vomiting
  • Aggressive or agitated behavior
  • Prolonged or worsening signs or symptoms

Concussions that don’t have such high-risk symptoms can be seen within the first three days of the injury.

Learn more about our Pediatric sports medicine care.

How is the University of Minnesota Health Sports Medicine Clinic well-positioned to care for a concussion?
Our physicians are national leaders in sports medicine. Our involvement with Gopher Athletics and professional sports teams mandate that we be on the forefront of knowledge, treatment and education in this field. We provide a comprehensive approach to patient care, focusing on each individual's unique situation, partnering with an extensive, integrated care team. Our team of physicians works closely with neurologists, psychologists, athletic trainers, physical therapists and occupational therapists to provide the best possible care.