Concussions

   A concussion is an injury to the brain typically caused by a external trauma towards the head.  In sports jargon it is known as 'having your bell rung' or getting 'knocked out ! The brain also can jam against the skull from any violent force to the region of the body.
   Sports historically glorifies the courageous athlete who would get knocked out but return to the field of combat to perform heroic feats. Hockey legend Maurice 'the Rocket' Richard got knocked unconscious during a playoff game but returned in overtime to score the winner on a spectacular end-to end skate. Less is heard about him suffering a seizure in the dressing room after the game. How many tales exist of boxers getting knocked down, barely beating the referee's 10 count, and still winning the match? These are the stories of sporting folklore. Today there is a greater recognition that concussions can lead to future mental health problems.
 
 A number of incidents recently have brought the issue  of sports concussions into the public eye.

• A few summers ago, three National Hockey League enforcers (or tough guys) died within a short time span. Two were deemed suicides and one was alcohol/painkiller related. All 3 suffered depression symptoms consistent with concussion syndrome.  Professional hockey is the only team sport that lightly penalizes but condones fist fighting.
•  The National Football League recently settled a multi-million dollar class action lawsuit in favor of former players with concussion related cognitive problems.
• Dementia symptoms in ex-boxers has always been accepted as a hazard of the trade. The term 'punch drunk' has its origins in pugilism.
•  In pro-football, league governors fear the consequences of linking football contact to concussions. What if millions of mothers stop their sons from playing football? The sport would die on the vine. 
• In Canada there is a movement afoot to delay the age of full contact body checking for minor hockey. The old guard thinks that this is heresy but many hockey parents want their children to enjoy the sport without the greater risk of physical harm. Their chances of making the pro leagues are minimal. Why not keep it safe?
• A few years back in my home town of Ottawa, a high school aged elite woman rugby player died from a head injury during a game.  It was suspected that she entered the game with a previous undiagnosed concussion.
• Sidney Crosby, the world's current hockey superstar received 2 consecutive concussions in back-to-back games. He missed major portions of 2 playing seasons.
• The next 'great one' in hockey, Eric Lindros,  never lived up to full expectations due to a series of concussions. His brother Brett retired after one professional season due to concussions.

   I will even go out on a limb here with my own theory about O.J. Simpson. Simpson was an NFL football running back. If a running back gets the ball  he gets a touchdown or runs out of bounds or most likely gets tackled. Without the ball he is usually blocking some gargantuan defensive player will ill intent towards the quarterback. Even if you believe that O.J. Simpson was not guilty of the Nicole Simpson / Ron Goldman murders, there are still possible signs of cognitive impairment. Where is the rational thinking in the police chase with the white Bronco or the kidnapping scenario to retrieve his memorabilia? Could not post-concussion syndrome cause such bizarre behavior?
   There is much evidence that a first concussion can make a person more susceptible for successive concussions. It is also accepted that a concussed athlete should not return to action until totally free of any symptoms. Rocket Richard heroics should be left as ancient history.
   Coaches, athletic trainers, and team doctors are starting to see the light and working as a team to diagnose concussions and keep competitors out of competition until the brain injury has healed.
 
   If you Fitness Train athletes that participate in contact or collision sports you may have clients that come in with disregarded or delayed head injury symptoms. Hopefully you are proactive enough to prevent clients from getting head trauma during your exercise sessions! Nevertheless, stuff happens.
It's best to prepare for the worst:

• Be sure your first aid certification is current.
• Be familiar with the Sport Concussion Assessment Tool (SCAT).
• Monitor speech, eye motion and pupils, pronator drift, and gait.
• Watch for signs such as; headache, confusion, neck pain, dizziness, nausea, irritability, confusion, memory problems, concentration lapses, ringing ears,  hearing problems, drowsiness, fatigue, head pressure, or any malingering physical concerns.
• Refer client for a medical evaluation if symptoms seem minor.  
• Call an ambulance or transport to a medical center if symptoms are significant. 
• It is better to over react than to under react.  

Before being allowed to return to action the athlete or client should progress in sequential stages as follows:

1. Rest physically and mentally until symptoms subside.
2. Light aerobic exercise (less impact is preferred).
3. Sport specific exercise
4. Training drills and light resistance training. Avoid body contact.
5. Full contact practice only after a final medical clearance.
6. Return to competition.

If the client is not a competitive athlete, ensure a gradual progression in intensity for the workouts.
Ensure a full day before progressing to any advanced stage.
If symptoms recur, return to stage 1.  Ensure that medical follow up is adhered to by the client or athlete.

Any severe set backs will require a further medical evaluation! 
Keep ahead of the learning curve.

Getting your bell rung!
Even the most high tech helmet provides only limited
 protection from a targeted head shot.

Until next time,....

Keep fit!

Little Bobby Strong!













References
1.  Sport Concussion Assessment Tool (SCAT)
2. 'League of Denial' by Mark Fainaru-Wada and Steve Fainaru
Crown  Archetype Publishing   2013

Links
schwabe27.uwmfatloss.hop.clickbank.net
AudienceBuilder.ca
www.fitnwell.com
www.rabbitview.com/rabbitview-crossfit