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Concussions common among high school athletes
Physicians say players often return to the field too quickly after a head
injury.
It's an old sports adage: You gotta play hurt. But when there's a head
injury, doctors say, it's time to hit the sidelines rather than return to the
huddle.
A Cleveland Clinic study of 233 high school football players in Ohio and
Pennsylvania showed that nearly half had suffered concussions during one season
-- and stayed in the game or practice scrimmage. Some of those concussions, the
report said, should have ended the teen athlete's season, yet didn't.
"Coaches have to educate the athletes that if they get dazed during the
game or in practice, they should come to the sideline at the end of the
play," says Bruce Cohen, M.D., chief of pediatric neurology at The
Cleveland Clinic and lead author of the study. "Athletes like to play
tough, but coaches need to stress safety to kids. These are serious events and
it's necessary to come out for a play or two, or for a
quarter."
The study data was conducted five years ago and released last fall. It
was based on questionnaires that were given to 450 prep athletes beginning in
the 1997 season, nearly half of which were returned. The intent of the study,
Dr. Cohen says, was not to alarm parents to the high incidences of concussions
or to blame coaches, but rather to gage whether athletes themselves recognized
when they were hit hard enough to cause a concussion. Furthermore, results
showed that 81 of the 233 high school football players that responded suffered
more than one concussion.
Its findings point to a crucial problem that has plagued athletes for years
and is just now being addressed as a result of better education and new
technology that shows the effect of hard knocks on the brain, often by burly
fellow athletes.
Recognizing the symptoms of a concussion can be both complex and simple, Dr.
Cohen says. "A serious concussion is very easy to detect: A loss of
conscious or the person is acting confused," he explains. "Mild
concussions are more difficult. There's no loss of consciousness and the person
may feel internally confused, but show no outward sign of the confusion."
Dr. Cohen adds that "there's really no way to tell when there has been a
mild concussion -- they may be so frequent and so inconsequential and they may
not amount to anything at all."
But going back into the game is when the situation could get dicey, he adds.
"That's when something called the second impact syndrome may occur,"
Cohen says. "It can become more serious if the person gets hit on the head
too soon after the first concussion." Although there is debate regarding
the seriousness of the second impact syndrome, Dr. Cohen prefers to take a
conservative approach with his patients.
Dr. Cohen stressed that modern football gear, the heightened awareness of
coaches about head injuries, strict attention to rules about tackling and
placing medical staff at all games has made high school football much safer for
athletes. In other sports where athletes do not typically wear protective head
gear, like soccer or basketball where occasionally a player is hit with an elbow
or foot leave also many athletes vulnerable to concussions. With such a wide
spectrum of concussion symptoms, some amateur and professional athletic groups
have recently started to publish health guidelines that include information on
spotting the head injuries early -- and treating them quicker by benching the
athlete.
"I think we're seeing an increase in the number of reported concussions
because of the fact that we have tried to make people more aware of what they
need to look for," says Jerry Diehl, assistant director of the National
Federation of State High School Associations, an organization representing
nearly 20,000 U.S. high schools based in Indianapolis. "We tell coaches to
look out for anything that is abnormal -- incoherence, glassy eyes, a stagger.
Student athletes today are bigger and they are hitting harder."
Mr. Diehl adds that the national federation recently published a sports
medicine handbook that includes a section on concussions. "Overall, there's
more awareness out there. We tell our coaches that it's better to be safe than
sorry."
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