Illustration by Sam Woolley.
by Beth Skwarecki
Concussions aren’t just for NFL players. They can happen while playing in aweekend sports league or even from an unlucky slip and fall. If you know how to spot a concussion and where to find good treatment, you can avoid the risk of further injury.
While you can get a concussion elsewhere in life—falls, car accidents, and assaults are among the common causes—concussions have a special place in sports. Athletes subject themselves to the possibility for falls and collisions constantly in many sports, and it’s important to pay attention to recovery so that you’re fully healed by the time you return to play.
Many people may not even realize they have a concussion, and they don’t always come from an obvious blow to the head. Slight dizziness or a headache may not seem like a big deal at first, but they can be symptoms of a more serious issue. In several reports, players in college and high school sports admitted they had had possible concussions in the past season, but hadn’t reported them. More than of half the time, it was because they didn’t realize they’d actually had a concussion, or they didn’t think their injury was serious enough to report. In one case, College football offensive linemen had 27 unreported possible concussions for every one they spoke up about.
So first things first: If you have any of the symptoms described in this post, even mild ones, you should step back from any activity where you could injure yourself further. A responsible coach will bench you, even if it’s the middle of a game—and if they don’t, you should remove yourself from play.
To determine if you really do have a concussion, and what you should do about it, you should see a doctor who has expertise in dealing with brain injuries. We spoke with neurologist Dr. Jeffrey Kutcher to bust some myths about concussions and help you understand what to do if you get one.
Spot the Signs and Symptoms
A concussion isn’t a simple injury like a bruise or sprain, where a body part is torn or smashed or broken. Rather, a concussion starts with an injury—often the brain smacking against the inside of the skull—and then the brain cells, attempting to return to normal, alter their function.
Those results can include brain cells firing more or less often than they should, being unable to reach brain cells they normally communicate with, and other subtle changes that don’t show up on MRI or CT scans. Instead, the damage is only noticeable in the way the brain functions. The exact symptoms differ from person to person and injury to injury, and can involve almost any part of the brain. This means symptoms can range from slowed reaction time to difficulty focusing or thinking clearly to nausea and vomiting.
That’s why it’s so important to be on the lookout for the symptoms of a concussion. You could notice them after a hit to the head, or some other fall or collision that whips your brain around without touching your head. A concussion can result from a hit so hard you get knocked out, or it can be a “ding” that you’re tempted to shrug off.
If the hit is one you experienced yourself, watch out for symptoms like:
- Blurry vision
It’s also your job if you’re a coach—and a good idea just as a friend or teammate—to be on the lookout for signs of a concussion in others. Even if they don’t admit to any of the symptoms above, you should suspect a concussion if someone has:
- Changes to balance, coordination, or reaction time
- Slow movements or slurred speech
- A blank stare or dazed look
- Confusion about where they are
- Loss of consciousness (which only occurs in about 10 percent of concussions)
Those are just a sampling of the features to look for; this concussion “quick check” card from the American Academy of Neurology gives more detail. (It’s also available as an app for iOS and Android.)
Understanding what’s going on is important when you’re standing on the sidelines and wanting to know when you’ll be able to play again. While there are plenty of apps and checklists to help you know what’s going on in case of a suspected concussion, including well-respected tools like the Sport Concussion Assessment Tool (SCAT3), Dr. Kutcher stresses that these aren’t meant to tell you, as an observer, whether somebody actually has a concussion or not. If somebody “passes” a concussion test, they still shouldn’t go back on the field. Your job as a coach or teammate is to rule out911-level head trauma and then just to help somebody realize that they should sit out. Any further evaluation is a doctor’s job…