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The Impact of Concussions on Minor Football Athletes

Download the "Concussion Awareness Management Chart" to know specifics about concussions:

        [ENGLISH]  [FRENCH]

 

What is a concussion? It is a brain injury.

A concussion occurs when a person experiences a significant hit to the head, face, jaw or body causing the brain to shift and impact the inside of the skull forcing a temporary loss of normal brain functioning.

It may also result from a whiplash effect to the head and neck in a front-to-back or side-to-side motion. Imagine not wearing your seatbelt and being suddenly thrown against the inside of your vehicle and getting injured; the brain slamming into the skull gets an injury during a concussion.   


THE IMPORTANCE OF PROPER FITTING EQUIPMENT

       Everyone has a role in ensuring the proper fit of helmets, shoes, and shoulder pads, including hip, tail, thigh, and kneepads.  This is a responsibility of the players, coaches, trainers, and parents. Advances in protective equipment have given players a false sense of security plus an incorrect attitude to be able to enforce injury to others.  Getting or giving an injury is ‘not cool’ as this is poor sportsmanship and disrespectful to other athletes.

Three items that get a lot of discussion:

       i) Helmets: Many people believe a helmet will prevent a concussion.  A helmet can’t prevent a concussion; its most important role is to protect the head. A properly adjusted helmet holds the head securely to help reduce the force of impact during a hit.  A properly fitted helmet protects the skull of the player from physical damage (broken skull, impalement, bruising, etc). The helmet also protects against cuts, bruises, fractures, and focal lacerations.  Helmets supplied to players by Regina Minor Football are certified, meet the proper safety requirements, and are regularly inspected for safety throughout the year.  Make sure your helmet is properly sized and fitted throughout the entire season not just at the start!! Helmet manufacturers have improved designs over time to help address concussion issues, but remember helmets do not prevent concussions.

       ii) Mouthguards: The primary function is to protect the teeth from physical shock and damage. Some research indicates mouthguards shift the lower jaw at the rear (TMJ). This shift has not been shown to prevent concussions, but may reduce impact within the skull bone itself. A mouthguard helps prevent jaw fractures by dissipating the shock transferred during an impact. Mouthguards also help reduce transfer of damaging vibration up into the brain and in the temporal area.
The quality of the mouthguard is not as important as the proper fit and wearing of the mouthguard. Professional molded dental appliances will help ensure a snug, secure fit on the teeth, however standard ‘boil & bite’ mouthguards, when properly fit, will also provide adequate dental protection to the player. Ensure the mouthguard protects ALL of the teeth, especially at the back of the mouth.  Do NOT chew or mangle the mouthguard as this will reduce the ability of the mouthguard to protect from shock.    Mouthguards do not prevent concussions.

       iii) Shoulderpads: Although Shoulder pads will not reduce heaad injuries it is important to have them properly sized. This video shows proper shoulder pad fitting: [CLICK HERE!]

 


PHYSIOLOGY OF THE BRAIN

       The brain is surrounded in the skull by cerebral fluid.  This acts as a shock absorber cushion between the brain and skull bone matter.  Just like the albumen inside a raw egg protects the yolk, the cerebral fluid protects the brain.  As a matter of physics, inertia causes the brain to continue to move when the skull stops abruptly.  Speed is a contributing factor to concussion severity (i.e.: speed of hockey is faster than speed of football).  A severe concussion occurs when the brain twists inside the skull.  Permanent brain injury occurs when the menegial connective tissue at the top of the skull tears as the brain rotates inside.  This can occur when a severe hit causes the head to move in an alternate direction to the body impact.  Impacts to the side of the head are most damaging in concussions, creating a sideways force where the head moves towards the shoulder.  Repetitive impacts to the front & rear of the brain accumulate over time and contribute to long-term brain damage and post-concussion syndrome.

       i)  A primary concussive injury occurs when the brain impacts the skull.  This is what most athletes experience during a violent hit to the head, face, jaw, or body.

       ii) Second-Impact-Syndrome concussion occurs when the brain experiences a second concussive force impact in the same region of the first impact resulting in more intense damage to the brain. This injury occurs when a player continues to play after being initially concussed. Therefore, Return-To-Play criteria must be adhered to prevent permanent brain damage (memory loss, vision loss, motor control, etc) to players.

       iii)  Only time and rest can allow the brain to recover!  No medication will help to speed up recovery!  Do NOT give pain medication to a concussed player.


RESPECT, ATTITUDE, AND SUPPORT

        Players need to use common sense when making contact with other athletes on the field.  No hits from behind, or to the head or face which can cause serious injuries to other players.  Treat one another with respect on and off the field – treat others the way you would want to be treated, safely.  Concussed players need positive support from their teammates by recognizing the importance of a healthy brain to avoid long-term brain disabilities.  Players need to acknowledge they are ALL susceptible to experiencing concussions and being concussed does not make a player a ‘wimp’ nor does it make them somehow ‘stronger’.  Being concussed is NOT ‘cool’.  A concussion is serious matter as it is a brain injury that can have lasting harmful consequences. 

       The player’s attitude towards continuing to play when injured must be stopped.  A player must wait before returning back to play!  An injured played may involve themselves in light activities only, with gradual increase in activities with observation and proper assessment from trainers, coaches, doctors, etc.

       Coaches also have a vital role in preventing injuries by ensuring proper respectful behaviour as role models for players, and through teaching players proper techniques in tackling and blocking in football.  Coaches must be the example and the teacher when instructing in football.  The personality of the coach will translate into the team therefore coaches must be made aware of this to ensure players play fairly and with respect towards others.  Players must be in control of their level of aggression.  Also, coaches and fellow teammates can help maintain proper level of control and respect during the game.

       Referees and officials need to enforce ejection from games if unsportsmanlike conduct occurs where a player could be seriously injured from hits from behind or to the face/head where a serious or severe brain injury can result.
Rules and Regulations Committees also need to ensure safety exists through proper development of regulations and strict enforcement of rules to prevent and minimize injuries.

       Parents and family members need to support the player by ensuring the proper Return-To-Play protocols are being followed, and that the player is supported in their decision to properly heal before returning to play.  Some parents may pressure their children to return to the game too early for fear their child may lose out on vital opportunities on the field, rather than realizing their child needs to heal physically, psychologically, and emotionally before returning to the game.

The use of Return-To-Play checklists by coaches and medical staff must be strictly adhered to.  Use of a quick assessment short card on the field, followed up with an intensive checklist after the game is required to assess the condition of the concussed player.  Concussed players must also be seen by a doctor who is properly trained in concussion assessment and treatment to ensure proper medical care is provided to the athlete.  Click to access the Concussion Awareness & Management chart:  [ENGLISH]  [FRENCH]

KNOW THE GAME AND HAVE FUN!

       Players need to find a balance between safety and performance.  To reduce the chances of being injured, players must be aware of themselves on the field in relation to other players to avoid disastrous hits.  Practice! Know your drills! Athletes must also be skilled at footwork and drills allowing players to keep alert while not actively thinking what to do during the play.  Always be aware of players around you even if not involved in the immediate play (ie: accidental collision, tripping backwards, etc) as there is player traffic all around you at all times.   Players must exercise and keep fit which helps strengthen bones and develop muscles to reduce the incident of injuries.  And, always properly wear your equipment!

WHAT CAN PEOPLE DO? WHAT MUST BE DONE?
       Step 1:  Education and awareness for everyone of concussion injury potential.
       Step 2:  Remove player from game play until assessment of injury is completed.
       Step 3:  Implementation of ‘Return-To-Play’ criterion.  Click here: [ENGLISH]  [FRENCH]

Be aware of the following symptoms!  A loss of consciousness is NOT the only indicator to a concussion!
Early warning signals: loss of memory, loss of consciousness, headaches, dizziness, nausea, poor concentration, slurred speech, loss of vision, vomiting.

Later symptoms (after the injury several weeks/months/years): memory loss, fatigue, sleepiness, blurred or double vision, vertigo, light sensitivity, ringing in the ears, insomnia, irritability, personality changes, seizures.

 


For further information, check these resources:

Website demonstrating the effects of traumatic brain injury in sports.
http://wipeout.knowledgenetwork.ca/
Maintains several videos containing testimonials from people who have experienced concussions and severe brain injuries & damage.

Pashby Sport Safety Concussion website
http://www.drpashby.ca/
Developed with the assistance of Drs. Karen Johnston and Charles Tator, McGill University, 2004.

Ontario Brain Injury Association
http://www.obia.ca

Last Updated on Saturday, 15 February 2014 19:12
 


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