Traumatic brain injury (TBI) occurs when the head strikes or is stuck by an object. The head does not have to experience an external blow for the brain to be injured. Brain damage can occur when the head is pushed strongly against the skull, such as with whiplash.
Concussion is a mild form of TBI from which recovery often occurs without long term effects unless a person experiences multiple concussions. Repeated brain injuries have a cumulative effect resulting in more severe and more prolonged post-concussion symptoms. A very serious and dangerous condition or even death can occur if a second concussion is suffered while symptoms from a previous concussion still persist. This condition is called second-impact syndrome (SIS).
Sports-Related Concussions: Causes and Frequency
According to the Centers for Disease Control and Prevention (CDC), about 300,000 people experience concussions each year from sports injuries. Most sports-related concussions come from contact sports, especially football, boxing, hockey, and martial arts. Other major causes of a large number of sports-related concussions are falls or collisions in sports such as skiing, bicycling, horseback riding, basketball, and soccer. In soccer an additional risk for concussions is “heading” the ball.
The most likely population to suffer concussions due to sports activities are males between the ages of 16 and 25. Within this group, the risk is highest at the high school level. About 25 percent of the 300,000 sports-related concussions reported each year are suffered by high school students playing contact sports. At the college level, over one third of football players has suffered a concussion and about 20 percent have had multiple concussions.
The Dangers of Multiple Concussions
Second-impact syndrome (SIS), which is a concussion that occurs while the victim is still recovering from and earlier concussion, has resulted in at least 26 deaths in the past 20 years since this condition was first characterized. Most of these victims were in high school.
While most cases of SIS and multiple concussions do not cause death, the neuropsychological brain damage they cause is significant. Many studies have shown that athletes who have suffered multiple concussions are more likely to have prolonged learning difficulties and perform more poorly on neuropsychological tests compared to people who have had one concussion or no concussions. Some the well-documented neuropsychological impairments in athletes who have had multiple concussions are:
- Reduced speed in processing new information
- Problem solving and planning difficulties Increased number of headaches
- Concentration difficulties
- Memory impairments
- Behavioral problems
Why Athletes Suffer Multiple Concussions
Factors that contribute to why athletes suffer multiple concussions are related to the ability to accurately assess severity and recovery from symptoms. For example, there are several different scales for rating severity at the time of the concussion but there is general lack of agreement on which to use. There is also lack of agreement on what amount of time should pass before athletes can safely return to sports. This is because there are not any widely accepted guidelines for assessing whether the athlete has recovered.
Preventing Traumatic Brain Injury
Using proper protective equipment can prevent many cases of concussion. Helmets or other appropriate headgear should be used in contact sports, and in sports for which falling or colliding are risks (skiing, horseback riding, bicycling). Custom fitted mouth pieces may also help prevent concussions in contact sports. To be effective, all protective equipment should be properly fitted and used for the purpose in which is was designed.
Although the risk of concussion is inherent in sports participation, decisions as to what sport to participate in can help mitigate the risk of concussion.