Concussions

 

The start of a new school year means a new season for high school and college sports, including football, cheerleading, field hockey, cross country, golf and volleyball. As teams hit the practice fields, it’s a good time to be reminded of one of the common injuries associated with playing a sport: concussions.

Armin Harandi, MD, is an orthopedic provider at Novant Health UVA Health System Culpeper Medical Center who frequently treats sports-related injuries in young athletes. Dr. Harandi and his team see the full gamut of sports injuries at their practice and are well-prepared for varying levels of severity.

“The majority of injuries we see are ligamentous or soft tissue, such as overuse injuries, sprains, strains and contusions. These injuries usually heal quickly and without lasting impact,” said Dr. Harandi. “Concussions, however, are a big concern among young athletes and their parents due to their potential for long-term neurological impact.”

 

Concussions

Head injuries are a big concern, especially in contact sports. Schools’ athletic training departments participate in concussion training and athletes are given concussion tests at the beginning of the season.

“When a patient shows signs of a concussion, we use the concussion test as a baseline neurocognitive test,” said Dr. Harandi. “We use this along with evaluation of their symptoms and a physical exam to determine recommendations for further management.”

Signs of a concussion can include:

  • A history of head injury followed by a headache

  • Lightheadedness

  • Dizziness

  • Fatigue

  • Difficulty with balance

  • Sleep problems

  • Increased anxiety 

 

In serious cases, individuals might also lose consciousness, experience seizures or exhibit unusual behavior. These cases should be evaluated immediately by an athletic trainer or emergency medicine provider and may require a computed tomography (CT) scan. 

Since neurologists generally don’t have the availability to assess athletes on a weekly basis, the last decade has seen marked improvements in concussion diagnosis and management among primary care providers. According to Dr. Harandi, primary care sports medicine doctors who are trained in concussion management are much better at treating concussions efficiently and effectively and getting athletes back to play safely.

“Even head injuries that seem minor can lead to ongoing symptoms, so follow up visits are an important part of concussion management,” said Dr. Harandi. “In the past, doctors diagnosed concussions acutely and recommended taking a week off, but rarely saw the patient again unless there were persistent symptoms. We now understand that wasn’t an effective way of managing a concussion.”

To return to their sport, an athlete must be symptom free and back to baseline measurements. The athlete gradually increases activity in accordance with a three- to five-day “return to play” protocol. If symptoms are observed during this window, the athlete restarts the process. Doctors caution against sending athletes back into play before they are fully recovered and symptom-free. 

Don’t Live in Fear

Despite the risk of injury, Dr. Harandi emphasizes the benefits of kids and teenagers participating in sports, including teamwork skills, lessons in sportsmanship and healthier lifestyles. In fact, many doctors encourage kids to be multi-sport athletes, which helps avoid overuse injuries.

 

“There is always a risk of injury, but you can’t live in fear,” said Dr. Harandi. “You can do the same amount of damage slipping on ice or tripping on stairs. I would never discourage athletic activity because of the overall health benefits of exercise.”

Primary care sports medicine providers are trained to recognize even subtle injuries. To offer more comprehensive treatment to patients, many have expanded their training to also include eating disorders and mental health conditions.

For more information about orthopedics and sports medicine services at Novant Health UVA Health System Culpeper Medical Center, please visit novanthealthuva.org/services/orthopedics--sports-medicine.aspx.

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