Concussions can linger for young athletes

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April 11, 2011 - 7:00pm

As youth sports have become more competitive, they have also come with an increased risk of concussion. The increased number of head injuries youth sports is part of a deeper look at high school football on Frontline on NET Television. Nebraska lawmakers have sent a bill to the Governor that would require more precaution with students who may have a concussion, as coaches and doctors learn more about how to prevent them. NET News' Grant Gerlock talk with psychologist, Lori Terryberry-Spohr, who heads the Brain Injury Program at Madonna Rehabilitation Hospital in Lincoln, where they often treat athletes from the area who suffer from sports head injuries.

GERLOCK: Which sports are responsible for most of the head injuries in high school athletics, or even younger athletic program? I would imagine football maybe is the number one.

TERRYBERRY-SPOHR: Yeah. Football always comes to mind first, particularly in our state. And based on the research that we did, we had a 5-year grant at Madonna to study high school athletes, it was the sport that provided the most incidents. And that's been true around the country. There's some other surprises in there, though, in terms of second most is often in most of the studies, girls soccer. Followed by boys soccer, girls and boys basketball, then wrestling, softball. Then there are some other things that are thrown in there that aren't necessarily organized sports, like equestrian, diving, swimming, things like that.

GERLOCK: So there aren't many activities that are left out here?

TERRYBERRY-SPOHR: No, you can get a concussion participating in virtually any organized activity or unorganized activity for that matter.

GERLOCK: Have these injuries always been happening, and we're just noticing them now? Or do you think they're actually becoming more frequent and more common?

TERRYBERRY-SPOHR: Most of us who work in the field believe that it's a combined effect. Kids are bigger, stronger, and faster than they've ever been before. They condition year round, and we know particularly the high school athletes are going to great lengths to be faster and stronger than ever. So we think there probably is an increase in incidents. But there's also been huge efforts made in terms of increasing awareness. So we also believe that we're doing a better job of recognizing and identifying these incidents.

GERLOCK: At Madonna you're working with students who are dealing with some lingering effects of head injuries. What sort of problems are they dealing with even after the initial recovery takes place?

TERRYBERRY-SPOHR: Yes. At Madonna we helped many of the schools in our area establish concussion monitoring programs. But our primary role as a healthcare provider is to help those kids who don't recover as expected. From the research and the literature about 90% of youth will recover independently within about 10 days from their first concussion. Just with a little education and prevention in that time they do quite well. There's those 10% or so that have lingering effects. Issues with headaches is one of the most frequent complaints. Memory problems. Attention. Reasoning. Sometimes difficulties with balance. Irritability. So our role is to assist with treatment of those using a multidisciplinary team approach. It might be physical therapy, occupational therapy, speech therapy, neuropsychology, physiatry - which is a form of medicine involving physical rehab. And we assist those youth in getting back to normal, full participation in the classroom, and back to play.

GERLOCK: These are injuries that can have lingering effects that still reach into the classroom?

TERRYBERRY-SPOHR: Absolutely. There are many cases where the kid's grades will drop for a little while if it's not managed and the school isn't informed and given a little extra time to do the homework or a little extra breaks in there. We can do a lot in the couple weeks following the event to help the schools with that if we are aware and they are aware of what needs to happen.

GERLOCK: Can a concussion for a teenager have effects that can last their whole life?

TERRYBERRY-SPOHR: It's possible. It's actually fairly rare. And usually when the effects last their whole life it's from multiple concussions. It's the repeated incidents we're most concerned about, which is why so much of the focus and awareness and prevention has been on repeated concussions, in other words too many of them and too many of them close together.

GERLOCK: There's a bill in the legislature that's very close to being passed that addresses this issue. How does it get at the problem?

TERRYBERRY-SPOHR: Yes it does. LB 260 (passed Final Reading in the legislature and is before the Governor) and it has three primary components. The first is education - annual education provided to coaches, parents, and youth on the symptoms of concussion and the need for prevention of repeated concussion and just to raise the awareness so that it's properly managed. The second part is to immediately remove the youth athlete who's expected of having a concussion from play so they can be appropriately evaluated and monitored. And the third part is having them cleared to return to play by a licensed healthcare provider who's trained in concussion.

GRANT: It seems like what that gets to is you need to kind of change the culture in the athletics. Because the tendency is to want to just kind of shake off the cobwebs and get back in the game. Is that a challenge to get past?

TERRYBERRY-SPOHR: A little bit. As people understand the ramifications and hear about the recent research and what we've learned in the last 10 to 15 years, most people pretty quickly transition to understanding why this is so important. It's not that we want to eliminate athletics in any way or eliminate contact athletics in any way. We've just learned a lot more about what those repeated injuries particularly too close together can do. And particularly we're concerned about something called second impact syndrome which is a catastrophic reaction to two injuries too close together. So like a bleed or something like that that can occur. So just that need to prevent those injuries and keep our kids safe so they can play longer is what needs to happen. And the culture change has to happen from the top down. The NFL is on board. They're actually advocating and lobbying in the states for legislation. So I think as it happens from the top down it makes our job easier. We don't have to convince as many people because they see even the pros are doing it.

GRANT: Do you think there is then kind of a balance between matching the competitiveness with the precaution.

TERRYBERRY-SPOHR: Yes, I mean, I think that we know that the greatest risk is to youth. All the cases of really catastrophic injury have happened in age 23 and under. So we know that's the biggest risk and so that of course leads to the most precaution. They're also the kids with the most years left in terms of years to play, years of life, years of work. And so we want to be a little more cautious with them. But even so, the NCAA, the NFL, the NHL, all of the higher level athletics have put in place these precautions now too.

GRANT: The problems that they're seeing later in life for some of their athletes is really catastrophic.

TERRYBERRY-SPOHR: Yeah, there is a real concern there. As we've gotten more research on repeated events in particular there is a concern with athletes who've played comptetitively. There's a brain bank at Boston University who's doing a lot of research in this area. And they're looking at the effects of multiple brain injuries on long term incidents of dementia. And one of the things that they're finding that they're very concerned about is increased incidents of dementia among professional athletes, in particular professional football players, as well as earlier onset. And so that's raised a lot of concerns about what do we need to prevent this early on so we don't have these effects later.

GRANT: Dr. Lori Terryberry-Spohr thanks for being here.

TERRYBERRY-SPOHR: Thank you. Very glad to be here.



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