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We need a plan for addressing concussion

Posted Feb 05 2011 12:00am

Seriously. When it comes to handling concussion and mild traumatic brain injury, especially among student athletes, we desperately need a plan of action to address the injury when it happens.

Because it can and does happen. And it will continue to happen so long as we are doing more than sitting passively in a chair watching the game. Provided you never move from that chair, you’ll be safe… until obesity and all the health issues that accompany sedentary life catch up with you.

Personally, I’d rather run the risk of concussion.

And so would a lot of other people.

So, given that there are individuals out and about who are engaged in activities which carry a danger of head injury, how shall we address it when it happens?

I say, we come up with a plan for this. Especially among athletic trainers and other healthcare professionals and those who have been down the road of mild TBI and lived to tell about it.

People who are in a position to respond response-Able individuals need to step up and put some thought into not just prevention and immediate response, but also concussion recovery. Because if we just say, “You got hurt, but we really don’t know what to do to get you back on your feet. Every brain is different, so we really don’t know what to tell you, other than rest,” I will bet you any amount of money that the under-reporting and symptom concealment and unsafe return to play will continue, even escalate.

At the same time, you don’t want to set unrealistic expectations with the Plan and set people up for disabling disappointment. It’s true that every brain is different, so we have to be careful about making ‘guarantees’. There are none in life, especially with brain injury.

I think there’s definitely a fine line between providing hope and supporting health, and getting yourself into a professionally untenable position. The last thing you want, as a professional healthcare provider, is to have angry athletes and parents showing up at your doorstep shouting, “But you PROMISED my kid would be okay in three months!” I won’t even go into the lawsuit stuff.

Still and all, we need to do something. All of us, not just a select few. And outside the realm of commercial enterprise. Commerce and Concussion should never mix, but unfortunately, they increasingly do. We need to seize the moment and step up, as this concussion business is getting a lot of press – and heaven forbid we squander the opportunity to rise to the occasion.

How about this? Say, we craft a “crowd-sourced” response to concussion which draws on the collective intelligence and training and insight of experts of many kinds all over the place. And we do it for free. Online. As a community.

I envision the following Concussion Response Plan (CRP) for responding to concussion:

This would be an approach which, after a mild traumatic brain injury:

  • Leverages expertise in conditioning and protection and prevention, which comes from the Athletic Trainer camp. We need this to educate players (and others, like parents and coaches) about the source of their injury, to show them how and why their concussion happened.
  • Incorporates knowledge about the physical nature of mild traumatic brain injury, which comes from the Medical camp. We need this to educate folks about the nature of brain injury, to explain the inner workings of it and how physical changes in the brain affect its functioning. We need to stop being so squeamish and start calling concussion what it is a mild traumatic brain injury.
  • Incorporates knowledge about the potential physical, mental, and emotional impacts of mild traumatic brain injury , which comes from the Neuropsychological/rehabilitation camp. We need this to educate everyone affected about the potential issues that may come up, help them craft intelligent coping mechanisms, AND to show that healing and recovery are possible… and where recovery is not 100% complete, there are indeed coping mechanisms that can be used to offset the effects of the injury, or other options available in life to the impacted individual.
  • Has a firm foundation in physical and cognitive-behavioral conditioning and fitness in Action. We need to not just sit around and think about “this concussion stuff”. We need to put what we learn into action. This is especially important for concussed athletes, because the agitation that can come from TBI can be a huge issue, and the energy needs to be directed in some productive and constructive direction.

This CRP needs to be clearly defined and articulated from the start, even before athletes are concussed. The uncertainty of sitting out for an indeterminate amount of time, with no structured activity and now outlet for this crazy agitation that comes up and stays is no way to spend your days, especially as a student athlete with a concussion. If there’s no planned response to concussion in place, and athletes are left hanging with no structure or direction, the experience is HELL, and it’s all the more reason to hide your symptoms or pretend you’re all better before you are.

And that can quite literally get you killed.

But when you’re 16 years old, and the only way you’ve found to be the popular, successful person you always wanted to be, has just been yanked out from under you, it’s easy to choose to risk your life instead of honest disclosure. When your whole identity and sense of self hinges on being able to play and play well having that taken away from you might as well be death.

Yes, we need a Plan a cohesive, coherent, well-thought-out program of action to address Concussion in youth sports across the full spectrum of experience, after the injury as well as before it happens. We need to chart a course that offers some level of structure and predictability to kids and parents alike after the concussion, and gives them some assurance in the midst of a situation which is chronically devoid of predictability.

Even if it’s the assurance of knowing what has happened and that there are specifiic, orderly steps they can take to take to address it without any specific guarantee that it will all work 100% as they hope/expect at least that would be something.

We need a Plan for addressing Concussion how to prevent them, how to appropriately respond to them, and what to do during the time period required to recover . Without such a Plan, athletes at all levels are going to continue to avoid this issue and not address it directly or modify their behavior. Because sometimes uncertainty is the scariest thing of all. And nobody likes to be scared.

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