Study: Athletes staying in game despite concussion leads to worse short-term mental function

*Staff Photo by Dan Henry / The Chattanooga Times Free Press- 11/20/15. East Ridge quarterback Eric Bennett (7) looks for an open player while battling Notre Dame during Friday's quarterfinal playoff game on November 20, 2015.
*Staff Photo by Dan Henry / The Chattanooga Times Free Press- 11/20/15. East Ridge quarterback Eric Bennett (7) looks for an open player while battling Notre Dame during Friday's quarterfinal playoff game on November 20, 2015.

More Info

Read Tennessee’s policy on how to treat athletes who suffer a concussion.

Concussion signs, symptoms

Signs and symptoms of a concussion may include:› Headache or a feeling of pressure in the head› Temporary loss of consciousness› Confusion or feeling as if in a fog› Amnesia surrounding the traumatic event› Dizziness or “seeing stars”› Ringing in the ears› Nausea› Vomiting› Slurred speech› Delayed response to questions› Appearing dazed› FatigueSome symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:› Concentration and memory complaints› Irritability and other personality changes› Sensitivity to light and noise› Sleep disturbances› Psychological adjustment problems and depression› Disorders of taste and smellSource: Mayo Clinic

East Ridge head football coach Tim James said he and his staff knew their starting quarterback, Eric Bennett, had taken a hard hit to his head during a two-point conversion play in the first quarter of Friday night's game against Brainerd.

"We saw him taking a pretty good lick, and I asked him if he was OK," James said Monday. "He said 'Yes sir, I'm OK,' but a little later he came to me and said, 'Coach, I'm having a little trouble; I'm having a blind spot here.'"

James sought medical advice to determine if Bennett had suffered a concussion.

"We had doctors on the sideline and they were able to evaluate him," James said. "And based on their recommendation, we kept the young man from going back in."

James was following Tennessee's rules for treating high school athletes suspected of suffering a concussion, and according to a new study, the theory behind those rules has a solid foundation in fact.

Continuing to play despite a concussion doubles recovery time for teen athletes and leads to worse short-term mental function than in those immediately removed from action, according to a study published Monday in the journal Pediatrics and reported by The Associated Press.

The study involved athletes with an average age of 15 participating in any of several sports such as football, soccer, ice hockey and basketball who had concussions during a game or practice. Half continued to play and took 44 days on average to recover from symptoms, versus 22 days in those who were immediately sidelined.

Sidelined players reported symptoms immediately, including dizziness, headaches, mental fogginess and fatigue, and were diagnosed with concussions by trainers or team physicians. The others, who continued playing for 19 minutes on average, delayed reporting symptoms and were diagnosed later.

Those who continued to play had worse scores on mental function tests performed eight days after the concussion and 30 days after the concussion. Medical records showed mental function had been similar in all players before their concussions.

The study was small, involving 69 teens treated at a University of Pittsburgh Medical Center concussion clinic, but the results bolster evidence supporting the growing number of return-to-play laws and policies nationwide.

Tennessee's policy took effect in the 2010-2011 school year.

"It is very important that every administrator, coach, parent, official, athlete and health care provider know the symptoms and steps to take when dealing with student-athletes that display signs of a possible concussion," the policy reads. "Concussion can be a serious health issue and should be treated as such."

It requires coaches or officials to remove any athlete from a game if they have reason to believe an athlete has suffered a concussion. If a doctor or other trained medical staffer at the game does an examination and concludes the athlete is OK, they can return, but the doctor must file paperwork to back up his or her decision. The team's trainer cannot make the decision.

A concussion usually occurs after an athlete is hit hard in the head, and the brain is jarred. Symptoms include a persistent headache, difficulty concentrating, nausea, difficulty with memory, blurred vision, unexpected mood changes, or a lack of energy.

One of the main reasons to keep athletes out of a game if they have suffered a concussion is to prevent a rare condition called second-impact syndrome - potentially fatal brain swelling or bleeding that can occur when a player still recovering from a concussion gets hit again in the head.

The study results show that a prolonged recovery is another important risk from returning to play too soon - one that "no one had really calculated" until now, said Dr. Allen Sills, a Vanderbilt University neurosurgeon. He was not involved in the research.

About 300,000 sports-related concussions occur each year nationwide among all ages. In high school athletics, they occur at a rate of almost 3 per 10,000 games or practices.

Evidence suggests up to 50 percent of concussions in teen sports aren't reported. Athletes are sometimes not aware they've experienced a concussion, or they suspect a head injury but continue playing because "they don't want to let their teammates down," said University of Arkansas concussion researcher R.J. Elbin, the study's lead author.

The results "give us more ammunition" to persuade young athletes to heed the return-to-play advice, Elbin said.

East Ridge Coach James said he doesn't need to be convinced.

"We always want to err on the side of caution," he said. "The sooner you get them out of the game, the sooner they will be recovered and return to play."

He said while "there are still kids who try to hide it," most athletes now realize that the long-term consequences of a concussion can ruin their careers.

"With the public awareness and the highly publicized NFL cases going on the past few years," he said, "it is becoming more socially accepted among athletes to be honest if they have a concussion."

The Associated Press contributed to this story.

Contact staff writer Steve Johnson at 423-757-6673, sjohnson@timesfreepress.com, on Twitter @stevejohnsonTFP, and on Facebook, www.facebook.com/noogahealth.

Upcoming Events