BEKKAH HAS A CONCUSSION
Bekkah was injured in yesterday's game, she incurred a mild concussion. Allowing that it was just a hard hit, one that rings your chimes so to speak, she was allowed to play today. It became very apparent that she was not up to speed, so she got pulled and taken to the hospital today. She will not be allowed to play for about a week and she will be back to the doctor before she can be released to play. She has High School Soccer tryouts next week.
posted by MYSTIC @ 6:10 PM
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Don’t Be KO’ed by a Concussion
Sayre Priddy
09/05/2007 11:32 pm
After suffering a concussion, U.S. Women’s National Team player Lori Chalupny was out for nearly six months. Here, Sayre Priddy chats with Dr. Ruben Echemendia and finds out how to properly manage the injury to avoid the same fate.
It is every soccer players’—and surely every parents’—worst nightmare: suffering a vicious blow to the head and being unable to play for an extended period of time. Unfortunately, that bad dream became reality for United States Women’s National Team member Lori Chalupny, who suffered a concussion on January 20, 2006 after two blows to the head in a game against France during the Four Nations Cup in Guangzhou, China.
Partly due to her concussion history and also as a result of some bad medical advice, the former University of North Carolina star didn’t fully return to the pitch until this past June, nearly six months after the injury. However, armed with some knowledge gleaned from Chalupny’s experience, the average soccer player can steer clear of a similar scenario.
A Common Injury
Chalupny first suffered a concussion in 2000, and then endured two more in the space of two or three months in the fall of 2005, making her most recent experience her fourth. While her latest rash of concussions is rather unusual (“It’s just bad luck; kind of a wrong place at the wrong time type of thing,” she says), the concussion is the most common head injury in soccer, reveals Dr. Ruben Echemendia, a leading expert in the field of sport concussions who helped to treat Chalupny.
Echemendia, who is the neuropsychological consultant to the U.S. Soccer Federation, among other posts, is running a longitudinal study on the soccer players in the national program, from U-13s all the way up to the senior squads. “Depending on what measure used and what age group is focused on, our data suggests concussion frequency in soccer is at the same level as American football, although certainly not quite as high as ice hockey or rugby,” says Echemendia.
“Approximately 39 percent of all players on the U.S. soccer national programs have had at least one concussion, which itself is likely an under-estimation.”
While he acknowledges that some people might be more susceptible to concussions than others, but the researchers don’t yet know why. It could be a genetic predisposition, or a difference in the style of play, or a gender difference (some studies show that female soccer players are more susceptible to concussion, while other shows that men and women are about equal).
Concussions 101
First things first: What is a concussion, exactly? “A concussion is defined as a blow to the head which causes mechanical forces to move the brain and subsequently causes a set of symptoms,” explains Dr. Echemendia.
Soccer players can suffer a concussion in a bunch of different ways. The most common is head-to-head contact, but there is also head-to-elbow, head-to-ground, head-to-foot, head-to-goalposts. “However, concussions are typically not caused by heading the ball,” stresses the doctor. “That is a misconception.”
There are two different types of forces which cause concussions: linear and rotational. In the former, a front-to-back force (or vice-versa) strikes the skull, sending the brain forward (or backward) and causing it to strike the skull. The latter, however, involves a blow which initiates a rapid rotation of the skull, bruising the brain and more often leading to loss of consciousness.
Early concussion symptoms to watch out for include confusion, disorientation, amnesia, headache, nausea/vomiting, motor problems and incoordination. Later symptoms are decreased processing speed, short-term memory impairment, irritability and depression, fatigue and sleep disturbance and a general feeling of fogginess.
Treatment and the Return of Activity
The most crucial decision when seeking treatment is to make sure that the doctor has specific experience with sports concussions. “On a routine basis, I see players who have been cleared to resume activity by a physician when they should not have been,” said Dr. Echemendia. In fact, Chalupny was one of those players. She had initially been advised by a neurologist that it was safe to resume activity—however, once she went for a run, her symptoms returned and her recovery time was prolonged significantly.
Treatment for concussions is primarily rest: physical as well as cognitive. Physically, players should avoid increasing their heart rate or blood pressure, because that increases the brain’s intercranial pressure, which in turn may bring about symptoms. Cognitively, players should avoid doing a lot of computer work, a lot of heavy reading and similar activities.
The rest required to recover from a concussion is typically three to five days, although younger players (junior high and high school players) tend to have symptoms longer than college-age players and pro/elite athletes. Most concussions tend to resolve, at the longest, within eight to 10 days.
Once Chalupny was symptom-free for a significant period of time—and neuropsychological testing determined that she had really recovered—her doctors then allowed her to begin some very light cardiovascular activity (See Timeline sidebar). As she remained symptom-free, they gradually ramped up her activity over a period of time. While the progression is normally increased every twenty-four hours, the doctors increased her activity every three or four days because of her atypical case.
Preventative Measures
“Parents and players shouldn’t worry,” says Dr. Echemendia. “Don’t make foolish plays and use your head in a way that you are not supposed to use it, but there aren’t ways to necessarily prevent concussions. We aren’t going to take concussions out of soccer, but we can become much more aware of how to best manage concussions.”
While some in the soccer community believe that the answer is head gear, the doctor hasn’t seen evidence to either recommend its use or to discourage it—he feels any helpful data is three or four years away. His only concern—not based on data—is that some players feel invincible when they use the head gear. They feel much more protected and play much more aggressively, which could result in more injuries.
Interestingly, Dr. Echemendia reveals that it is, “not necessarily true that as a person accumulates more concussions, the incidents get progressively worse. The jury is still out on that one. What’s much more important is how closely spaced the concussions are to each other and how they are managed.”
Don’t “Tough It Out”
However, if all those warnings weren’t enough, Chalupny has a message for those who still might try to “play through” the pain: “I want everyone to know that head injuries are a very serious thing. It is really important to treat concussions, even a mild one, with a period of rest. Don’t try to tough it out or play through it when you think you might have concussion.”
Take it from someone who knows.
Good. One day out for that kind of thing sure doesn't sound like enough.
Bekkah is still suffering headaches but at home... She rested at home the day of the injury, but it was obvious during the next game she was not the same. A referee friend of mine informed me of the injury the day it happened and he was calling the next days game and pointed it out to the coach that she was not OK... The coach benched her for health and safety. Next was a trip to the hospital for evaluation. The rest is history.
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