Concussion in Sports

Concussion in Sports

Fast Facts

• A concussion is a brain injury and all are serious.
• Most concussions occur without loss of consciousness.
• Recognition and proper response to concussions when they first occur can help prevent further injury or even death.

What is a Concussion?

A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious.

 

 

Concussions can occur in any sport or recreation activity. So, all coaches, parents, and athletes need to learn concussion signs and symptoms and what to do if a concussion occurs.

• How do I recognize a possible concussion?
• What should I do if a concussion occurs?
• What can I do to prevent concussions?
• Where can I find additional resources?

 

How can I learn more?

CDC has created free tools for youth and high school sports coaches, parents, athletes, and health care professionals that provide important information on preventing, recognizing, and responding to a concussion.

Did you know?

• Each year, U.S. emergency departments treat an estimated 135,000 sports- and recreation-related TBIs, including concussions, among children ages 5 to 18. (MMWR July 2007)
• Athletes who have ever had a concussion are at increased risk for another concussion.
• Children and teens are more likely to get a concussion and take longer to recover than adults.

 CDC

Sports Injuries

Prevention First
Worried about sports injuries? Don’t sweat it. Think of avoiding injury as just another part of playing by the rules — only this rulebook is the one that keeps you from getting hurt. That’s because the best way to deal with sports injuries is to prevent them. Prevention includes knowing the rules of the game you’re playing, using the proper equipment, and playing it safe.

But you’ve practiced with your team, played it safe on the field, and still sustained an injury. Don’t worry, it’s not the end of the world — just the beginning of a healing process. Read on to find out what this process is and how you can deal with a sports injury.

What Are Sports Injuries?
Sports injuries are injuries that typically occur while participating in organized sports, competitions, training sessions, or organized fitness activities. These injuries may occur in teens for a variety of reasons, including improper training, lack of appropriate footwear or safety equipment, and rapid growth during puberty.

There are two general types. The first type is called an acute traumatic injury. Acute traumatic injuries usually involve a single blow from a single application of force — like getting a cross-body block in football. Acute traumatic injuries include the following:

•a fracture — a crack, break, or shattering of a bone
•a bruise, known medically as a contusion — caused by a direct blow, which may cause swelling and bleeding in muscles and other body tissues
•a strain — a stretch or tear of a muscle or tendon, the tough and narrow end of a muscle that connects it to a bone
•a sprain — a stretch or tear of a ligament, the tissue that supports and strengthens joints by connecting bones and cartilage
•an abrasion — a scrape
•a laceration — a cut in the skin that is usually deep enough to require stitches
The second type of sports injury is called an overuse or chronic injury. Chronic injuries are those that happen over a period of time. Chronic injuries are usually the result of repetitive training, such as running, overhand throwing, or serving a ball in tennis. These include:

•stress fractures — tiny cracks in the bone’s surface often caused by repetitive overloading (such as in the feet of a basketball player who is continuously jumping on the court)
•tendinitis — inflammation of the tendon caused by repetitive stretching
•epiphysitis or apophysitis — growth plate overload injuries such as Osgood-Schlatter disease
Often overuse injuries seem less important than acute injuries. You may be tempted to ignore that aching in your wrist or that soreness in your knees, but always remember that just because an injury isn’t dramatic doesn’t mean it’s unimportant or will go away on its own. If left untreated, a chronic injury will probably get worse over time.

You may think of your back or your arms and legs as the only places where you could get hurt while playing, but you can get a sports injury anywhere on your body, including your face, neck, head, back, sex organs, hands, and feet.
Head and Neck InjuriesHead injuries include concussions, contusions, fractures, and hematomas. A concussion is a violent jarring or shock to the head that causes a temporary jolt to the brain. If severe enough, or recurrent, concussions can cause brain damage but fortunately this is not common in teens. A hematoma is a bleeding or pooling of blood between the tissue layers covering the brain or inside the brain. All of these injuries can be caused by impact to the head from a fall, forceful shaking of the head, a blow to the head, or whiplash. Whiplash is an injury to the neck caused by an abrupt jerking motion of the head.
Always wear helmets for contact sports and when doing activities like biking and in-line skating to prevent head injuries.

Neck injuries are among the most dangerous. You can hurt your neck through a sudden traumatic injury in sports like mountain climbing, skydiving, horseback riding, gymnastics, diving, rugby, judo, or boxing.
Neck injuries include strains, fractures, contusions, and sprains. Another very common sports-related neck injury is a stinger or burner from stretched nerves in the neck. Most neck injuries are caused by impact to the head or neck sustained during a fall or a blow. Your neck can also be injured a little at a time. Too much strain on your neck can cause increasing pain, sometimes only on one side of your neck. Sometimes you may feel only a slight pain when you move a certain way.
If the injury is severe and there is a chance that the neck might be injured, it’s very important to keep the injured person still with the head held straight while someone calls for emergency medical help. If the person is lying on the ground, do not try to move him or her. Never try to move someone who may have a neck injury — a mishandled neck fracture could lead to permanent paralysis or even death.
How do these injuries happen? Serious head and neck injuries occur most often in athletes who participate in contact sports (like football or rugby) or sports with the potential for falling accidents, such as horseback riding.

Back Injuries: Back injuries include sprains, fractures, contusions, stress fractures, and strains and are caused by twists or overexertion of back muscles during bending or lifting movements. These injuries can occur in contact sports like football and ice hockey or in weight lifting, figure skating, gymnastics, dancing, baseball, and basketball.
Sex OrgansWhen it comes to injuries to the sex organs, guys usually suffer more trauma than girls because the penis and testicles are outside the body and lack natural protection during contact sports. Guys should always wear athletic supporters, or in some sports a cup, to protect the genitals from serious injury.
Injuries to the uterus or ovaries are rare, but breast injuries are common complaints among teen girls. As the breasts develop, they can often be sore, and a blow from a softball or a jab from an elbow, for example, can be painful. Girls should wear supportive sports bras while playing sports or exercising.
Hand and Wrist InjuriesHand, finger, and wrist injuries include fractures, dislocations, and sprains and often occur in contact sports such as football, lacrosse, and hockey. Hand injuries can result from a fall that forces the hand or fingers backward, a forceful impact to the hands, or a direct blow.
Foot InjuriesFoot injuries can include ligament strains, stress fractures, heel bruises, and swollen growth plates. Because your feet support all of your weight and must absorb a lot of force over and over again, they can be particularly susceptible to injury. Another reason some teens may suffer foot injuries is because of differences in their feet. For example, some people have flat feet or high arches. These differences don’t mean that sports should be avoided, but it does mean that precautions, such as a special shoe insert, may be needed.

Taking Care of Sports Injuries: If your pain progressively increases with activity (what sports medicine doctors call an “upward crescendo”) and causes swelling, limping, or loss of range of motion, you need to see a doctor as soon as possible.
What kinds of pain should you be on the lookout for? Any injury that results in swelling, numbness, intense pain or tenderness, stiffness, or loss of flexibility should be taken seriously.
You should also know the difference between soreness and chronic pain. Soreness is temporary, but chronic pain continues over a greater length of time. For example, it’s not always necessary to see a doctor right away if your shoulder is sore, but you should schedule an appointment if the pain is worsening at any time or if it persists for a week or more. You should also see a doctor if your pain progresses from happening only after playing to happening during sports or if you notice it when you wake up or are doing daily activities.
The most important thing to do when you suspect you are injured is to stop doing whatever sport has caused the injury right away and go see a doctor. For more severe or complicated injuries, it may be best to see a doctor who specializes in sports medicine.
The doctor will examine your injury and use diagnostic tools such as X-rays and magnetic resonance imaging (MRI) to determine the extent of your injury. MRI allows doctors to see soft tissues more clearly than X-rays or CT scans do.
Once the doctor knows the full extent of your injury, he or she usually will start with conservative treatment techniques such as rest and ice to help decrease swelling. Pain relief and anti-inflammatory medicines such as ibuprofen (like Advil or Motrin) may be prescribed. Splints, casts, and surgery also may be needed, depending on the injury.
One of three things will happen next. Your doctor may:
recommend that you not play while you healthat you play and use a protective device (a knee brace or wrist guard, for example)that you undergo rehabilitation (physical therapy)Sports medicine doctors won’t let you play if you are at risk for getting another injury or aggravating an injury you are recovering from.

Getting Back in the Game: If your doctor has asked you to stop playing, your #1 question is probably “When can I play sports again?” This depends on your specific injury, so make sure you discuss this with your doctor. There are things you can do while injured to stay fit without making your injury worse — but make sure you check with your doctor first. These activities are known as cross training, and they include using stationary cycles, swimming, water therapy, and rowing machines.
Your rehabilitation program will also help you stay fit as you recover. Rehabilitation, or rehab, is the process that gets you back in shape and ready for action again. Rehab may be part of your treatment program and can include exercise, manual therapy from a physical therapist (a specialist who is trained to help you recover from a sports injury), and technology such as ultrasound. Ultrasound equipment is used to heat the injured area. This heat relieves pain, promotes healing, and increases your range of motion.
Playing SafeWhat can you do to protect yourself from getting hurt again? Use protective gear — such as helmets for contact sports like football — that is appropriate to the specific sport.
When you return to play, you might need some new protective gear, including modified shoes (such as those with inserts or arch supports or those designed for use in a particular sport), tapings (tape used to wrap a knee, for example, to provide extra support), knee and elbow braces, and mouth guards. These devices help support and protect your body part from strains, direct blows, and possible reinjury.
To help prevent reinjury, be sure to warm up adequately before practice and games. Remember to take it slow when you first get back into your sport and gradually build back up to your preinjury level.
Also, know your limits. If the previously injured part (or any body part) begins to hurt, stop immediately and rest. Don’t delay in seeking medical attention if the pain persists. It’s your body’s way of telling you something is not right.
So, play, but play safe. Try to learn from your experience and do the things that can help you avoid getting hurt again.

Medlineplus

Whiplash

What is Whiplash?

Whiplash-a soft tissue injury to the neck-is also called neck sprain or neck strain. It is characterized by a collection of symptoms that occur following damage to the neck, usually because of sudden extension and flexion. The disorder commonly occurs as the result of an automobile accident and may include injury to intervertebral joints, discs, and ligaments, cervical muscles, and nerve roots. Symptoms such as neck pain may be present directly after the injury or may be delayed for several days. In addition to neck pain, other symptoms may include neck stiffness, injuries to the muscles and ligaments (myofascial injuries), headache, dizziness, abnormal sensations such as burning or prickling (paresthesias), or shoulder or back pain. In addition, some people experience cognitive, somatic, or psychological conditions such as memory loss, concentration impairment, nervousness/irritability, sleep disturbances, fatigue, or depression.

Is there any treatment?

Treatment for individuals with whiplash may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, physical therapy, and cervical traction may also be prescribed. Supplemental heat application may relieve muscle tension.

What is the prognosis?

Generally, prognosis for individuals with whiplash is good. The neck and head pain clears within a few days or weeks. Most patients recover within 3 months after the injury, however, some may continue to have residual neck pain and headaches.

NINDS

Chronic Pain

Synonym(s): Pain – Chronic

What is Chronic Pain?

While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap — sprained back, serious infection, or there may be an ongoing cause of pain — arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).

Is there any treatment?

Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.

What is the prognosis?

Many people with chronic pain can be helped if they understand all the causes of pain and the many and varied steps that can be taken to undo what chronic pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for chronic pain in the years to come.

NINDS

What is Back Pain?

What is back pain?

Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and range of motion, or an inability to stand straight. Chronic back pain is pain that persists for more than 3 months. It is often progressive and the cause can be difficult to determine.

Is there any treatment?

Most low back pain can be treated without surgery. Treatment involves using over-the-counter pain relievers to reduce discomfort and anti-inflammatory drugs to reduce inflammation.  The goal of treatment is to restore proper function and strength to the back, and prevent recurrence of the injury.  Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies.  Although the use of cold and hot compresses has never been scientifically proven to quickly resolve low back injury, compresses may help reduce pain and inflammation and allow greater mobility for some individuals.  Bed rest is recommended for only 1–2 days at most.  Individuals should resume activities as soon as possible.  Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles.   In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries.

What is the prognosis?

Most patients with back pain recover without residual functional loss, but individuals should contact a doctor if there is not a noticeable reduction in pain and inflammation after 72 hours of self-care.  Recurring back pain resulting from improper body mechanics or other nontraumatic causes is often preventable. Engaging in exercises that don’t jolt or strain the back, maintaining correct posture, and lifting objects properly can help prevent injuries. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, vibration, repetitive motion, and awkward posture. Applying ergonomic principles — designing furniture and tools to protect the body from injury — at home and in the workplace can greatly reduce the risk of back injury and help maintain a healthy back.

NINDS

Cartilage Disorders

Cartilage is the tough but flexible tissue that covers the ends of your bones at a joint. It also gives shape and support to other parts of your body, such as your ears, nose and windpipe. Healthy cartilage helps you move by allowing your bones to glide over each other. It also protects bones by preventing them from rubbing against each other.

Injured, inflamed or damaged cartilage can cause symptoms such as pain and limited movement. It can also lead to joint damage and deformity. Causes of cartilage problems include

• Tears and injuries, such as sports injuries
• Genetic factors
• Other disorders, such as some types of arthritis

Osteoarthritis results from breakdown of cartilage.

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Osteonecrosis

Also called: Aseptic necrosis, Avascular necrosis, Ischemic necrosis
Osteonecrosis occurs when your bones lose their blood supply. The bones die and eventually collapse, leading to pain and arthritis. You can have osteonecrosis in one or several bones. It is most common in the upper leg. Other common sites are your upper arm and your knees, shoulders and ankles. The disease can affect men and women of any age, but it usually strikes in your thirties, forties or fifties.

Early in the disease you might not have any symptoms. Later, you will probably have joint pain that becomes more severe as the disease gets worse.

No one is sure what causes the disease. Risk factors include

Long-term steroid treatment
Alcohol abuse
Joint injuries
Having certain diseases, including arthritis and cancer
Treatments include medicines, using crutches, limiting activities that put weight on the affected joints, electrical stimulation and surgery.

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Acute Injury Care

The care of the acutely injured is a public health issue that involves bystanders and community members, health care professionals, and health care systems. It encompasses prehospital emergency medical services; emergency department assessment, treatment, and stabilization; and in-hospital care surgery and medical management among all age groups. The importance of acute injury care became increasingly clear in the aftermath of the events of 9/11 and subsequent mass casualty events.

Because CDC recognizes that injuries continue to occur, despite our best efforts at prevention, the Division of Injury Response (DIR) at CDC’s Injury Center seeks to improve outcomes for those who have survived severe injuries and to improve acute injury care practices. To meet this challenge, DIR works with national and international organizations spanning the continuum of injury prevention and acute injury care, including those responsible for emergency medical services and emergency medicine and trauma surgery, other public health organizations, other federal agencies, and the corporate sector.
cdc

Injuries Among Older Adults

Injury and violence are a serious threat to the health and well-being of Americans ages 65 and older. Older adults are at higher risk for many types of injuries that can lead to death or disability. Through research and a wide range of activities, CDC’s Injury Center is working to protect older Americans from the threat of injury. Below is a directory of links to more information about the types of injury and violence that pose the greatest threat to older adults in the United States.

source from CDC

Water-Related Injuries

How big is the problem?

In 2005, there were 3,582 fatal unintentional drownings in the United States, averaging ten deaths per day. An additional 710 people died, from drowning and other causes, in boating-related incidents.
More than one in four fatal drowning victims are children 14 and younger.1 For every child who dies from drowning, another four received emergency department care for nonfatal submersion injuries.
Nonfatal drownings can cause brain damage that may result in long-term disabilities including memory problems, learning disabilities, and permanent loss of basic functioning (i.e., permanent vegetative state).
Who is most at risk?

Males: In 2005, males were four times more likely than females to die from unintentional drownings in the United States.
Children: In 2005, of all children 1 to 4 years old who died, almost 30% died from drowning.1 Although drowning rates have slowly declined,1, 3 fatal drowning remains the second-leading cause of unintentional injury-related death for children ages 1 to 14 years.

Minorities:
Between 2000 and 2005, the fatal unintentional drowning rate for African Americans across all ages was 1.3 times that of whites. For American Indians and Alaskan Natives, this rate was 1.8 times that of whites.
Rates of fatal drowning are notably higher among these populations in certain age groups. The fatal drowning rate of African American children ages 5 to 14 is 3.2 times that of white children in the same age range. For American Indian and Alaskan Native children, the fatal drowning rate is 2.4 times higher than for white children.
Factors such as the physical environment (e.g., access to swimming pools) and a combination of social and cultural issues (e.g., valuing swimming skills and choosing recreational water-related activities) may contribute to the racial differences in drowning rates. If minorities participate less in water-related activities than whites, their drowning rates (per exposure) may be higher than currently reported.

What are the major risk factors?

Lack of barriers and supervision. Children under one year most often drown in bathtubs, buckets, or toilets. Among children ages 1 to 4 years, most drownings occur in residential swimming pools.6 Most young children who drowned in pools were last seen in the home, had been out of sight less than five minutes, and were in the care of one or both parents at the time. Barriers, such as pool fencing, can help prevent children from gaining access to the pool area without caregivers’ awareness.
Age and recreation in natural water settings (such as lakes, rivers, or the ocean). The percent of drownings in natural water settings increases with age. Most drownings in those over 15 years of age occur in natural water settings.
Lack of appropriate choices in recreational boating. In 2006, the U.S. Coast Guard received reports for 4,967 boating incidents; 3,474 boaters were reported injured, and 710 died. Among those who drowned, 9 out of ten were not wearing life jackets. Most boating fatalities from 2006 (70%) were caused by drowning; the remainder were due to trauma, hypothermia, carbon monoxide poisoning, or other causes. Open motor boats were involved in 45% of all reported incidents, and personal watercraft were involved in another 24%.2
Alcohol use. Alcohol use is involved in up to half of adolescent and adult deaths associated with water recreation and about one in five reported boating fatalities. Alcohol influences balance, coordination, and judgment, and its effects are heightened by sun exposure and heat.
Seizure disorders. For persons with seizure disorders, drowning is the most common cause of unintentional injury death, with the bathtub as the site of highest drowning risk.

What has CDC research found?
A CDC study about self-reported swimming ability14 found that:

Younger respondents reported greater swimming ability than older respondents;
Self-reported ability increased with level of education (i.e., high school graduate, college graduate, etc.);
Among racial groups, African Americans reported the most limited swimming ability; and
Men of all ages, races, and educational levels consistently reported greater swimming ability than women.

How can water-related injuries be prevented?
To help prevent water-related injuries:
Designate a responsible adult to watch young children while in the bath and all children swimming or playing in or around water. Adults should not be involved in any other distracting activity (such as reading, playing cards, talking on the phone, or mowing the lawn) while supervising children.
Always swim with a buddy. Select swimming sites that have lifeguards whenever possible.
Avoid drinking alcohol before or during swimming, boating, or water skiing. Do not drink alcohol while supervising children.
Learn to swim. Be aware that the American Academy of Pediatrics does not recommend swimming classes as the primary means of drowning prevention for children younger than 4. Constant, careful supervision and barriers such as pool fencing are necessary even when children have completed swimming classes.
Learn cardiopulmonary resuscitation (CPR). In the time it might take for paramedics to arrive, your CPR skills could make a difference in someone’s life. CPR performed by bystanders has been shown to improve outcomes in drowning victims.
Do not use air-filled or foam toys, such as “water wings”, “noodles”, or inner-tubes, in place of life jackets (personal flotation devices). These toys are not designed to keep swimmers safe.

If you have a swimming pool at home:

Install a four-sided, isolation pool fence that completely separates the house and play area of the yard from the pool area. The fence should be at least 4 feet high. Use self-closing and self-latching gates that open outward with latches that are out of reach of children. Also, consider additional barriers such as automatic door locks or alarms to prevent access or notify you if someone enters the pool area.
Remove floats, balls and other toys from the pool and surrounding area immediately after use. The presence of these toys may encourage children to enter the pool area or lean over the pool and potentially fall in.
If you are in or around natural bodies of water:

Know the local weather conditions and forecast before swimming or boating. Strong winds and thunderstorms with lightning strikes are dangerous.
Use U.S. Coast Guard approved life jackets when boating, regardless of distance to be traveled, size of boat, or swimming ability of boaters.
Know the meaning of and obey warnings represented by colored beach flags.
Watch for dangerous waves and signs of rip currents (e.g. water that is discolored and choppy, foamy, or filled with debris and moving in a channel away from shore). If you are caught in a rip current, swim parallel to shore; once free of the current, swim toward shore.
CDC

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