Sports-Related Concussions & Subconcussive Injuries

Baseline and post-concussion neuropsychological (NP) testing is now recommended for all athletes in sports with a high risk of concussion (e.g. football, lacrosse, hockey, soccer, basketball), regardless of age or level of performance, but the timing and type of testing may need to be adjusted for children and adolescents.

Football is still responsible for the majority of concussions at the
high school level and the highest concussion rate.

The finding by a neuropathologist that brain damage from repeated concussions suffered by former NFL star Andre Waters likely led to his depression and ultimate death by suicide in November 2006 highlights once again the critical need for parents and youth athletes to become educated and proactive about concussions.

An April 2007 Canadian study found that children receiving emergency room treatment for a head injury (HI) are nearly twice as likely to experience another HI requiring medical attention in the next six months compared to children who initially visited the ER for a non-head related injury. The Canadian study is consistent with earlier study finding that once an athlete suffers a concussion, the risk of suffering a second concussion is three to four times greater.

In recent years, new scientific research and clinical-based literature have given the athletic training and medical professions a wealth of updated information on the treatment of sport-related concussion. To provide athletic trainers, physicians, other medical professionals, parents and coaches with recommendations based on these latest studies, the National Athletic Trainers' Association (NATA) has developed a set of guidelines to prevent and manage sport-related concussion and improve decisions about whether an athlete should or should not return to play after experiencing head trauma.

One of the signs usually but not always present with concussion is poor balance. An athlete's balance and equilibrium can be tested using low-technology, intermediate technology, and high-technology methods, but the most widely used and validated is the Balance Error Scoring System (BESS).

The emerging model of sport concussion assessment now involves the use of brief screening tools to evaluate post-concussion signs and symptoms on the sideline immediately after a concussion and neuropsychological testing to track recovery further out from the time of injury. One of the tools of value for sideline evaluation is called the Standardized Assessment of Concussion.