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Preventing and Recognizing Concussions in Athletes

December 08, 2019 | Concussion Treatment | Varacallo, Christopher P., DO


It’s winter sports season in area schools, and through every season, thoughts turn to an athlete’s safety, and preventing and recognizing concussions.

A concussion is caused by physical trauma to the head or body, which results in acceleration and deceleration of the brain within the skull, according to David Younkin, a certified athletic trainer with a master’s degree in exercise science at Penn Highlands Healthcare. Younkin is contracted to work with athletes at Penn State DuBois, and he also works alongside Dr. Christopher Varacallo, sports medicine physician, at The Concussion Clinic of Penn Highlands Healthcare.
 
“A concussion is an alteration to one’s normal cognitive functioning after that trauma,” Younkin said. In the past, they were given levels or grades. Today, most health care professionals no longer acknowledge levels of a concussion, Younkin said. If two individuals have the same symptoms and were both diagnosed with a concussion through identical trauma, one person may feel back to normal in a week, while another may take a month. “Therefore, attempting to grade this sort of injury doesn’t really get a clinician very far,” he said.

Regarding the symptoms of a concussion and how long they can last, Younkin said essentially a concussion will probably have you feeling unlike your normal self. 

“There can be physical, mental and emotional symptoms, as well as sleep disturbances,” he said. “There are many symptoms that can occur with a concussion: headache, nausea, vomiting, dizziness, vision deficiencies, fatigue, sense sensitivities (light, noise), mental fog, difficulty concentrating, irritability, sadness and more.”

Younkin recommends going to the emergency room for treatment if an athlete is confused and/or disoriented, has lost consciousness, if there is evidence of deteriorating mental status, if their symptoms are worsening, related neck pain - especially along the spine, numbness and tingling in the arms or legs, unequal pupil size or having seizures.

“My best advice - is if the individual or witnesses are unsure of the situation or the severity - then I would recommend going to the ER,” he said.

What is the treatment for a concussion? The number one ingredient for concussion recovery is rest, according to Younkin.  

“Most clinicians will follow a set of protocols, which start with rest and progress all the way to return to play, return to learn, or return to work being the final step,” he said. “Rest will not only include physical rest, but also mental and/or cognitive rest. Most protocols will last a minimum of 6-7 days, but again, each case is different.”

Younkin added research also suggests that the use of anti-inflammatory medications (such as ibuprofen) and aspirin medication after a head injury should be avoided because it may increase intracranial bleeding which may worsen or prolong symptoms. “Acetaminophen can be used to help with mild headaches,” he said.

Recovery is different for everyone. 

“It’s not uncommon for someone to have symptoms after a traumatic incident, and then feel 100 percent better a couple days later,” Younkin said. “And, on the other hand, it’s not uncommon for someone to feel better on day two, but have increased symptoms after they begin activity, exercise, schoolwork, etc. I guess I am just driving home the point that all concussions are unique.”

Playing sports does raise your risk for getting a concussion. “Football and soccer are certainly two of the sports with the highest incident,” Younkin said. “Hockey and other contact sports fit closely into the equation, as well. Although, some sports have higher risks, a concussion can happen to anyone. One could occur simply by slipping and hitting your head while you’re shoveling the driveway.”

Younkin said the best prevention in athletics is education. For example, in football, players perfecting head up tackling form, as well as the ball carrier keeping his head up will help. Other prevention methods have included rule changes to protect defenseless players, as well as penalizing teams and players when they lead with the head, he said. 

What are the long-term effects of a concussion?  “Leaving out extrinsic and intrinsic factors, there is certainly speculation for long-term effects of concussion,” Younkin said. “Typically, the more often they occur or the greater number of concussions a person has, the higher the risk for serious health concerns.” 

Younkin said the most obvious condition is depression. He said there is a lot of research available now, especially in professional football players, where the continuous exposure to head impact has led to a neurodegenterative disorder called chronic traumatic encephalopathy, or CTE.  “If the name sounds familiar, the discovery and research was conducted by Dr. Bennet Omalu in Pittsburgh on deceased Pittsburgh Steelers players,” he said.

Concussion can affect other parts of the body, Younkin said. “The brain controls everything,” he said.  “So, if there is an imbalance in the head, then there can be symptoms related to almost everything it controls, including balance, vision, speaking, and heart rate, and if the head injury produces enough inflammation, there can be serious cardiovascular complications. The complications can become quite serious, so someone with a head injury should be monitored closely for the emergent symptoms mentioned earlier.”

Age also has an affect because it is believed that adolescents are at higher risks for concussion based on structural immaturity and other factors, according to Younkin.

Younkin said the criterion has changed in determining and defining a concussion over the years. 

“There has certainly been an increase in recognizing concussion,” he said. “Certain head injuries that may have been overlooked in the past are now throwing up red flags. There was a time where athletes ‘got their bell rung’ or ‘they were seeing stars,’ and the injury was shrugged off with little concern. Those terms downplayed the severity of an athlete’s injury, and I believe the use of such phrases are quickly phasing out, and rightfully so.”

For more information about concussions, call The Concussion Clinic at 814-375-6200.


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Varacallo, Christopher P., DO

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Sports Medicine

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Penn Highlands Orthopedics and Sports MedicineA Service of Penn Highlands DuBois

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