Concussions and Football

Medical Reviewer:

Football players are more likely to sustain a concussion than kids who play other sports. Each year, more than 25,000 kids go to the emergency room with a football-related concussion. No other team sport sends more kids to the emergency room.

Football is a contact sport that requires players to collide with each other. "When you think about athletes that play football, it's a very physical sport," says Margot Putukian, MD, director of athletic medicine services at Princeton University. "They're going out to battle. There are a lot of analogies to wartime combat."

Effects of Concussion

Your brain is cushioned by a layer of fluid inside your skull. A sharp hit can cause your brain to bump the inside of your skull, causing an injury called a concussion. A concussion is more than just a simple bruise to the brain. This type of injury can make your brain stretch and swell. And when brain cells get damaged, chemical changes occur resulting in memory loss, difficulty thinking, mood swings, and changes in personality.

Signs and Symptoms of Concussion

Tell a coach or your parents immediately if you experience:

  • headache or a feeling of "pressure" in your head
  • Dizziness or trouble with balance
  • Double vision or blurred vision
  • Nausea or vomiting
  • Pain caused by light or noise
  • Trouble thinking or remembering
  • Sluggishness or haziness
  • Confusion
  • Mood swings that make you feel angry or depressed

Any loss of consciousness is considered a strong warning sign of concussion. Football players with concussions also might:

  • Appear dazed or stunned
  • Speak slowly or slur speech
  • Forget what they're supposed to do
  • Become confused about their position on the field
  • Stagger or move clumsily
  • Answer questions slowly
  • Have trouble remembering what happened before getting hit
  • Display changes in mood, behavior or personality
  • Have one pupil larger than the other

Other serious symptoms of concussion include:

  • Vomiting
  • Convulsions
  • Seizures or drowsiness

It's important to understand that symptoms do not always appear right after the hit. You might feel fine at first, but hours later have a headache, nausea, or blurred vision.

Any player showing these symptoms should be pulled out of the game immediately and be checked by a doctor as soon as possible. These symptoms can last for days or weeks, and rest is the only cure. If you do have a concussion, you should not return to play or practice until a doctor says it's safe.

That's because the brain of a person with a concussion is more vulnerable to further injury. And a player with a concussion who receives another blow to the head might suffer what's called "second-impact syndrome." A second impact can cause serious brain damage or even death.

The brain injuries caused by multiple concussions also might add up over time. Some studies have shown that people who experience more than one concussion during their lifetime have a harder time learning or solving problems. And the risk of lasting damage increases for people who receive more than one concussion.

Preventing Concussion

There are a number of safety precautions you can take to minimize your risk of concussion. Some relate to practical precautions. Others are aimed at changing the culture of football.

  • Practice "heads-up" football. Never lower your head during a hit. Tackling with your head up reduces the force of the hit and lowers the chances of either player receiving a concussion.
  • Use good sportsmanship. "Instead of 'taking someone out,' support the idea of fair play," Putukian said. "Take hits out of the game that are malicious and not in the spirit of the game."
  • Drill proper blocking and tackling techniques. Players who use proper form are less likely to sustain -- or cause -- a concussion.
  • Wear a helmet and other protective gear that fits properly. Regularly check helmets and equipment to make sure they fit well. Also keep an eye on players to make sure they are wearing safety equipment properly.
  • Realize that helmets help protect the brain but cannot prevent a concussion. Protective equipment can make you feel invincible, but helmets are not foolproof. Interestingly enough, one Cleveland Clinic study found that old-time leather helmets protect against concussion about as well as modern football helmets. Another study presented at the 2013 annual meeting of the American Orthopedic Society for Sports Medicine found that generic football helmets protect just as well as fancy high-tech helmets.
  • Learn to recognize the signs of a concussion. Immediately report any suspected injury to a coach, even during a game.
  • That last point is particularly important. "There's been a significant move to try to change the culture of the game, to make it safer," says Putukian. "Make sure they don't play through pain. Make sure they report symptoms. It's not a sign of toughness to hide symptoms, especially as it relates to head injury."

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