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How to Manage a Sports Related Concussion

Janet Lee, MD

Janet Lee, MD
Pediatric Hospitalist

What is a concussion?
A concussion is a mild brain injury that causes a change in mental status that can occur with direct insult to the head. A concussion may also occur with movement of the body that cause acceleration/deceleration forces to the head.
 
What are the symptoms of a concussion?
  • Headache
  • Dizziness
  • Loss of consciousness
  • Amnesia
  • Difficulty concentrating
  • Confusion
  • Nausea and/or vomiting
  • Difficulty balancing
  • Sensitivity to light
  • Sensitivity to noise
  • Ringing in the ears
  • Drowsiness
  • Irritability
  • Sadness
When should I seek medical attention for a concussion?
  • A healthcare provider should evaluate every child or adolescent suspected of a concussion. 
  • If this occurs during a sporting event, the child should sit out the rest of the game
  • Your provider may conduct a standardized neuropsych assessment to help guide return to activities/sports
What is the best treatment for a concussion?
  • Rest, rest and more rest!
  • Absence from school may initially be necessary until one can concentrate on a task without exacerbating symptoms
  • Avoid excessive time texting, on the computer, watching television, playing video games or listening to loud music
  • Return to activity too soon can lead to worsening and prolonged symptoms.  A second injury to the brain while the brain is healing can lead to severe brain injury that is life-threatening
When can a child return to sports after a concussion?
A person with a concussion should not return to play until they no longer have symptoms at rest for at least 24 hours.  Return to play should then be a step-wise progression.  The child/adolescent should be symptom free for 24 hours before progressing to the next level of play:
  • Light aerobic exercise (e.g.: walking)
  • Sport-specific exercise
  • Non-contact training drills
  • Full contact practice
  • Return to play (Must first be cleared by a provider)
What resources are there for concussions?
Swedish’s Spine, Sports and Musculoskeletal Medicine team has developed a Sports Concussion Clinic with the following resources:
  • Baseline neurocognitive testing with a computerized exam called ImPACT can be done prior to playing a sport to assess changes and recovery if a concussion occurs.
  • Comprehensive concussion management, including clearance for return-to-play
Click here to learn more about the Sports Concussion clinic.  The team includes sports medicine physicians, psychiatrists, an athletic trainer, physical therapists and a neuropsychologist that can deliver individualized care for every athlete

Think about injury prevention when returning to baseball season

Melissa Ballance AT/L, ATC

Melissa Ballance AT/L, ATC
Athletic Trainer, Swedish Pediatric Specialty Care, Sport and Dance Medicine

Baseball season is finally here! As we watch our Major League Baseball heroes take the field this April, kids of all ages will be returning to the field after winter break and time off from practicing. 

It is important that our kids return safely to help prevent overuse injuries from occurring during the season. Common overuse injuries in baseball are injuries to the elbow (ulnar collateral ligament, UCL) and shoulder in the throwing arm. A proper warm up, maintaining an age appropriate pitch count and good throwing mechanics are essential to preventing overuse injuries. 
 
Here are some specifics to keep in mind:

Atlas of Ultrasound Guided Musculoskeletal Injections

Sean Colio, MD

Sean Colio, MD
Board Certified, Sports Medicine

The most comprehensive atlas of ultrasound guided musculoskeletal injections is now available!  I contributed a chapter to the hip section.   This book is considerably more comprehensive than another book just published with the same name and has contributions from many all-star sports medicine physicians. Click here to check it out.

Tips for keeping young athletes safe and healthy

Sonal Avasare, MD

Sonal Avasare, MD
Pediatric Nephrologist

We all know exercise is an important factor in maintaining an active and healthy life. However, over-exercising can lead to a rare, but serious complication known as rhabdomyolysis – a medical team that literally means ‘dissolution or destruction of skeletal muscle’. There has been a recent increase in rhabdomyolysis amongst teen athletes so it is important to recognize the warning signs and learn how to prevent them.

The classic triad of rhabdomyolysis is dark urine, muscle weakness or fatigue, and muscle pain. Although exercise can be the primary factor, other key contributing elements such as dehydration, genetic conditions (e.g. sickle cell), metabolic disorders, nutritional supplements, drug use, and heat stress can exacerbate muscle damage. Without appropriate medical evaluation and care, rhabdomyolysis can cause permanent damage to the kidneys and may even be life-threatening in severe cases. Here are some tips to help your young athlete remain active and healthy:

  1. Maintain adequate hydration – preferably with plain water.  Sports and energy drinks may often contain caffeine and excessive amounts of sugar which can cause dehydration.  On average, children that are 6-10 years old should have about 1L of fluid a day, children 10-14 years old should have 1.5L/day and teens over 14 years should have at least 2L of fluid a day. It is important to increase fluids with increased activity due to the additional fluid losses that occur.
  2. Eliminate protein supplements. A recent study by the American Academy of Pediatrics found ...

Treating and preventing common sports injuries

Scott Ruhlman, MD

Scott Ruhlman, MD
Orthopedic Surgeon

Looking to be more active in 2014? Have you been waiting all year to enjoy winter sports such as skiing or snowboarding?

There are a few common injuries that often get my patients down when they are on the go. Below are a few tips and tricks to help you prevent these common injuries and determine the best treatment options should you need it.

Sprains/Fractures
The most common injuries in the wrist and ankle are sprains and fractures. Throwing, twisting, weight-bearing, and impact can put you at risk for a wrist injury. Ankle sprains and fractures are typically caused by making a fast, shifting movement with your foot planted on the ground.

In most cases, I recommend the RICE approach: rest for around 48 hours; ice the injured area to reduce swelling (use a pack wrapped in a towel); compress with an elastic ACE wrap; and elevate the injury above heart level.

However, if you experience these symptoms, contact your provider for further evaluation.   
  • Pain at the time of injury
  • Swelling
  • Bruising or discoloration
  • Difficulty moving the wrist or ankle
  • A “popping” or tearing sensation during the trauma
  • Warmth and tenderness of the skin
More serious injuries will likely be treated with a splint, boot or cast. The healing process can take up to six weeks. Surgery may also be required.

ACL Tears
The ACL, or anterior cruciate ligament, is one of the major ligaments in your knee that helps with stabilization when turning or planting. ACL injuries take place during cutting or pivoting movements. The hallmark of a torn ACL is a distinct popping noise and your knee may give out. The  ...

Swedish Sports Concussion Clinic

Sean Colio, MD

Sean Colio, MD
Board Certified, Sports Medicine

The Sports Concussion Clinic at Swedish Spine, Sports & Musculoskeletal Medicine was developed to provide comprehensive concussion management and help guide return-to-play decisions for children and adults. We are a team of sports medicine physicians, physiatrists, physical therapists, and a neuropsychologist that deliver individual care for athletes. We provide physical evaluation, assessment of concussion severity, neuropsychological evaluation, ongoing monitoring and education for athletes, parents, coaches and school staff. We use clinical guidelines to implement the most appropriate treatment for return-to-play and return-to-school. Click here to learn more or to make an appointment.

4 tips to prevent injuries in sports

Terrence Cronin, MD

Terrence Cronin, MD
Pediatric Sports and Dance Medicine Physician

How do you prevent sports related injuries? Here are four tips:

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