In an investigation published online in January 2020 in JAMA Neurology, young athletes who were treated within the first week of receiving a concussion were almost 5 times more likely to recover in less than 30 days compared with those who didn’t receive care quickly. “Patients should not wait for a week or more to seek care to see if things improve on their own,” says lead study author Anthony Kontos, PhD, research director at the University of Pittsburgh Medical Center Sports Medicine Concussion Program. “They should seek care as soon as they can to enhance their recovery process.” Dr. Kontos and his team based their results on data collected on 162 participants, ages 12 to 22, who had been diagnosed with a symptomatic concussion. The early-care group consisted of 98 people who were seen within seven days of the injury, and the late-care group consisted of 64 people seen between 8 and 20 days of their injury. Although recovery times ranged from 9 to 299 days, athletes evaluated within a week of injury recuperated an average of 20 days faster than those individuals seen two to three weeks after the injury. RELATED: Sports Leading Cause of Traumatic Brain Injury in Teens, Study Finds
A Widespread Problem That May Go Unreported
The Brain Injury Research Institute reports that 1.6 to 3.8 million sports- and recreation-related concussions occur in the United States each year. While most people recover quickly, sometimes symptoms can last for days, weeks, or longer, according to the Centers for Disease Control and Prevention. The effects of concussion may include trouble with thinking or remembering (some describe feeling mentally foggy), blurred vision, sensitivity to light, headaches, irritability, sadness, nervousness, and trouble sleeping. A study from the National Athletic Trainers’ Association found that concussions often go unreported because many players don’t tell coaches or team trainers about symptoms that they consider not severe enough. “I believe that there is a great percentage of athletes who ignore or hide their symptoms because they are afraid of losing their spot on the team, losing playing time, or they have a fear that they’re letting someone down if they cannot play,” says Kevin Rooney, PhD, program director of exercise science and clinical coordinator of athletic training and exercise science at Endicott College in Beverly, Massachusetts. “We need to continue to educate athletes, coaches, parents, administrators, and others on the impact concussions can have on one’s life.” Many young athletes who have mild concussion symptoms may think that rest and restricted activities are enough unless they have severe problems. Kontos, however, underscores that even those with minor impairments will benefit from early care. “Seeking earlier care can get patients on a pathway to recovery faster than if they take a wait and see approach,” he says.
How an Early Thorough Exam Can Help
Although there is not a single definitive diagnostic test for concussion, doctors may perform a comprehensive exam and assessment using a computer-based testing program such as the ImPACT Neurocognitive Assessment. This assessment records the athlete’s health history, current concussion symptoms, and neurocognitive data, and it offers tests to measure verbal and visual memory, processing speed, and reaction time. If testing like this can help identify problems, more targeted treatments can begin earlier and provide greater benefit, according to Kontos. Someone with a concussion may be diagnosed with vestibular impairment, for example. Damage to the vestibular system affects parts of the inner ear and brain that help control balance and eye movements. “A patient with vestibular impairment would be able to begin therapy earlier and potentially accelerate their recovery simply by coming in for specialty care sooner,” says Kontos. “In addition, earlier care with a trained clinician allows patients to begin behavioral management strategies involving physical and cognitive activity, sleep, nutrition, hydration, and stress management, all of which can enhance the recovery process.” Dr. Rooney, who was not involved in the investigation, adds that specialty care for concussion could involve visual exercises, fine motor and reaction time training, hand-eye coordination, balance training, dual task exercises, and body mechanics and posture rehabilitation.
Taking Steps to Limit Risk
Avoiding concussion in the first place may be the best advice, but that can be difficult, especially in sports such as football, ice hockey, soccer, and basketball, for which head injuries are common. To help limit injury risk, Rooney advise players to learn proper techniques and form, to wear properly fitted equipment, and to work on neck strengthening exercises to possibly reduce twisting the head (torsion) during impact. Because the study relied on previously recorded information and did not follow young athletes directly, it did not examine the factors that may influence concussion recovery. “Concussions are not to be taken lightly,” says Rooney. “It is very important that athletes take the time to educate themselves on what a concussion is, learn how to recognize the signs and symptoms, as well as take them seriously, and receive early concussion care. While you may not be able to avoid sustaining a concussion, limiting its effects can get you back on the field sooner and restore your quality of life.”
