By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
After more than a year of endless postponements and cancellations due to COVID-19, it appears we are finally starting to “get back to normal.” And for a large segment of the population, this means the return of a favorite American pastime: sports.
While there are endless physical and mental benefits to playing sports (no matter what your age), there’s one distinct drawback: the risk of concussion. The risk is especially high with contact sports. I mean, the chances of suffering a concussion playing golf, tennis, or badminton is pretty low, but you can’t say that about sports like football, hockey, wrestling, soccer, rugby, and boxing.
I have some personal experience with concussions, dating all the way back to my college wrestling days. I was in the middle of a match, and the next thing I remember was my coach staring me in the face while I was laying on my side, telling me I was behind two points. My opponent had head butted me and knocked me out for a few seconds. The referee noticed I wasn’t responding and stopped the match. I finished it, and it was decisioned 4-2—my first loss in college. For the few days, I remember not feeling my usual self.
This was back in the mid-1960s, when there was far less awareness about traumatic brain injuries, and concussion protocols certainly didn’t exist. Today, thankfully, concussions are taken a lot more seriously in professional, college, and even youth sports.
What Is a Concussion?
We hear about concussions a lot lately, especially since games are paused any time a player appears to show signs of a one. But even so, not many people know what a concussion is and what happens to the brain during one.
A concussion is a mild traumatic brain injury caused by a violet bump or blow to the head. It can also occur with an upper body injury that causes your head or brain to rapidly jolt back and forth, like whiplash.
With this sudden movement, the brain bounces around against the skull, which leads to inflammation—the body’s natural and normal response to any trauma or injury. The cells in the regions of the brain that have been affected by the blow have a temporary breakdown of sorts. During this time, the cells don’t get enough oxygen, which affects normal functioning.
Concussion Symptoms
Some signs of a concussion may appear right away, while other symptoms take hours or even days to emerge. Not only that, symptoms may change over time as the brain heals. It’s definitely not a one-size-fits-all injury, but here are just a few of the more common signs and symptoms of concussion:
- Memory loss (especially right after the initial blow)
- Confusion
- Headache
- Ringing in ears
- Vision problems
- Slurred speech
- Sleep disturbances
- Sensitivity to light and noise
- Irritability
- Tiredness, sluggishness
- Loss of balance/clumsiness
- Changes in mood, behavior, or personality
In children, who sometimes don’t have the ability to describe what they’re experiencing, you should additionally look out for:
- Listlessness
- Excessive crying/crankiness
- Unsteady walking
- Changes in eating or sleep patterns
If you or a loved one is experiencing these symptoms of signs or concussion, seek medical attention. Usually, physical and cognitive exams, and neurological/imaging tests, help a doctor make the diagnosis.
Treatment is pretty straightforward: Rest. But complete rest, such as sleeping/lying in bed all day or avoiding all stimuli, doesn’t necessarily help with recovery. Instead, doctors usually recommend “relative rest,” which means limiting activities that require a lot of mental concentration, for at least the first few days. After that, you can gradually resume normal activities as you can tolerate them.
Long-Term Effects of Concussions
Fortunately, concussions are usually considered mild brain injuries because they’re rarely life-threatening. And if you have a single concussion in your life, you will likely recover with little to no long-term effects. The vast majority of people see all their symptoms resolve within two weeks.
In some cases, though, a concussion sufferer may end up with persistent post-concussion syndrome, which is the lingering of symptoms beyond the normal recovery timeframe—usually longer than six weeks. By some estimates, this occurs in 10% of high school athletes, and up to 30% of the general population.
The biggest problem with contact sports is the risk of enduring multiple concussions. The more concussions you suffer, the greater the risk of long-term consequences, especially if you don’t give your brain enough time to heal.
Research has shown that football players with a history of concussions are not only more susceptible to future concussions, they’re more likely to experience slower recovery of neurological function.3
Multiple concussions can also lead to depression, anger, and increased risk of suicide.4-5
And while the majority of us aren’t professional athletes, it’s worth nothing that those who play contact sports for a living and sustain multiple concussions have a higher chance of developing neurodegenerative disease later in life. You may have heard of a relatively new dementia-like condition called chronic traumatic encephalopathy (CTE), which has notably affected several well-known football players. Research shows there’s a strong relationship between concussions and CTE, although the most important driver of this disease is repeated and chronic head trauma, irrespective of concussion symptoms.6
Either way, concussion—and especially multiple ones—is something you want to avoid if you can. The brain is an amazing organ with tremendous healing power—but there’s just so much it can take before it starts giving in to constant damage.
Support and Protect Your Brain
Concussions are often unavoidable. Car crashes and freak accidents happen, unfortunately. If you end up with a concussion, the key is to follow doctor’s orders to a T and allow your brain to rest and heal.
If you play a sport that holds a risk of concussion, protective headgear and mouthguards offer some (though not full) protection. Even so, the nature of contact sports often makes a blow to the head pretty likely. I venture to guess most athletes are aware of the risks and choose to accept them to play the game they love.
Finally, whether you (or your child) is a pro/amateur athlete or not, it’s always a good idea to adopt some lifestyle approaches that support brain health. These habits won’t prevent concussions, but they can help make your brain more resilient and aid in faster healing.
A Mediterranean diet is one of the “brain-friendliest” diets you can eat. It’s rich in my favorite food, olive oil, which not only reduces inflammation but also Alzheimer’s risk.
Some brain-supportive supplements you may want to consider adding into your daily regimen include omega-3 fatty acids, coenzyme Q10, the amino acid carnosine, and phosphatidylserine.
You can find other brain-friendly lifestyle habits here:
References:
- The potentially long-lasting effects of concussion. 2019 May 21.
- What is PCS? Concussion Foundation.
- Guskiewicz KM, et al. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA concussion study. 2003 Nov 19;290(19):2549-55.
- Yang J, et al. Post-concussion symptoms of depression and anxiety in division 1 collegiate athletes. Dev Neurophychol. 2015 Jan;40(1):18-23.
- Bryan CJ and Clemans TA. Repetitive traumatic brain injury, psychological symptoms, and suicide risk in a clinical sample of deployed military personnel. JAMA Psychiatry. 2013 Jul;70(7):686-91.
- Stein T, et al. Concussion in chronic traumatic encephalopathy. Curr Pain Headache Rep. 2015 Oct;19(10):47.
© Stephen Sinatra, MD. All rights reserved.
