August 12, 2008

Rest is the Best Prescription for Dealing With Concussions

By Lauran Neergaard / The Associated Press

Your brain needs more of a time-out than just missing the next game to recover from a concussion. New research suggests student athletes who are too active - not just on the field, but at home and school - might hinder their recovery.

More puzzling, female athletes might take longer to recover than males.

It's part of growing evidence that healing from this common sports injury is more complicated than once thought, an important message for parents and coaches as school sports programs gear up for the fall.

"No two concussions are the same," said Kevin Guskiewicz, an athletic trainer who chairs the sports science department at the University of North Carolina at Chapel Hill. "We need to be cautious with what we're allowing someone to do and at what point in their recovery they're allowed to do it."

Concussions are brain injuries and among the most difficult of sports injuries, starting with diagnosing one. Many athletes never lose consciousness, the most obvious symptom. Brain scans can't diagnose a concussion. O ther symptoms also aren't always apparent right away, and players can sometimes hide or minimize them: "Nope, no headaches, coach; put me back in."

Doing so has grave risks. A second concussion before recovering from the first can cause brain swelling that can trigger permanent damage, even death.

And there's mounting concern from studies of retired professional athletes that those who suffered multiple concussions over the years might be at increased risk for depression, memory problems and other neurological problems later in life.

The latest U.S. estimates suggest there are anywhere from 1.6 million to 3.8 million sports- and recreation-related concussions each year.

How much time is needed to heal, and how much activity is OK while recovering, remains uncertain.

Researchers at the University of Pittsburgh and one of Guskiewicz's UNC colleagues tracked 95 high school athletes evaluated in a university-based program that gave a battery of memory, reaction time and other cognitive tests up to a month after they had suffered a concussion. The researchers grouped patients by activities recorded in their medical records: no school; some schoolwork but no other activity; moderate activity described as schoolwork and some routine home chores; that plus sports practice; or schoolwork and playing some sports.

Those with moderate activity showed the best recovery, scoring better on brain tests than even the less active patients, researchers reported in the Journal of Athletic Training. The more active patients scored much worse - and although their allowed activity suggested they were thought to have a mild concussion, they ultimately performed as poorly as athletes initially diagnosed with a more serious concussion. Annually, there are between 1.6 million and 3.8 million sports- and recreation-related concussions in the United States.

Concussions are difficult to diagnose. Brain scans can't pick them up. Most athletes don't even lose consciousness, and they can hide symptoms to continue playing.

Those who suffer multiple concussions might have a higher risk of depression, memory problems and other neurological problems.


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