Concussions in Athletes: Responding to a Sports Injury

“When in doubt, take them out.”

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“There's always this battle, particularly in sporting events: What do you do if someone's had maybe a concussion, but you're not sure, and it's the big game, and maybe there's a recruiter from a college?” says Steven Flanagan, MD, chair of the Department of Rehabilitation Medicine at NYU Langone Health.

What Is Second-Impact Syndrome?

One of the biggest risks for athletes who have sustained a concussion is something called second-impact syndrome, or SIS. This is when someone gets a second head injury within a few weeks of the first, and it can result in serious complications such as brain swelling, shifting, and possibly death.

This is why it’s so crucial for athletes with head injuries to be taken out of the game or competition, and not return to play until given the OK from a physician. Of course, things can get complicated when you’re dealing with heightened pressure (“We have to win!”) or elevated emotions (“I’ll be devastated if you take me out!”).

Because of these nuances and pressures, some research suggests that close to 70 percent of athletes who had concussion symptoms continued to participate, according to the Centers for Disease Control and Prevention. That’s not great news.

Communication About Symptoms

It’s crucial for athletes to be honest since only they know how they truly feel. “The coach and the parents also need to be on the lookout. Is someone just so eager to get back on the football field or the baseball field or back into gymnastics that they're not being honest with their symptoms?” says Dr. Flanagan.

Because the answers aren’t always clear, Dr. Flanagan recommends the following mantra: “When in doubt, take them out.”

Additionally, it’s important for coaches to be able to recognize the symptoms of a concussion (also known as a “mild traumatic brain injury”). There are some telltale symptoms of a concussion that you can recognize in others, even if they’re claiming to be “fine.”

“That's probably the most important thing to do—recognize it when it happens,” says Dr. Flanagan. “If they've had a concussion, their balance may  be off, their reaction times may be off. You're setting them up for another concussion.”