Trainer Says Concussion Prevention Not About The Hardware

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COLUMBIA - At a time when teams and fans are more focused on head injuries in football--including a new rule about players who lose their helmets--many times the head injury is still not fully understood.

A concussion occurs from violent shaking of the head, not from impact. The brain is suspended in fluid inside the skull. After the head shakes, the brain moves in that fluid and makes contact with the skull. This causes damage to the brain.

One might think that a concussion is an impact-related injury. For example, in football one might think that hard hits cause concussions. While a hard hit to the head can cause a concussion, players can get the injury from a fall that causes the head to shake rapidly.

According to mid-Missouri athletic trainer Pat Forbis, football helmets do not prevent concussions. Forbis said a helmet will protect against impact-related injuries, but it cannot keep the brain stationary inside the skull. Forbis said this is a common misconception.

"If an athlete is out there with symptoms, and they get another concussion. They can sustain a second impact which leads to swelling of the brain. And in those cases 50 percent of those kids who sustain that type of injury are impaired significantly or the other 50 percent are fatalities," Forbis said.

Jefferson City High School football coach Ted LePage said teaching proper tackling techniques will help prevent concussions. He said the awareness of the injury has increased in latter years.

"One of the first things we do on the first day of practice is have our players read the warning label on the back of the helmet," LePage said.

Forbis said when athletes suffers concussions, it is important that they follow the proper procedures for treatment.

After a concussion occurs, athletes must undergo:

1. A Sports Concussion Assessment Tool (SCAT 2) test. A doctor or trainer will ask athletes a series of questions illuminating concussion symptoms. Also, athletes must undergo Immediate Post-Concussion Assessment and Cognitive (ImPACT) testing. The ImPACT test includes cognitive testing like word memory, design memory, symbol and color matching and other memory tests. Doctors or trainers must conduct both the SCAT 2 and ImPACT tests within 48 hours of the injury.

2. After initial tests, immediate responders will refer patients to a physician where they must be cleared for activity again. Physicians must follow guidelines set by the state when treating concussion patients.

3. After physician treatment and clearance, athletes can begin a progression program 24 hours after being symptom-free. Progression programs must be conducted by an athletic trainer and supervised by a medical director. Concussion progression includes 15 minutes of light aerobic stationary bike riding, light jogging, outdoor activity, agility drills and other athletic tests.

4. After completing a progression program, athletes will complete another baseline concussion test to assure they are still symptom-free. A medical director must approve patients' release before returning to practice.

Once athletes complete all of these steps, they can return to practice.