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COLUMBIA - The Brain Injury Association of Missouri hosted a “Sports Concussion: Facts, fallacies and new frontiers” seminar Thursday in front of mid-Missouri coaches, nurses, athletic directors and trainers.

Maureen Cunningham, executive director of the Brain Injury Association of Missouri, said there has been an increase in referrals for concussions, but that overall awareness and detection of symptoms throughout the community can be better.

“There has been an increase in the referrals for the students to licensed health care professionals, it’s not dismissed when a player comes off the ice or field,” Cunningham said. “The NFL has also brought more awareness and really raised the commitment of the community and school sponsored teams to understand concussions better.”

Even with more education than in recent years, there are still misconceptions that she said many parents still believe.

“The student athlete doesn’t have to lose consciousness to suffer a concussion, in fact 90 percent of concussions happen when there’s no loss of consciousness,” Cunningham said. “Also, brain rest is key and really helps with recovery, so it’s okay to let athletes sleep when one is suspected.”

Jonathan Dodd, St. Louis Children’s Hospital pediatric neuropsychologist, said the root of today’s concussion problem still occurs immediately after the injury. 

“50-70 percent of sport concussive events are not reported, with many athletes saying that they can just play through it,” Dodd said. “Those who do so are at increased risk for a longer recovery, future injuries and slower balance and reaction time.”

Removal from play after a potential concussion is key, even if it’s not a hard hit. Football, ice hockey and lacrosse are the three most common sports, but sports like soccer, cheer, volleyball and basketball are not far behind due to the high number of play and practice contact hours.

With the number of practices athletes at higher levels partake in, Cunningham said parents should ask team leaders about their protocol.

“Ask what concussion education they utilize, what are their concussion protocols. As a parent, you can ask questions of how much of a commitment there is to concussion education and protecting your child,” Cunningham said. “A concussion is a brain injury, with every concussion there is a risk of additional concussions.”


Dodd said, “It’s better to miss one game than the whole season. Playing through it creates worse neurocognitive symptoms and likely doubles the average full recovery time from 22 to 44 days."

Direct short term symptoms include headaches, nausea, feeling dizzy, but also abnormal changes in student sleep patterns and personality in daily activities.

“If someone is walking or running a little funny, off-balance or slow after a collision or fall, you need to say, 'you are done for a minimum of 24 hours,'” Cunningham said. “Keep track of symptoms, keep a check mark every 15 minutes of how they’re feeling and ask open-ended questions about the collision to understand comprehension.”

This protocol applies for all ages, as Cunningham said it takes longer for youth athletes to recover than adults, since the developing brain needs more time to adjust and get back to daily functions.

There is still no gold standard for concussion treatment, and it takes a licensed professional trained in the management and care for concussions to truly diagnose an injury. Dodd encourages coaches and teammates to keep this in mind when a player is struggling.

“Common sayings like being called 'too chicken to play', or 'I didn’t want to let my teammates down' or 'I need the stats for scholarships' are all excuses players can use, and shouldn’t,” Dodd said.