IF YOU ASKED THE PEOPLE you know what they've heard in the news about sports concussions, they'd likely cite reports about concussion concerns related to professional American football. They aren't wrong. There are a multitude of studies, reports, opinion editorials and feelings on this very subject. While concussion in football should absolutely be taken seriously, it certainly isn't the only cause of concussion in sports. It's also important to remember that collisions and/or blunt force directly to the head isn't the only way a concussion can be sustained. In fact, falls remain the most significant cause of concussive head trauma. The type of athletic event notwithstanding, we can all probably agree that there's lots of falling in sports. As a sports neurologist, I want to make sure the public isn't so hyper-focused on concussion from collisions in football that we miss the variety of other ways that sports concussions happen – and perhaps more importantly, how we can be on the lookout for and safeguard against them. Playing soccer. Players colliding with one another is typically considered the most common cause of diagnosed concussions in soccer players, and most concussion prevention efforts are designed with this "unintentional" head impact in mind. However, heading the ball – a technique that utilizes the head of the player to control the soccer ball during play – is actually an under-recognized cause of concussion symptoms in soccer players. Part of the issue is that many unintentional collisions or strikes from head-to-head, head-to-elbow or head-to-ground contact during attempts at heading the ball result in concussion. But even in the best of circumstances, heading the soccer ball is an intentional impact – meaning it's a chosen action and is in the player's complete control. A plethora of research is revealing that heading the ball isn't a benign or harmless head impact. In fact, a study recently published in the journal Frontiers in Neurology has revealed that players who headed the ball the most performed worse on attention and reaction time tests than those who headed the ball less often. The concern among researchers and neurology professionals alike is that even subtle reductions in neurological function, what we sometimes refer to as subconcussive events, can translate to microstructural changes in the brain that can lead to more pervasive or persistently impaired brain function later on. Because heading the ball is a potential cause of brain injury, and it's under the control of the player, these head injury consequences can be reduced or prevented through education and proper training of coaches, athletes and in the case of young soccer players, their parents. While cycling. Would it surprise you to know that nearly 100,000 visits to the emergency room each year are due to bicycle-related head injuries? Worse, hundreds of those result in death caused by a catastrophic traumatic brain injury. Especially for professional cyclists or mountain bikers, crashes happen a lot. But what doesn't happen as often after those crashes is evaluation for concussion. Sometimes, the ER visit is precipitated by another physical issue – suspicion of a broken bone or a severe laceration and the head injury is identified only because the cyclist was brought in for another reason. Whether it's due to a fall during a race or on a rocky mountain terrain, riders just aren't routinely checked for head injuries after a crash, so many who sustain a concussion don't know it and thus, these significant head injuries go undiagnosed. By contrast, the concussion rate in NFL football players has increased significantly in recent years, which might lead us to believe that more concussions are happening in football than any other sport. The reality, however, is that there probably aren't more concussions happening. It's more likely that the league and its sideline physicians have gotten better at identifying when a concussion has occurred, and then reporting and treating it. During water sports. When contemplating "safety" during water sports, it's usually the risk of drowning that springs to mind in terms of greatest threat, and as a result, injury prevention efforts. Most people just don't associate water sports with concussion. But the risk is absolutely there. That's especially true when you consider that accidents arising from water-related activities (including scuba diving, swimming, water polo, wakeboarding, water skiing and water tubing) are often in the top five sports responsible for head injuries treated in U.S. emergency rooms each year. The reason may seem clear: Pulling a water skier or wakeboarder from a fast-moving boat can turn the water into a wall if the rider falls or lands the wrong way. This is true. But even slow-moving water activities like being pulled by an inner-tube can result in concussion if the water is choppy and whiplash occurs. Remember, a concussion can occur when the head is forcefully jarred, and it doesn't have to make impact with anything for that to happen. Whether you're a seasoned athlete or a weekend warrior, no matter what activity you're engaging in, be sure you're well-educated on how to keep yourself safe while doing it. From properly fitting head gear to safety checks of sporting equipment and playing surfaces, there's so much you can do to help prevent a head injury during athletic activity. But perhaps more importantly, be on the lookout for concussion symptoms if you've fallen, hit your head or have been otherwise forcefully shaken. Remember that you don't need to have lost consciousness to have sustained a concussion and any suspicion that a concussion may have occurred warrants a trip to the emergency room or to your neurologist for evaluation. Source
