Local medical team working to increase concussionawareness

The term “getting your bell rung” is slowly being purged fromthe often colloquial jargon of the world of sports.

For some local doctors and athletic trainers, the adverseeffects of an athlete taking a blow to the head has a more seriesterm — concussion. Dr. Nick DiGiovine said coaches, athletes andtheir parents have in the past minimized the seriousness of impactinjuries to the head during games.

“We’ve been aware these problems have been under-diagnosed ormismanaged for years,” DiGiovine said.

A team of Butte physicians, nurses and sports medicine personnelis increasing the awareness of this issue to the sportscommunity.

Montana Sports Medicine out of St. James Healthcare startedmonitoring athletes on the high school level and at Montana Techfor possible signs of concussion at the beginning of 2010. Thegroup has contracted with seven regional high schools and monitorsall athletes participating in contact and impact sports.

Those in sports medicine are treating possible head injuries asthey would a torn ligament or bone fracture. Brandon Byars, theathletic trainer for Anaconda High, said he examines every playerclosely for signs of concussion.

“There’s no more ‘bell rung,’” Byars said.

Concussions have flown under the radar in sport diagnosis formany years because they can’t be seen.

DiGiovine, of Montana Orthopedics, explained there’s nostructural abnormality to the brain in a concussion.

“With a concussion, cells in the brain are just not working,” hesaid.

Concussions vary, depending on the part of the brain injured. Aconcussion can cause confusion, blurred vision, short-term memoryloss, trouble with cognitive ability, sleep problems and inabilityto control emotions.

Diagnosing and treating concussions are different from otherinjuries, according to Dr. Derrick Johnson of Rocky MountainClinic.

“Unlike a knee, it can’t be repaired surgically,” he said.

TESTING

Montana Sports Medicine uses a computer program called SportConcussion Assessment Tool 2, or SCAT2. the test is a standardizedmethod used to evaluate athletes for concussions from age 10 andup. the program uses a series of memory exercises designed to testthe athlete’s recall and reaction time.

An example of one test involves flashing a series of words onthe computer screen. the program will then show another series ofwords and the athlete will have decide if any of these words werein the first series by clicking either “yes” or “no.” the programmeasures the number of correct answers and the reaction time.

All healthy athletes from area schools who participate incontact sports were given the test at the beginning of the year,Johnson said. the sports medicine team could use the test resultsfrom the healthy athletes as a basis of comparison for when theytest them again for possible signs of concussions.

“All the athletes’ scores who were diagnosed with concussionsdropped significantly,” Johnson said.

TREATMENT

Athletes diagnosed with concussion are immediately pulled fromtheir sport until cleared by a physician or trained healthprovider. DiGiovine said recovery time for a concussion can takeanywhere from two weeks to six months.

“Both cognitive rest and physical rest is important,” DiGiovinesaid.

Physicians can order concussed athletes be removed fromclassroom work for a period of time, because cognitive exercisescan cause undue stress on the brain. This would also involvelimiting the injured athlete’s reading time.

Once an athlete starts to lose the symptoms, he or she moves tolight aerobic activities such as walking and stationary biking. Thenext step involves sport-specific training like skating andrunning. Non-contact training drills follow this step, which isfollowed by full-contact drills.

Once all these steps are met, the athlete is cleared for gameplay. if symptoms return during any of these steps, the athletegoes back to the first step of inactivity, and starts overagain.

RESULTS

In 2010, Montana Sports Medicine had 198 football players fromButte High, Butte Central and Anaconda tested by SCAT2. of thatnumber, 37 were treated for concussions. the average age of thefootball players who received concussions was 15. the recovery timeaveraged 16 days.

DiGiovine noted that 71 percent of the concussions occurredduring practice as opposed to games. Fifty percent of theconcussion occurred due to helmet-to-helmet contact.

The sports medicine team plans to share these finding withcoaches and athletic trainers.

DiGiovine believes this information may help coaching staffprevent further concussions next season.

There are three main points.

First, because half the injuries were due to helmet collisions,coaches will be asked to focus teaching better tacklingtechniques.

With many of the concussions happening to younger players, thesecond point will be to work on strength and conditioningexercises, such as strengthening the neck.

The third finding involves the large number of practice-relatedinjuries.

DiGiovine recommends coaches limit exposing athletes to contactdrills and try to avoid mismatches between larger and smallerplayers.

Coaches, athletes and parents have been supportive of thisprogram and are understanding the importance of properly treatingconcussions, he said.

“We have seen a 180 degree flip (in awareness) from just a fewyears ago,” he said.

Reporter John Grant Emeigh may be reached via e-mail at.