Sports medicine professionals talk about management of concussions

Scott Ahrenholz, a sports medicine physician from Fairview Lakes Regional Medical Center in Wyoming, presents information about concussions at North Branch Area High School Aug. 14. Photo by Derrick Knutson

Scott Ahrenholz, a sports medicine physician from Fairview Lakes Regional Medical Center in Wyoming, presents information about concussions at North Branch Area High School Aug. 14. Photo by Derrick Knutson

For many people who’ve played youth or college sports, especially ones that involve repeated contact like football or hockey, having one’s “bell rung” isn’t all that uncommon of an occurrence.

Scott Ahrenholz, a sports medicine physician from Fairview Lakes Regional Medical Center in Wyoming, said about one in 10 sports injuries are concussions.

He and Ryan Henry, a certified athletic trainer from Fairview who works with North Branch athletic teams, talked about the diagnosis and management of concussions Aug. 14 at North Branch Area High School.

Ahrenholz said even just 5-10 years ago, a concussion wasn’t viewed as that serious of an injury. Some players, coaches and parents thought an athlete could just shake if off and get back on the field or court.

Some people thought only losing consciousness signified a serious concussion.

That mindset, Ahrenholz said, has changed in recent years with much more attention being paid to concussions because of states passing legislation that requires youth education about the injury and the recent concussion NFL lawsuit.

Managing concussions 

Ahrenholz noted that if managed correctly, most players could come back from a concussion in a relatively short time with no long-lasting effects.

He noted that the term “managed” should not be used and not “treatment” because there really isn’t a way to treat a concussion.

Unlike in other areas of the body, physical therapy isn’t really used much for concussions because they’re mild brain injuries, and medications often just mask symptoms instead of treating them.

The key in managing a concussion, Ahrenholz explained, is “making your life boring.”

He said a certified athletic trainer, like Henry, can often make the diagnosis of a concussion, and tools like Immediate Post-Concussion Assessment and Cognitive Testing, a computerized concussion evaluation protocol, is sometimes used to help trainers and physicians further evaluate concussion severity and symptoms.

After that diagnosis is made, a patient should be removed from activities or stimuli that can be overwhelming when recovering from a concussion, such as school, video games, television, reading or loud music.

“We’ve seen band class can really flair kids up,” Henry said.

Ahrenholz said physicians often do not prescribe medication for concussions unless a patient is struggling with recurring symptoms, because they want to be able to monitor a patient’s progress.

When a patient says he or she is feeling better, trainers run them through a return-to-play plan.

If they’re symptom-free, Henry said he has players start by doing light aerobic activity, such as stationary biking or jogging.

The next day the focus is sport specific, such as throwing a football, kicking a soccer ball or running around cones.

The following day the player is allowed to return to non-contract drills, such as passing soccer balls, catching passes in football or running routes.

On the final day, the player is allowed to take part in a full practice.

“If they come in Monday and say, ‘I’m symptom-free,’ if everything goes well, they can play on Friday night,” Henry said.

Trouble recovering 

Ahrenholz said most athletes recover from concussions in one or two weeks; youth athletes usually take closer to two weeks or longer because their brains are developing. But in some cases, athletes have long-lasting struggles.

When their symptoms persist, Ahrenholz said, it’s often because they return to activity too quickly.

Even doing something as simple as riding a bike or lifting weights before an athlete has fully recovered can cause prolonged concussion symptoms.

Or if an athlete sustains another head injury before recovering totally from a concussion, the presence of symptoms can last longer.

Ahrenholz said he treated a basketball player who had a concussion during a game, and he didn’t take a break from activities.

The next week, he was hit in the head during gym class, and his concussion symptoms lasted for more than six weeks.

For more information on concussions, visit www.cdc.gov/Concussion.

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