Steps For Safely Returning to Class After a Concussion

concussionYou might remember a commercial from a few years ago featuring a football player laying on the field after a hard tackle. He tells his coach, “I’m fine.” But when the coach asks him what his name is, the player replies, “I am Batman.” The end of the commercial shows the concussed player sitting out the rest of the game enjoying a Snickers bar.

Though sometimes taken lightly, concussions are no laughing matter. The Centers for Disease Control estimates between 1.6 and 3.8 million concussions happen every year, many of them to young people playing sports. While most concussions resolve themselves within a few weeks, they can have lasting effects for those who suffer from them including headaches, dizziness and an inability to concentrate in school. The goal becomes not only treating the concussion but managing how and when the student athlete can get back in the classroom without jeopardizing his or her health.

Diagnosing a Concussion
Dr. Darin Leetun, orthopedic surgeon and sports medicine specialist at Altru Advanced Orthopedics, has been team physician for USA Hockey since February 2010 and for US Ski and Snowboarding since 2009. He said after a player is injured, diagnosing a concussion starts with the basics.

“We’ll ask them the day, time, place. We’ll have them repeat numbers or do the alphabet backwards,” he said. “We can get a pretty good idea of their mental acuity from that.”

Dr. Leetun said if they determine the student athlete has had a concussion he or she is required to sit out the rest of the game. That’s a departure in protocol from years ago when athletes were allowed to get back in the game if their symptoms subsided. But Dr. Leetun said research has shown how important it is to let the brain rest, especially in kids.

“You don’t want to have a second hit,” he said.” A second hit can be catastrophic; it can cause permanent damage and sometimes even death.”

Dr. Billy Haug, family medicine and sports medicine specialist at Altru Advanced Orthopedics, who served as the team doctor for the USA ski team from 2002-2007 and has treated local athletes for many years, knows that all concussions aren’t to be treated equally.

“The severity of the initial blow to the head does not necessarily correspond to the duration or severity of the symptoms. A light blow in the right spot may cause more symptoms than a harder impact.”

Because of this, he and the team at Altru Advanced Orthopedics look at many aspects of the injury before making a diagnosis or treatment recommendation.

Giving it Time
Both doctors said the key is time and watching athletes, even those with seemingly minor concussions, for continued signs of confusion, memory loss, headaches, trouble concentrating or troubles with balance or sleep.

“We say wait at least a week. It takes that long for everything to settle,” said Dr. Leetun. “It takes more than just a few hours for the brain to reset.”

Return to Learn
But when you’re talking about student athletes it’s not just about returning to the football or soccer field or the hockey rink, it’s about returning to school. Some organizations such as the American Academy of Pediatrics offer guidelines to physicians, parents and educators as to when and how a student should return to school. At first, the student should stay home and even avoid mental stimulation like television or video games because over-stimulating the brain prolongs the healing process. As the student improves, he or she might go back to school part-time and with certain conditions.

“We try to work with schools as the student returns,” Dr. Haug said. “They might need a modified work load or to do their work in a quiet room or a room with lower light.”

Eventually, students can add a few more hours to their school day and return to learning under normal conditions. Dr. Haug said he advises common sense with his patients in and out of the classroom. If reading, studying or watching television gives you a headache, take a 10-minute break to give the brain quiet time.

“I counsel patients to avoid physical exertion, but also to avoid loud noise or bright lights if those are causing increased symptoms, as well,” he said.

Both doctors said they’re glad more people are talking about concussions and ways not only to treat them, but ensure their effects upon education and learning are minimized.

“Concussions are serious but are still poorly understood,” Dr. Haug said, “Still much more needs to be done.”

If you would like to meet one-on-one with an Altru Advanced Orthopedic specialist, schedule an appointment by calling 701.732.7700 or click here and request an appointment on the left hand side of the page.

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