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Lessons from the School of Hard Knocks

s2010 soccer 2
Now in college, A.J. Dudon
has returned to soccer, more mindful of its risks.

Dings. Hard knocks. Bellringers.

Those slang terms for concussions can shrug off, if not dismiss, what sports medicine professionals now recognize as a serious health problem.

Concussions are disruptions in brain function. They occur when the brain slams against the skull or is rapidly spun as the result of a trauma, such as a fall, collision or blow to the head.

Teen Brains at Higher Risk

For teens in particular, concussions are risky business because their brains aren’t fully formed, explains Michael Barrow, MD, Medical Director for sports medicine at Good Samaritan North Health Center.

Concussions are invisible injuries that can’t be seen with a CT or MRI scan. Therefore, coaches and trainers on the field rely on simple tests to evaluate players for symptoms: fatigue, blurred vision, headaches and impaired memory, balance and cognitive function. Unfortunately, they can’t count on players to give reliable feedback on their condition.

“Asking a kid with a concussion, ‘Are you OK?’ is like asking a drunk, “Are you OK to drive?’ They can’t make an informed decision,” says Dr. Barrow.

No one understands that better than A.J. Dudon who, in 2006, returned to the soccer field less than 10 minutes after cracking heads with another player and suffering a concussion—not his first. A.J. says he had “no idea what was going on,” but after lettering in soccer as a high-school freshman, he didn’t want to miss playing the first game of his sophomore varsity season.

Long-lasting Symptoms

S2010 Barrow HS
Dr. Michael Barrow

A few years ago, it was fairly typical to send players back into a game if they hadn’t lost consciousness as a result of the blow and the concussion symptoms had eased, Dr. Barrow says.

But new research shows most players still suffer symptoms two days after the injury. Up to 20 percent of high schoolers can still have the effects a month later, even though they may act and feel normal . Studies also show that repeated concussions can create longterm brain damage with symptoms that include depression, sleep disorders, learning problems, and headaches.

As a result, concussions are taken much more seriously today. The NFL is looking for ways to reduce the incidence of concussions and several states like Washington have passed new laws to safeguard young players.

New Guidelines Delay Return to Play

New guidelines should help. Published last year after the third International Conference on Concussion in Sport, they advise that players not return to play on the day they sustain concussions and recommend physical and cognitive rest until the symptoms resolve. Cognitive rest includes limiting activities such as reading, studying, playing video games, text messaging, listening to loud music and using a computer.

But getting that word out is a challenge, says Dr. Barrow. Not only do the new guidelines run counter to long-held beliefs, many coaches are parents and volunteers so they’re a transient, hard-to-reach audience. That’s where players like A.J. come in.

After his last concussion, A.J.’s parents took him to see Dr. Barrow where they all learned more about concussions. Today, as a freshman at Ball State University, A.J. shares that knowledge with other athletes.

After a few years’ hiatus, he’s playing soccer again, but A.J. says he approaches the game differently now. He wears a mouth guard to lessen the impact of a collision or fall and says he’s “not nearly as aggressive,” as he once was. “I won’t head the ball. It’s not do-or-die for me to get that ball anymore.”

Learn more at our Sports Corner.

2010 soccer 3 s2010 soccer 4
Today, A.J. Dudon avoids head balls like this one
(left) in 2006 that could aggravate the concussion he
got in his last high school varsity game that year (right).