Concussions

Warning Signs of Concussions Not Always Visible

Because the effects are not always visible, many athletes return to their sport too quickly following concussions and head injuries. Unfortunately, this can cause long-term negative health effects. That’s why it’s critical to educate parents, coaches and other athletic officials about the importance of having head injuries examined by a specialized physician who has experience caring for patients with concussion, which can occur with or without the loss of consciousness. Learn more about what we are doing at Emory Orthopaedics, Sports & Spine to care for concussions and to educate the community on the importance of waiting to return to play following a head injury in this short video:

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What are the Signs and Symptoms of a Concussion?

Symptoms of ConcussionEarlier this year Governor Nathan Deal signed a youth concussion bill that will go into effect on January 1, 2014.  The new law mandates that if a young athlete is suspected as having a concussion he or she will not be allowed to return to their sport until cleared by a healthcare professional.

If not treated appropriately and released,  the young athlete can be at a higher risk for more concussions.  Multiple concussions can have a negative, long term effect on the brain by impairing memory and processing new information.

Schools can prepare for this change by educating teachers, students and coaches on the signs and symptoms of a concussion.

Symptoms of Concussion Include

  • Stiff neck
  • Blurred vision
  • Nausea
  • Personality changes
  • Difficulty walking, speaking or using their arms
  • Severe headache
  • Vomiting over and over
  • Confusion that does not get better
  • Unusual sleepiness
  • Convulsions

Other important facts:

  • Over 50 percent of the youth concussions occur in football.
  • Approximately 10 percent of all high school age athletes will suffer from a concussion as a result of their sport in a typical year.
  • Only  10 percent of patients who suffer from a  concussion lose consciousness.

To protect our young athletes all coaches, recreational leaders and parents need to take an active role in ensuring young athletes who receive bumps/blows to the head get evaluated by a physician ASAP.

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About Dr. Olufade          

Oluseun Olufade, M.D.Dr. Olufade is board certified in Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Interventional Pain Medicine and Sports Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team.

Dr. Olufade employs a comprehensive approach in the treatment of sports medicine  injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in treatment of sports related concussions, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration. Dr. Olufade sees patients at our clinic at Emory Johns Creek Hospital.

Dr Olufade has held many leadership roles including Chief Resident, Vice-President of Resident Physician Council of AAPM&R, President of his medical school class and Editor of the PM&R Newsletter. He has authored multiple book chapters and presented at national conferences.

About Emory Ortho, Sports and Spine in Johns Creek and Duluth
Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth. Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek. Mathew Pombo, MD and T. Scott Maughon, MD see patients in Duluth. Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine. To schedule an appointment call 404-778-3350

Governor Deal Signs New Youth Concussion Bill

Governor Nathan Deal signed a youth concussion bill on Tuesday called the “Return to Play Act”.  This bill will place restrictions on when a young athlete can return to their sport after suffering a  head injury.  Emory Sports Medicine physician, Ken Mautner, MD was highly involved in helping to get the new legislation passed and was at the signing of the bill with Governor Deal.  Dr. Mautner is an expert in the area of sports concussions and is Co-chairman of the Georgia Concussion Coalition, a group whose sole intent is to promote education and awareness of youth concussion across Georgia.

This bill will help coaches, parents and players make the right decisions for their athletes.  The bill requires public and private schools to provide information to parents on concussions and establish certain policies for dealing with student head injuries. Under the law, any youth athlete who is suspected of having a concussions must be removed from play.  The athlete must then receive medical clearance from a health care provider trained in concussion management before he or she can return to play.

The Return to Play Act was written in such a way to implement basic protections and give schools flexibility to build their own programs depending on how much funding they can commit. Georgia joins 43 states with similar laws. Government estimates show hospitals treat some 173,000 traumatic brain injuries among youth that are connected to sports and recreation activities each year.

About Ken Mautner, MD
Ken Mautner, MD is an assistant professor n the Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner started practicing at Emory in 2004 after completing a fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in PM&R with a subspecialty certification in Sports Medicine. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, and several local high schools. He has focused his clinical interest on sports concussions, where he is regarded as a local and regional expert in the field. In 2005, he became one of the first doctors in Georgia to use office based neuropsychological testing to help determine return to play recommendations for athletes. He also is an expert in diagnostic and interventional musculoskeletal ultrasound and teaches both regional and national courses on how to perform office based ultrasound. He regularly performs Platelet Rich Plasma (PRP) injections for patients with chronic tendinopathy. Dr. Mautner also specializes in the care of athletes with spine problems as well as hip and groin injuries.

About Emory Sports Medicine Center
The Emory Sports Medicine Center is a leader in advanced treatments for patients with orthopedic and sports-related injuries. From surgical sports medicine expertise to innovative therapy and athletic injury rehabilitation, our sports medicine physicians and specialists provide the most comprehensive treatment for athletic injuries in Atlanta and the state of Georgia. Constantly conducting research and developing new techniques, Emory sports medicine specialists are experienced in diagnosing and treating the full spectrum of sports injuries.

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Youth Concussion Law in Georgia- House Bill 284

ConcussionsThe Georgia House is reviewing a new youth concussion bill. The bill, House Bill 284, is aimed at concussion education as well as protecting many young Georgia athletes after they experience a concussion. Emory Sports Medicine Center orthopaedist, Ken Mautner, MD comments in the CBS News piece that “There’s a lot of misinformation and unawareness about concussion and I think passing a law like this will bring it into the spotlight, will allow better education, and will ultimately allow protection of our athletes”. Only six states don’t have a youth concussion law so we are hoping the bill passes the House. Watch the News important news report that could keep our young athletes safe here -

How to Recover Fully and Quickly from a Concussion

ConcussionsConcussions get a lot of press in the heart of football season as football players aggressively go after the big win each week but this very serious injury can happen to anyone. It is very important to know the symptoms of this injury to ensure full recovery.

A concussion usually occurs when there is impact to the head or neck area that causes an alteration in mental status. This may or may not involve loss of consciousness (passing out). Common symptoms following a concussion include headaches, noise sensitivity, problems with concentration and memory, irritability, depression, anxiety, fatigue and poor judgment. Some symptoms appear immediately and others may take weeks or months to develop. Symptoms can also continue for weeks, months or even a year or more after a concussion, especially if not managed properly or if an athlete returns to their sport to soon.

Emory Sports Medicine physician, Dr. Ken Mautner, says it is important to take proper precautions and visit a physician right away if you suspect any type of brain trauma. Typically, mental and physical rest is the best prescription following a concussion. Medications are typically not prescribed early on after a concussion, but sometimes are helpful to patients who suffer from prolonged symptoms, known as post-concussion syndrome.

Luckily, most patients who sustain a concussion will make a full recovery within days or weeks after the injury. Some patients still experience symptoms for up to 6 months but are OK after this time period. Patients who have had repeated concussions or more severe symptoms may take longer to recover or may have permanent effects from the injury.

Dr. Mautner stresses how important it is to follow helmet and safety precautions when participating in any sport in order to prevent head and neck injuries, including concussions. Experts are constantly studying head injuries and developing new protocols and devices to ensure we all stay safe as we participate in the sports we love.

About Ken Mautner, MD

Ken Mautner, MDKen Mautner, MD is an assistant professor in the Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner started practicing at Emory in 2004 after completing a fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in PM&R with a subspecialty certification in Sports Medicine. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, and several local high schools. He has focused his clinical interest on sports concussions, where he is regarded as a local and regional expert in the field. In 2005, he became one of the first doctors in Georgia to use office based neuropsychological testing to help determine return to play recommendations for athletes. He also is an expert in diagnostic and interventional musculoskeletal ultrasound and teaches both regional and national courses on how to perform office based ultrasound. He regularly performs Platelet Rich Plasma (PRP) injections for patients with chronic tendinopathy. Dr. Mautner also specializes in the care of athletes with spine problems as well as hip and groin injuries.

About Emory Sports Medicine Center
The Emory Sports Medicine Center is a leader in advanced treatments for patients with orthopedic and sports-related injuries. From surgical sports medicine expertise to innovative therapy and athletic injury rehabilitation, our sports medicine physicians and specialists provide the most comprehensive treatment for athletic injuries in Atlanta and the state of Georgia. Constantly conducting research and developing new techniques, Emory sports medicine specialists are experienced in diagnosing and treating the full spectrum of sports injuries.

Female High School Soccer Players 64% More Likely to Suffer from Concussions Than Males

Female athletes concussion riskShe’s only 16, but she’s already been playing soccer for over a decade. In that time, Alex Anne Matthews, a junior at the Lovett School in the Buckhead area of Atlanta, has broken several bones and sustained two concussions. Unfortunately, according to a new study, the injuries Alex has sustained over her currently 12-year-long soccer career are not only common, but more common for female high school soccer players than males.

During a soccer game on September 4th of this year, Alex hit the ground with force. “She came up from behind me and slide-tackled my feet out from under me, and I landed on my side, and the first thing to hit the ground was my head,” she recalls. Alex’s parents looked on as it happened, and as her mother, Anne Matthews puts it, “Alex Anne got up like she always does and staggered a little to her right. And Chip and I looked at each other and went, ‘that doesn’t look good.”

Despite a noticeable headache, Alex charged on and played in a second soccer game that same afternoon, but it wasn’t too long before routine concussion symptoms: nausea, dizziness, and blurred vision set in. According to Dr. Kenneth Mautner of Emory Sports Medicine, “There’s actually sheering forces that occur inside the brain, and the brain literally gets shaken inside the skull.”

But, according to a new study, it’s much more common (64% more common, in fact)  for female high school soccer players such as Alex  to sustain concussions than it is for males playing the same sport. So what makes concussions more common for female soccer players? Dr. Mautner says it could be a few things.

“Something just as simple as girls report concussions more because they’re more likely to say when they’re hurt and not feeling well,” according to Mautner, could be one reason. There is also evidence to show that stronger neck muscles in men and their ability to absorb shock more effectively may lower their concussion risk, or that hormones may make female athletes more susceptible to sustaining an injury.

Female athletes may also take longer to recover from concussions. For both men and women, however, Dr. Mautner emphasizes the importance of not returning to the field too soon. “There’s no one test to say you’re ready or you’re not ready, so we see how their symptoms are. They need to be completely asymptomatic at rest, they need to be asymptomatic with exertion.”

The findings of the study are not intended to alarm parents or child athletes, but rather, to help raise awareness around concussion symptoms and the importance of taking heed to them when they present themselves. Nausea, headaches, confusion, drowsiness, sensitivity to noise and dizziness are a few of the most common concussion symptoms.

Thankfully for Alex, six weeks after sustaining her most recent concussion, she is back on the field and pursuing her next goal, to play soccer in college. We’ll be keeping an eye out for her on ESPN in the coming years.

For more information on Dr. Mautner or Emory Sports Medicine, visit: www.emoryhealthcare.org/sports-medicine

Are Football Players Suffering Concussion-Like Damage in the Absence of a Concussion?

Ken Mautner, MDWith the NFL playoffs just around the corner – and our Atlanta Falcons certain to be in them – most of us have been watching a lot of football lately. Like many football fans, I watch simply to enjoy the games, but lately I’ve been watching with a new question in the back of my mind: Are any of the players receiving what we call “sub-concussive hits” that might over time, contribute, to concussion-like brain problems?

The question was prompted by a recent study published in the Journal of Neurotrauma. The study looked at youth football players who had never had a concussion, had never complained of the symptoms typically associated with a concussion, yet showed changes in brain activity and cognitive ability that are normally associated with people who have suffered one or more concussions.

We have a lot of experience treating concussions at Emory Sports Medicine. My focus is to get athletes, parents and coaches to know and recognize the symptoms of a concussion, and to seek out prompt concussion treatment when they have those symptoms. What should be done when athletes may not present any of the traditional symptoms? Or what about athletes who have not, in fact, had a concussion but who are experiencing similar problems associated with concussions?

We’re learning about this phenomenon because our tests for concussions have become far more sensitive and sophisticated in the last few years. In the study mentioned above, “hit monitors” – telemetry units – were installed in the studied athletes’ football helmets to measure the g-forces they took with every hit in practice and games throughout the season. Computerized neuropsychological testing (CNT) was administered, both pre-season and post-season, to assess changes in cognitive functional ability. And functional magnetic resonance imaging (fMRI) was used to look for telltale increases of activity in certain areas of the brain that are typical in those who have suffered concussions.

The surprising finding was that some athletes never sustained a hit strong enough, as measured by the hit monitors, to cause a concussion, and yet the fMRI and CNT results showed evidence of the characteristic increases in brain activity and decreases in cognitive ability normally associated with a concussion. This result was most common among offensive linemen, who may take 40-50 sub-concussive hits in a single, ordinary practice. Over the course of a season, this massive accumulation of lower g-force hits seems to have caused the same effects we’d usually expect only from more powerful, concussion-causing hits.

Long-term consequences are what concern me most here. It’s possible that brain activity and cognitive ability return to normal after the season is over and the youth athletes have had some time to recover. It’s also possible that some of these effects are enduring. Just as with those who suffer multiple concussions, it may be that this accumulation of sub-concussive hits will, years later, result in higher incidences of depression and cognitive impairment. We don’t know yet if this is the case, but the study has raised the possibility.

My own son plays Pee Wee Football, and I appreciate the self-discipline, toughness, and teamwork he learns from it. But like any parent, I have to weigh that value against the potential for negative long-term consequences. Everything in life is a trade-off of risks and benefits, but this recent finding adds a new variable to the decision.

So, what’s to be done? Well, first of all, we have to keep pressing forward with efforts to prevent, identify, and treat concussions. Concussions remain a serious problem in football and other contact sports, particularly among adolescent athletes, whose brains are especially vulnerable. I’m part of a group of health care providers and state action planners who are working in partnership with the NFL to pass legislation in Georgia to better prevent concussions and provide better treatment for those who do suffer concussions.

Some of the same measures being considered to prevent concussions, such as better helmet technology, may also prevent the damages of sub-concussive hits. The NFL is even considering more drastic changes, such as eliminating the traditional three-point stance, thereby requiring linemen to start with their hands off the ground. This change would greatly reduce the number and force of helmet-to-helmet hits. Should the NFL make this change, it will most likely be adopted by college, club, high school, and lower grade football leagues.

Ultimately, what we need is more research. The concussion testing we perform at Emory Sports Medicine has become far more sophisticated in recent years, and it will continue to become even more sensitive. Now that we’re aware of the effects of sub-concussive hits, I’m confident we’re just a few years away from being able to identify those athletes who may be at risk. I look forward to the day when I can again watch the gridiron drama without worrying that the players are fighting their way toward that Super Bowl ring at the cost of the long-term health of their brain functions.

For more information, check out the study, Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. If you have questions, please don’t hesitate to leave them in the comments below.

About Dr. Ken Mautner, MD:

Dr. Mautner is an Assistant Professor in Emory’s Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, the Atlanta Ballet, and several local high schools.