Head Pain

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.

Related Resources:

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

Take-Aways from Dr. Mautner’s Concussion Chat

Thank you for attending the live chat on “Concussions and the Young Athlete”.  As you know, concussions are serious conditions that need to be evaluated soon after they occur.   It is important that all parents, coaches and athletes should be aware of the signs and symptoms of a concussion in order to treat and heal properly.  If you were unable to join us, some key points we touched on during the chat are:

Question: What are symptoms of a concussion? 

Ken Mautner, MDAnswer: Symptoms of a concussion do not always arise right after the impact and they can last for days or weeks.  Some of the most common signs are:

Concussions in Young Athletes – Chat with Dr. Mautner!

School is back in session for most of Atlanta and the surrounding communities and that means the start of fall sports!  While this can be an exciting time, it can also be a time where parents and coaches educate themselves in order to keep our children safe.   According to a recent report from the Centers for Disease Control (CDC), there is approximately a 60% increase in the number of concussions and traumatic brain injuries during the last 10 years.  In 2009, there were more than 248,000  traumatic brain injuries in young people under the age of 19 from sports such as bicycling, football, basketball, soccer and from playground injuries.

If you have a young child or a student athlete who is participating in sports and want to learn more about how to prevent, detect and treat concussions join us on Tuesday, September 10th at noon for a live online chat to discuss the topic. We will also discuss what the new law in Georgia regarding concussion means for your child.  Dr. Ken Mautner will be available to answer questions in an informal yet educational session.

Sign Up for the Chat

For more information or to register please visit emoryhealthcare.org/mdchats.

About  Kenneth 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
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.

Our sports medicine patients range from professional athletes to those who enjoy active lifestyles and want the best possible outcomes and recovery from sports injuries. Our doctors are the sports medicine team physicians for the Atlanta Falcons and Georgia Tech and provide services for many additional professional, collegiate and recreational teams. Appointments for acute sports injuries are available within 48 hours in most cases. Call 404-778-7777 for an appointment.

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.