Posts Tagged ‘concussion recovery’

Experts Reveal New Post-Concussion Treatment Recommendations: Rest Is Not Best

footballEarlier this month, 37 concussion specialists and researchers from around the country met in Pittsburgh to discuss the effectiveness of a common treatment option for concussions. I had the honor of representing Emory Healthcare and participating in this game-changing conference.

The goal of the two-day conference, which was held at University of Pittsburg Medical Center (UPMC), was to get the word out that concussions are treatable injuries and should no longer be treated with strict rest alone. There were several consensus statements on the issue that were debated in detail, and ultimately agreed/disagreed upon.

After much conversation, my fellow concussion experts and I came to the conclusion that despite popular belief, prolonged rest, a common treatment recommendation for concussions, does not aid in the recovery from a concussion and can actually worsen it. This conclusion is somewhat controversial because prolonged rest is a worldwide treatment method used by almost every person following a concussion. A major takeaway from this group was agreement that concussions are treatable and under the appropriate care an athlete should recover from the injury and excel at his or her highest performance levels.

Attention to traumatic brain injuries has increased over the past few years mainly due to an increase in sports-related injuries, especially from football. Athletes in the United States suffer around 300,000 concussions every year, but many mild concussions go undiagnosed and unreported so the number is even higher. Each concussion is unique and there is no one-size-fits-all way to treat them. Symptoms are not always visible, making it hard to definitively know when it’s safe for an athlete to return to play.

Because concussions are unique to each patient, assembling clinical profiles with common symptoms and treatments is key to the future development of concussion research and therapies. Active rehabilitation of concussions includes managing overall activity, subthreshold cognitive and physical activity, and focused therapy. Depending on the clinical profile with which a person suffering a concussion best aligns, the treatment plan may include certain specialized therapies, periods of rest, or cognitive exercise.

While this agreement did not produce immediate treatment protocols or guidelines, our hope is that the conference will spark more research on the subject. Over the next few months, the other physicians and I will compile our findings to be published in a medical journal, which will generate additional papers. As these papers are shared publicly, I am confident we will begin to move the ball forward regarding current and future concussion research and care.

We are proud that Emory Healthcare is recognized as a leading concussion program, as evidenced by our role during this national conference, and because of the amazing opportunity it will afford us to play an active role in changing the way concussions are treated for generations to come.

About Dr. Pombo

pombo-matMathew Pombo, MD, joined the Emory Orthopaedic Surgery faculty as a highly regarded orthopaedic surgeon, speaker, author and researcher who specializes in getting patients with injuries back to an active lifestyle. His professional interests include anatomic single- and double-bundle ACL reconstruction, rotator cuff tears, shoulder instability, meniscal/cartilage injury and repair, joint preservation in the aging athlete, and minimally invasive joint replacement surgery of the knee and shoulder.

Dr. Pombo has conducted extensive scientific research, published multiple journal articles, written several book chapters, and has presented at both national and international meetings on topics related to sports medicine, concussions, and orthopaedic surgery. He has been instrumental in bringing awareness to sports-related concussions and the new Georgia “Return to Play” Act and is one of the top regarded experts in the area for the treatment of concussions. He currently serves as the Director of the Emory Sports Concussion Program.

Dr. Pombo, his wife, and two boys, Eli and Henry, live in Johns Creek, GA. Dr. Pombo enjoys spending time with his family during his days off. Many of his patients also enjoy watching him succeed in his second career as a professional race car driver where he can be found driving at race tracks across North America.

Related Resources
Warning Signs of Concussions Not Always Visible
Concussions and Female Athletes
How to Recover Fully and Quickly from a Concussion
Takeaways from Dr. Mautner’s Concussion Chat

Concussions and Female Athletes

Concussions in Female AthletesAs the number of sports-related concussions continues to rise across the United States, equally disturbing is recent awareness around increased prevalence of concussions in female athletes versus male athletes.

Currently, the Centers for Disease Control and Prevention (CDC) estimates that between 1.6 and 3.8 million sports-related concussions occur each year in the United States, accounting for 5–9% of all sports-related injuries. While the increase in occurrence can be contributed to greater awareness of the symptoms and consequences associated with the injury, it is believed that around 50% of concussions go unreported.

Recent data suggests an increase in the number of concussions sustained by female athletes versus male athletes – with some studies reporting the incidence of concussion in women to be double. Female athletes also experienced (or reported) a higher severity level of symptoms as well as a longer duration of recovery time. The sports in which these differences were most commonly seen were basketball, soccer and volleyball.

Why the sudden increase in female sports-related concussions? While an exact cause or scientific correlation is unknown, there are a few theories that may support why:

  • Physical Differences: women have more slender necks and smaller heads and can experience nearly 50 percent more head acceleration during head trauma.
  • Hormonal Differences: estrogen may play a role in the effects on the brain after injury, while progesterone levels may contribute to and worsen post-concussion symptoms such as headache, nausea, dizziness, etc.

However, not all studies have found significant differences in concussions between the sexes. A study of 15,802 high school athletes in North Carolina, reported more concussions amongst male soccer players than females, while female basketball players reported more concussion incidents than males.

It has been disputed that the difference between the sexes may also be due to reporting bias. Anecdotally, it’s suspected that male athletes may be less likely than female athletes to report concussions for fear of not being able to continue participating in sports. Also, the level of performance (elite versus recreational athletes) and sport types may also contribute to biased study results.

Until there’s more research to support whether an athlete’s sex plays a role in concussion risk and occurrence, all concussions should be prevented and treated the same. Parents, coaches and team physicians should be familiar of the signs and symptoms of a concussion, and provide the proper care. To make sure you know how to recognize the signs and symptoms of a concussion, view our checklist and make sure to report all heads injuries to a health care professional.

About Dr. Mines

Brandon Mines, MDBrandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream.

Dr. Mines is a rotational physician for United States soccer teams and team physician for the NFL’s Atlanta Falcons along with various local high schools, colleges, and community club teams. He enjoys giving talks and lectures regarding the prevention of sports injuries. In fact, as an active member of the American Medical Society for Sports Medicine and the American Society for Sports Medicine, Dr. Mines has attended and presented at various national conferences. Through the years, he has helped all levels of athletes return to the top of their game.

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.

Related Resources

How to Recover Fully and Quickly from a Concussion
Take-Aways from Dr. Mautner’s Concussion Chat
Youth Concussion Law in Georgia- House Bill 284
Female High School Soccer Players 64% More Likely to Suffer from Concussions Than Males

Resources

American Academy of Orthopaedic Surgeons
CDC Heads Up
Medscape

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.