Approximately 2 to 3.5 million sports-related concussions occur annually in the United States, of which 60,000 are sustained by high school athletes. Orthopedic physicians and the athletic training staff from Tahoe Orthopedics & Sports Medicine are working to combat the impact of concussions affecting young athletes in the region through a computerized test called ImPACT (Immediate Post-Concussion Assessment Testing).
Jonathan Finnoff, D.O., an internationally recognized concussion expert and former Co-director of the Mayo Clinic Sports Medicine Center Concussion Program now practicing at Tahoe Orthopedics & Sports Medicine says “most concussed athletes recover over a week or two with proper treatment, yet some athletes may develop persistent, disabling post-concussive symptoms referred to as post-concussion syndrome (PCS).”
Finnoff also discussed the complications associated with concussions, such as early onset dementia, movement disorders (similar to Parkinson’s disease), and emotional problems, such as depression.
“The most significant potential injury is second impact syndrome (SIS) which occurs when a concussed athlete who is still experiencing symptoms returns to athletics and gets another injury to the head. In this case, rather than just experiencing post-concussion symptoms, the blood vessels in the athlete’s brain rapidly dilate, increasing the pressure inside the head, causing either death or severe brain injury,” Finnoff added.
As part of Tahoe Orthopedics & Sports Medicine’s effort to reduce complications associated with concussions and promote concussion injury awareness in student athletes, concussion testing is now offered at area high school including South Lake Tahoe, Whittell and most recently, Douglas High. ImPACT - a computerized test administered by Tahoe Orthopedic & Sports Medicine’s certified athletic trainers Kris Terrian and Rebecca Schwebke - is given to all student athletes before their sports season. Kyle Swanson, orthopedic physician with Tahoe Orthopedics & Sports Medicine and local leading advocate for concussion testing, worked closely with school administrators, athletic directors and coaches to implement ImPACT testing and improve overall medical coverage at local high schools. Swanson did this by fostering the support of and hiring athletic trainers like Terrian and Schwebke to work with student athletes.
“Seeing the effects of concussions firsthand in my office, I know the importance of properly treating these athletes and keeping their health and wellness at the forefront of the game,” Swanson said. “I have pushed hard to get ImPACT testing in local high schools to improve our ability to manage concussions and other sports injuries.”
If an athlete sustains a concussion, they are typically evaluated on the sideline by an athletic trainer. Any athlete with a concussion is removed from the game and monitored for signs or symptoms that suggest a more severe brain injury. All concussed athletes should be referred to a physician with concussion expertise for further evaluation and treatment. The physician will review the athlete’s post-concussive symptoms, assess the athlete’s risk for concussion complications, and perform a physical examination that includes concussion-specific tests of balance and brain function. Each athlete’s treatment program is customized to address the severity and symptoms of their concussion. However, the primary treatment is physical and cognitive rest. Physical rest entails avoiding any activity that would increase the athlete’s heart rate. Cognitive rest involves avoiding any activity that requires significant concentration (eg. video games) or memorizing. When the athlete’s symptoms have resolved, the ImPACT test is repeated to detect any remaining problems with the athlete’s brain function. If the athlete’s brain function is normal, they are allowed to begin a stepwise increase in physical and cognitive activities under the supervision of their school’s athletic trainer. The athlete must successfully complete the entire return to play protocol before returning to full sports participation.
Concussion testing is among one of the many medical services provided by Tahoe Orthopedics & Sports Medicine’s athletic trainers. Athletic Trainers like Kris Terrian, also treat a variety of sports medicine injuries on the sidelines and in the training room.
“We are always treating injuries including ankle and wrist sprains, as well as more complicated issues like assessing various shoulder and knee ligamentous tears. On average, we see three to four ACL tears and shoulder dislocations each year,” Terrian said. “By having athletic trainers in our high schools, we are able to provide a more thorough and functional means of treating our injured athletes.”
To learn more about Tahoe Orthopedics & Sports Medicine’s concussion program, please visit tahoeorthopedics.com or call (530) 541-3100 for South Lake Tahoe, (775) 588-3636 for Zephyr Cove and (775) 783-3065 for Carson City.