Concussions-Scott Flashcards
What are the benefits of exercise & sport?
Weight control Lower blood pressure Improved HDL Reduced risk of diabetes Enhanced self-esteem Promotes life-long physical activity Fun, recreation Enjoy the challenge of competition Team work, motivation, concentration
What are the challenges of exercise & sport?
Sedentary, obese child Highly competitive, driven child Risk of injury-acute and overuse Risk of burnout Excessive exercise, eating disorders Early sport specialization Early, high level competition Overscheduled-lack of free play Parental influence
What is the approx % of overuse v. acute sports injuries?
overuse–45.9%
acute–54%
amount of overuse injuries is underestimated.
What are the risk factors for pediatric sports injuries?
they are growing!
increased muscle-tendon tightness
decreased physeal strength
bone mineralization lags behind linear bone growth
**can be faster & heavier & stronger than their minds.
larger size=large injuries
What are some things that you try to pick up on with sports physicals?
heart conditions
previous injuries–get help b/c higher risk of subsequent injury
You see an elementary or middle school child w/ a sprain. What do you think?
could be a growth plate injury (physis).
take X-rays of both ankles so that you can compare.
What does physis mean?
growth plate
T/F Physeal fractures are more common than sprains in the SKELETALLY IMMATURE athlete.
True. Worry about future growth.
What is an overuse injury?
Repetitive submaximal loading of musculoskeletal system when rest is not adequate for structural adaptation to take place
Injury can involve muscle-tendon, bone, bursa, neurovascular structures and the physis
Overuse injuries unique to young athletes include apophyseal injuries and physeal stress injuries
What is Osgood Schlatter?
Traction apophysitis of the proximal tibial tuberosity at the insertion of the patellar tendon
Common among adolescent males following a growth spurt
What is a concussion? What causes its effects?
Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than structural injury
What is an important part of the pathophysiology of a concussion, particularly w/ rotational or angular acceleration resulting in shear strain?
decreased cerebral blood flow
decreased metabolism
**includes K+ outflow into extracellular space & overwork of Na+/K+ pump to restore balance.
HOw many symptoms does it take to make a diagnosis of concussion?
only one symptom needs to be present to evaluate head injury & manage appropriately.
What are some cognitive features of concussion?
Unaware of game period, opposition, score of game
Confusion
Amnesia
LOC
What are some general symptoms of concussion?
Headache or pressure in head
Balance problems or dizziness
Nausea
Feeling “dinged”, “FOGGY, “stunned”, “dazed”
- foggy is the most commonly reported symptom
Visual problems (stars, flashing lights, double)
Hearing problems (ringing in ears)
Irritability or emotional changes
Subjective feelings of slowness or fatigue in the setting of an impact may also indicate that a concussion has occurred or has not resolved
What are some physical signs of concussion?
LOC or impaired conscious state Poor coordination or balance Concussive convulsion/impact seizure Gait unsteadiness or loss of balance Slow to answer questions or follow directions Easily distracted, poor concentration
Inappropriate emotions Vomiting (ER, CT) Vacant stare/glassy eyed Slurred speech Personality changes Inappropriate playing behavior Significantly decreased playing ability
What are the most important parts of the sideline evaluation?
appropriate disposition in a timely manner
NO RETURN TO SPORT ON SAME DAY AS INJURY!!!
T/F When in doubt, sit them out.
True!! Treat people conservatively when you don’t know.
Headache w/o injury or contact. Concussion?
NO.
Big injury, fine immediately. What do you do?
Wait 15-20 minutes to look for signs/symptoms of concussion.
What happens with intensive, year-round single sport training at exclusion of other sports?
considered less competent athletes than those who play multiple sports throughout the year.
get more injuries.
get more BURNOUT
Where do you see more burnout w/ kids?
w/ adult supervised activities
