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The Hidden Injury: Concussion misconceptions, myths abound

It's not 'all in your head'

Published: Wednesday, April 24, 2013 2:00 p.m. CST • Updated: Wednesday, April 24, 2013 2:50 p.m. CST
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(Video screen shot)
Newman cheerleading coach Susie LeMay felt great sympathy for Juan Gonzalez during his recovery from the concussion he suffered during practice.

No two concussions are created equal.

Instead, everyone reacts differently to concussions because their brains are different. Similarly, recovery also varies, case to case.

“Everybody’s going to recover different,” Newman athletic trainer Andy Accardi said. “If you and I get the flu, I might be back tomorrow and you might not go back until next week or longer.”

Rock Falls High School junior Addesyn Nailor suffered her first concussion – her first injury ever – diving for a loose ball in the middle of the 2011-12 basketball season.

“I dove head-first for it,” said Nailor, who also sprained her neck in the collision. “I didn’t really think about it, I’d done it a thousand times, so I just went for it. I just remember the other girls coming at me as I dove.”

A neurologist told Nailor that her recovery would be longer than others’, not because of heredity or her personal health.

It’s because she’s a girl.

A study by Tracey Covassin, PhD, a certified athletic trainer at Michigan State University, found that girls take longer to recover from concussions than boys. The study, published in The American Journal of Sports Medicine, also confirmed that high school athletes in general have longer recovery times. Middle-schoolers’ timetables are even longer, and so on.

Opinions vary when it comes to why girls are more susceptible to concussions. A study performed at The Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, suggests it could be as simple as girls’ tendencies to be more honest about their symptoms.

That study suggests biomechanical differences in the head and neck may be the reason for longer recovery times for girls.

Dr. Debra Drengenberg, a family practitioner with KSB Amboy, coaches youth soccer in Dixon, and her daughter plays, too. She agrees with that assessment.

Extra: Click here to watch a video interview with Dr. Debra Drengenberg and Dixon soccer coach Mahmoud Etemadi

“I think a good portion of it is physical,” Drengenberg said. “The recent study on neck strength points out the importance of size and general muscle mass. Girls don’t have as much muscle protecting their head where it meets the neck.”

Every concussion is different, and the aforementioned studies dispel several myths surrounding several of them. But there’s plenty more.

Let’s get to busting, shall we?

In order to suffer a concussion, a violent hit must occur: While that is how most concussions occur, it’s far from the truth. In fact, a concussion can happen without even the slightest brush of the head.

As Sterling High School athletic trainer Andi Sumerfeldt points out, “shaken baby” syndrome is a concussion. One can be suffered as a result of forceful acceleration or deceleration. Accardi, her colleague, has treated a number of people for concussions they suffered while water skiing, of all activities. When the head strikes the water, that sort of sudden deceleration is tough to prepare for.

Dixon soccer coach Mahmoud Etemadi is very deliberate in coaching proper heading technique for his players.

“Do not let the ball hit your head. You head the ball,” Etemadi said. “You must stiffen your neck muscles, make good contact with open eyes and use your forehead to hit the ball.”

If the neck muscles are loose, sudden motion can occur. While one such incident likely will not cause a concussion, repeating that technique – or lack thereof – can lead to one. Which leads us to our next myth.

A concussion is suffered in one action: Again, that sometimes is the case. But Newman graduate Juan Gonzalez suffered his Grade-1 concussion in football during a tackling drill. It was only after several hits that he became dazed. That incident involved another myth.

You must lose consciousness to get a concussion: Gonzalez never lost consciousness during that football drill, but exhibited several red flags.

“A lot of people think you have to lose consciousness to get a concussion, but that’s nowhere near the truth,” Accardi said. “I’ve seen a lot of people come back faster who were knocked out than those who weren’t.”

Accardi immediately pulled Gonzalez from practice. He missed the next day of practice and was eased back into regular daily activity. He first practiced with just a helmet, no pads, no contact. The next day he was in full pads, but was not allowed contact. He sat out that Friday’s game, despite, as he puts it, feeling back to normal.

If you feel normal, you’re concussion-free: As discussed in the first installment of “The Hidden Injury,” very specific criteria have been put in place by Accardi and other medical personnel, such as Dr. Michael DeFranco and his concussion team at CGH Medical Center, that must be satisfied before an athlete can return to play.

Better equipment means fewer concussions: This is a subject we’ll tackle – pun intended – in the fourth installment of this series.

Myriad studies have shown that technique is far more important than equipment, and that the equipment fitting properly supersedes technological innovation. In 4 weeks, we’ll take a long, hard look at the subjects of youth football and equipment.

Concussions are on the rise: The aforementioned criteria medical staff employ have caused the number of diagnosed concussions to spike.

Take comfort. That doesn’t mean more concussions are being suffered. More are being diagnosed, thanks to the tireless work of people like DeFranco.

Concussions are “all in your head”: The concussion in its entirety often is ill-perceived, its potential to derail a sufferer’s future sometimes hidden behind aspiration.

“I don’t think people bought into the idea of a concussion in the past, especially when you have a parent of a junior or senior who was going for a college scholarship,” Drengenberg said. “And you were telling them they can’t play? A college scholarship is one thing. But you only get one brain.”

Back to Ms. Nailor, we’ll have more on her in a future installment. We’ll catch up with her and her main squeeze, Sterling graduate Ryan Hermes, who suffered four concussions during his senior year. The latest came on a play at home plate during the baseball season, bringing back painful memories for Nailor.

“I was really worried,” she said. “He’s had so many. It can’t be good.”

More online

To read more from our special series on sports concussion, please check out The Hidden Injury project page on saukvalley.com. Click here to visit.

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