As the sports world debates all aspects of Miami Dolphins quarterback Tua Tagovailoa’s concussion, the injury affects more than just athletes and is becoming increasingly more common.
Getting hit on the pickleball court or merely falling off your bicycle can lead to a blow to the head hard enough to cause a concussion. In South Florida, where outside activity happens year-round, doctors say the steady stream of patients they treat, young and old, who have concussion symptoms has risen.
“There is more awareness than there used to be, but a lot of concussions still go unreported,” said Dr. Evan Peck, a sports medicine physician at Cleveland Clinic Florida. “It’s hard to quantify.”
Not every concussion will cause you to lose consciousness, which happened to Tagovailoa after he was sacked by a Cincinnati Bengals player and his head hit the ground on Thursday. Most of the time people do not black out.
Concussion symptoms can come on immediately once your head gets knocked — a headache, confusion, vomiting, dizziness.
“It’s not like there are 25 boxes and you have to check them all,” Peck said “Even one symptom is enough for you to have a concussion.”
Sometimes, though, symptoms are more subtle and can surface days later — difficulty sleeping, concentrating, or sensitivity to light and noise.
“When I see sports-related concussions in high school athletes, they usually have a blend of those things,” Peck said.
Concussions can be serious and lead to brain bruising or bleeding.
Experts believe the increase in concussions may be because of greater public awareness, better screening, more knowledgeable athletic trainers or stricter reporting laws in sports. Regardless, they say it’s important to know that a concussion can be serious and take days, weeks or even months to fully recover.
“If there is any concern, you need to get it checked out in the first three days, ideally,” said Dr. Geden Franck, a sports medicine physician at Memorial Healthcare System. ”Over time we have learned about the severity of concussions and their lasting effects.”
Teens are at the highest risk of any age group for concussions, mostly because of sports-related injuries. A study by the American Academy of Orthopaedic Surgeons collected information from nine sports over 13 years and found that the number of concussions increased significantly in all sports. It also found that girls experienced a significantly higher concussion rate than boys in similar sports.
Yet falls are the most common cause of concussion, which puts older adults at risk. Dr. Mohammed Elimar, a physician at Aviv Clinic in The Villages, said when someone arrives who may have a brain injury, he completes a full medical assessment and sometimes will need to do another evaluation to make sure the symptoms go away. The Villages in Central Florida is a retirement community with one of the largest elderly populations in the state.
Elimar said if you hit your head but remain alert, move and respond normally, the injury likely is mild and usually doesn’t need further testing. And, contrary to popular belief, it’s OK to sleep.
Athletes, even young ones, usually want to back in the game quickly. Doctors say anyone with a suspected or confirmed concussion should not return to activities that could lead to another concussion. A second head blow while still showing symptoms of the first can have more severe effects and recovery becomes longer.
“We will tell patients to get “relative rest” and avoid things like screen time and television light,” said Franck at Memorial. “Youth athletes will follow a ‘return to play protocol’ to give the brain time to heal.”
Peck at Cleveland Clinic Florida said he participated in a research study of 431 patients that found concussion symptoms on average lasted 18 days.
At the University of Miami, Dr. Michael Hoffer, professor of otolaryngology and neurological surgery at the Miller School, saw that even the short-term consequences of a head injury, or concussion, can derail a person’s life. So, using goggles with a virtual reality display, he came up with tests that help a doctor learn whether a patient has a concussion and when the patient has recovered from one.
“I have been researching concussions for years,” Hoffer said. “Everyone can remember a time when they have hit their head and seen stars. The majority of hits are mild. But about 30 to 40 percent don’t quickly get over a hit to their head. They have persistent symptoms and disabilities from it.”
Experts say there is still a lot more to learn about concussions, but for now, a lot of effort and money is being spent on prevention, particularly in sports.
”Every head injury is different,” Hoffer said. “It’s not just the force, but also the speed, size, angle and where and how your head is constructed. We are still learning a lot about concussions but it’s going to take more time.”
