Concussions

by Jeannie Dalmas

Concussions are an unfortunate side effect of sports. They range in severity from the minor, “he just had his bell rung” to major, “he was knocked clean out”. Concussions can occur anytime a rider falls and hits the ground, regardless of how hard they hit the ground. Even the slightest blow can cause a concussion.

What is a concussion? A concussion is the most common head injury. They are a form of brain injury that are caused by a blow to the head. It is an alteration in mental status caused by the brain’s being shaken inside the protective skull. A concussion occurs when the body is moving rapidly through space and suddenly stops. Keep in mind that the brain is traveling at the same velocity as the rest of the body. When the body suddenly stops, the brain continues to move at the same velocity in the same direction. The brain then hits the skull and bounces back, hitting the opposite side of the skull until it looses momentum. When the brain strikes the skull, a portion of it is damaged. When enough damage is done, it begins to operate improperly. This is when we notice the symptoms of the concussion.

Concussions are separated into categories:

• The racer’s head is struck or moved rapidly. It is characterized by a post injury headache and difficulty with concentration. The racer may not notice any other symptoms. The person may return to competition, but it is prudent to observe the racer for at least 10-20 minutes before allowing them to return.
• The racer suffers only momentary confusion (may appear stunned or dazed), characterized by inattention, poor concentration and an inability to process information or sequence tasks. There is no loss of consciousness. These symptoms usually go away in less than 15-30 minutes, in which case, neurologists say that the person involved may return to competition. Again, it is prudent to observe the racer for at least 15-30 minutes before allowing them to return.
• Symptoms characterized by headache, cloudy senses, tinnitis (ringing in the ears), amnesia, irritability, confusion, or dizziness. There is no loss of consciousness. Symptoms last longer than 15-30 minutes. The racer should not return to competition that day and remain symptom-free for a week. If symptoms persist longer than one hour they should see a doctor.
• This level of concussion is easy to recognize; the racer is unconscious for any length of time. If unconscious for only a few seconds, they can return to competition after a symptom-free week. If unconsciousness lasted for minutes, they should receive a thorough neurological examination and remain out of competition for two to four weeks or until all symptoms resolve. (Cornerworkers: Noting the length of time of the “blackout” may help determine a diagnosis later.)

What a racer with a concussion may experience:

• Disorientation, lack of awareness or surroundings
• Inability to recall events immediately before or after the injury
• Spacey feeling that doesn’t go away
• Behavioral changes, irritability
• Loss of consciousness
• Blurry vision
• Dizziness or vertigo
• Headache
• Slurred words
• Chills
• Nausea
• Vomiting
• Memory loss

What to do:

• For headaches take acetaminophen (Tylenol). Avoid aspirin because of the risk of bleeding.
• Do not give a person who has suffered a head injury any food or water, both can induce vomiting - which can create breathing problems in a semiconscious or unconscious person.
• Do not give the person alcohol or sedatives.
• Do not leave the person alone. Watch them carefully for at least 48 hours (most problems show up in the first 24 hours after the concussion).
• Allow the person to sleep as long as someone wakes them up every two hours. (They should be able to recognize you and tell you such things as their birthdate, age, and telephone number. If they can’t be easily awakened or don’t answer the question correctly, take them back to the hospital.)
• Make sure no symptoms recur. If they do, take them back to the hospital.

Each concussion is serious and should not be taken lightly. Look for any damage to a racer’s helmet. Even the smallest scratches should be taken seriously if a racer has a history of concussions. The effects of a concussion can be additive or cumulative and the after effects of a concussion, post concussive syndrome, can linger for days, weeks, or months. The bottom line is the safety of the racer! We have only one brain and when it’s damaged it’s damaged for life. If there is any question with the disposition of a head injury, refer to the proper medical professional. Ambulance crews are available at every race to check a rider, even after he has returned to the paddock.

Above all, don’t take anything for granted!