In a continuation of Eastbay’s interview with Dr. James Moriarity, Sports Medicine Consultant and Head Team Physician at the University of Notre Dame, we clear up what athletes need to know about concussion recovery. In our first segment, Dr. Moriarity told us about the symptoms of concussions, as well as how Axon Sports concussion testing can aid in managing head injuries. Continue reading to get his expert advice on treatment, including how he helps top-notch Notre Dame athletes deal with their injuries.

Dr. James Moriarity

Dr. James Moriarity

What is the effect of a concussion on a younger athlete, compared to an adult?

Each age group has a unique set of challenges when it comes to concussions. Children have a tendency to experience more of the emotional symptoms, outlined in Part 1 of our interview. However, because of the abstract nature of these symptoms, it can be difficult for a child to verbalize how they’re feeling. In addition, “Kids’ brains are malleable. They’re constantly changing. The nerve fibers themselves are still getting insulation,” Dr. Moriarity tells us. Whether that means they’re better at adapting and recovering or they’re simply more vulnerable to injury is still up in the air.

With all the uncertainty, what’s the best precaution for kids?

  • Keep your baseline test up to date. Before the age of 15, take a new baseline test every 6 months or so. Over the age of 15, once a year should be sufficient.
  • Youth concussion laws are tightening guidelines, so be aware of rules for removal from and return to play.
  • Wear proper gear for your sport, keep your equipment in good condition and follow the rules of the game.

Older athletes will be especially eager to get back to play and may be reluctant to admit they’re not feeling right. Dr. Moriarity’s crucial tip here? “Parents need to rely on healthcare professionals for their kids. A parent cannot and should not intervene on behalf of the child to get their child back to play sooner.” To the older athletes: be upfront with your coaching and medical staff. While it’s tempting to “tough it out”, a full recovery will keep you playing better and longer.

What are some of the Do’s and Don’ts of concussion recovery?

Do-

  • Be truthful with yourself and your care providers. Follow the advice of medical professionals.
  • Listen to what your parents are telling you. They know you well enough to recognize irregularities in your daily functioning.
  • Accept that your recovery will take time. Time is your biggest ally in recovery.
  • Get enough sleep. Try to avoid getting too much as well, but too little can be especially detrimental.
  • Notify your doctor if you are having trouble sleeping. Getting good sleep is as important as getting enough sleep.
  • Avoid overtaxing your brain with a lot of stimuli, multi-tasking or high-stress environments.
  • Eat well. This includes eating healthy and regularly.
  • Take an aspirin if you’re having some pain.
  • Use ice or heat to relieve head or neck pain, whichever you feel helps.

Don’t-

  • Think you can go back and play with your concussion. Being a martyr for your team means you’re playing at less than 100%. You’ll be more likely to make mistakes, a lose-lose situation for you and your team.
  • Do too much texting or playing video games. The visual stimulation can aggravate your symptoms.
  • Replace your team sports with another strenuous exercise routine.
  • Increase the blood pressure in your head with any heavy exertion, like weightlifting or pushups. Don’t look to “make up” for your lack of playing/practicing.
  • Do anything that makes your symptoms worse. The “no pain, no gain” theory doesn’t work here and pain will delay your progress.
  • Drive. Your attention and reaction time are lowered. In fact, Dr. Moriarity told us, “The way you score when you’ve had a concussion is the way you’d score if you were legally intoxicated.”
  • Work at a higher altitude, like on a ladder or platform.
  • Think that just wearing your helmet makes it okay to play again. Helmets can prevent skull fracture, but not necessarily concussions. You’re not properly protected from further damage if you return too soon.

As an example for Eastbay athletes, what do you tell your Division I college athletes who suffer concussions?

Dr. Moriarity typically tells Notre Dame athletes is that they should do the following:

  • Pay attention to how your symptoms react to daily activities like bending over, climbing stairs or walking to class. This gives your doctor a base for tracking your progress.
  • If you have difficulty focusing when watching film or listening to your coach, do not participate.
  • Do not participate in practice, even no-contact drills. If coaches question your decision, have them discuss your condition with your doctor.

Once the recovery process has begun, a little activity, such as 10 minutes on an exercise bike, can be beneficial. The driving philosophy here is that progress is monitored, but not rushed. Dr. Moriarity runs his treatment under “day-to-day evaluation,” saying, “I’m not going to make changes within 24 hours. We’re not going to micro-manage 24 hours of the day.” This way, an athlete isn’t pushing the envelope to move forward every moment and they aren’t bugging their coach or trainer for more activity.

Once our questions were finished, there was one thing Dr. Moriarity wanted to add on his own. Here’s his final point:

“Parents should not be afraid to get involved in the care of their athlete-children. You don’t need to wait for a physician to tell you that cognitive testing is a good thing. If they feel strongly about it and want that kind of testing, don’t feel intimidated against asking for it and learning what these tests are.”

“They may be told if you do a test at home, it’s not accurate. That is absolutely not true.” In actuality, home tests can be more accurate, since an athlete is not distracted by waiting or being in an unusual or uncomfortable environment. Dr. Moriarity encourages parents to stand up and protect their children from concussions. “There needs to be a forum. This problem of concussions is not going away.”