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
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?
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.
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.”
Concussions are a big topic today, especially in the professional sports world. The problem is that this subject is full of debate, leaving athletes unsure of how to handle their own injuries. Thanks to one of our partners, Axon Sports, Eastbay got the opportunity to talk with Dr. James Moriarity, Head Team Physician at the University of Notre Dame and a Sports Medicine Consultant. He’s been working with collegiate athletes for over twenty-five years and he knows what it means to take your sport seriously. So on behalf of our Eastbay athletes, we had some questions for Dr. Moriarity:
Dr. James Moriarity
What concussion symptoms, both seen and unseen, should athletes look for in themselves or their teammates?
Only a doctor can diagnose a player with a concussion. But you can be looking for symptoms like stumbling, disorientation, a slumped posture or lack of eye contact. If you’re speaking to a teammate whose eyes aren’t making a connection with yours, that can be a sign of head injury.
The severity of an impact is sometimes difficult to see from the sideline. That’s when teammates and coaches, who know the player’s normal responses, should be looking for changes. If a player doesn’t seem receptive or they’re detached from you, this may signal a concussion. Under many state and interscholastic guidelines, your coaching staff has an obligation to remove players from action if they aren’t acting normal or just “don’t seem right.”
After a few red flags, a trained professional looks for three things: thinking ability, emotional changes and physical symptoms. Dr. Moriarity broke these down for us:
Amnesia or no recall of events, like what they did earlier in the day.
Inability to name points in time, such as the date or day of the week.
Failure to list general items, when asked to name 10 fruits, for example.
Drastic changes in emotion; being either overly- or under-reactive.
Being disconnected, seen especially during direct conversation.
Difficulty sleeping or feeling overly tired during the day.
Difficulty focusing on simple tasks, like watching television or reading.
Feelings of depression.
Headaches or aches in the neck.
Feelings of fogginess, or blurred/double vision.
Inability to organize thoughts.
Sensitivity to stimulations like light or sound.
Lack of balance or steadiness on the feet.
Sluggishness or overly slow movements.
Often times, these changes, especially the emotional differences, are not recognized until the next day. That’s when it becomes more difficult to brush off fatigue or pain as just an effect of a strenuous game.
How does Axon Sports’ baseline testing aid in diagnosis and recovery of those cognitive symptoms?
It can be difficult to diagnose a concussion, especially in cases where a doctor may not see an athlete until a day or two after the injury. Ask Dr. Moriarity and he’ll tell you he has a lot of faith in the cognitive testing system. If a condition is uncertain, testing for a mental change can reveal a lot. He believes these tests are “extremely accurate at revealing changes in cognitive ability.”
A test like the Axon Sports CCAT is also incredibly valuable when assessing an athlete’s readiness to return to his/her sport. Begin your sports season by completing a baseline test online. Those results are stored in your secure account, ready when you need them. If you have a head injury, visit your doctor and share your baseline results. Your doctor may ask you to repeat the test, in order to compare those results with your baseline. This will help in deciding your recovery process.
Under Dr. Moriarity’s supervision, every Notre Dame athlete has an up-to-date baseline test on record. It’s a precautionary measure that keeps these top-tier athletes from returning to play too early and risking more severe consequences.
Some of the effects of concussions are still being debated. What do we know for sure about the short and long-term effects of head injury? What about returning to play too early after a concussion?
According to Dr. Moriarity, “The only thing we know for sure is that we need more information.” Every concussion is unique and individual so it’s often difficult to create overarching guidelines.
Dr. Moriarity told us that by definition, a concussion should be both short-term and reversible. A single concussion does not have to cause any permanent damage. That being said, the length of symptoms is variable. Acute symptoms may resolve in a few hours, while lingering effects can still be felt 5-10 days after injury. But in a world where most things are still unsure, there is one clear point: If a player suffers a concussion, he/she should be removed from play immediately and evaluated.
One of the best ways to protect yourself is to avoid returning to practice or games before you’re ready. This can prolong your symptoms, especially if you exercise within 48 hours of your concussion. There’s no getting around it. Unlike most of these concussion questions, this result is tested and proven. Accelerating your rehab can impair your recovery. But since it is also true that you should avoid no activity at all, a small amount of light exercise is the best option to get you back quickly and safely.
We’ve been hearing more and more about concussions in sports news lately. Is there an actual increase in their frequency or is this interest caused by something else?
Dr. Moriarity was quite certain that there has not been an increase in the number of concussions recently. He believes this attention is partially from our ability to better investigate and diagnose them in this day and age.
To read more of our interview with Dr. Moriarity, including Division I tips for recovery, check out Part 2 coming this week.
Back in April, we introduced you to Axon Sports and its online tool for managing athletes’ concussions. Now, with the summer in full swing, we not only have club sports and camps to think about, but also the fall sports season that is just around the corner. Eastbay and Axon Sports have done a little teaming-up of our own this summer to make sure that you’re prepared for your upcoming sports seasons with our top reasons to get a Baseline test.
#1 Just because you can’t see it, doesn’t mean it’s not there.
The primary purpose of the Baseline test is to measure what neither you nor a physician can see—changes in brain function. Once there is a baseline measurement for your personal functioning levels, it’ll be possible to measure any change in cognition due to injury, whether or not you’re noticing obvious symptoms. It takes some of the guesswork out of managing concussions and lets you get back to the game as soon as you’re back to your normal, baseline level.
#2 It goes with you, home or on the road.
The nice thing about a Baseline test with Axon Sports specifically is that your results are stored in your secure account on the Axon Sports website, so that instead of being trapped in a physician’s office, they’re accessible to you. No matter what sport, season or location, your test results are there with you. Plus, your test results are stored for a minimum of 15 years. They’re guaranteed to be at your disposal through club sports, school seasons, summer camps and everywhere in between.
#3 The most valuable part of the game isn’t 100% protected.
No piece of equipment out there can fully protect an athlete from sustaining a concussion. We’ve seen this proven even recently. Green Bay Packers’ quarterback Aaron Rodgers suffered a concussion last December and it wasn’t his first. He was clearly disoriented immediately following the impact and there was discussion all the way into February on if/how these injuries would affect his Super Bowl play. Even more shocking, was the May 18th game when New York Yankees outfielder Chris Dickerson took a fastball to the head. The pitch was enough to crack his helmet and drop Dickerson to the dirt. He returned to play a few days later, only after examination by a neurologist.
Of course, no player would consider competing without the necessary equipment. Equipment standards have come a long way and are continuing to make players safer. But while equipment regulations are changing, it’s a slow process, and as of yet, we still haven’t seen any sport with completely concussion-proof helmets.
#4 Multiple injuries can sideline your career.
Without a Baseline test and another test after injury, it’s always a possibility that an athlete will return to the game too soon. At that point, he or she is at risk of being injured again, when the brain is not fully healed. We’re seeing it discussed more and more as big-time athletes rack up injuries, some to the point of forcing early retirement. One concussion is rarely permanent, but repeated injury, especially on top of a still-healing brain, could put your sports career in jeopardy. And it’s happening at earlier and earlier ages. Student athletes who return too quickly can be left with not only a career that ended prematurely, but also difficulties in the classroom and with exercise in general. A Baseline test allows you and your team to be sure your condition is stable enough to return.
#5 Do it like the best do.
As athletes get faster and stronger, the competition gets more intense. Professional sports have already implemented rules on treating concussions and preventing head-related fouls. The NFL is releasing new guidelines for the 2011 season aimed at determining when an athlete is ready to return after a head injury. And that movement has been starting to trickle down to college organizations like the NCAA, who is now giving their recommendation to concussion testing as well. Even high school level concussion rates have doubled in the last decade, but it may be years before schools take the initiative to get players tested at a national level. At this point, athletes are getting more serious, and so is the injury risk. Getting a Baseline test is part of taking your game, as well as the future of your career, seriously.
If you’re ready to get started, sign up with Axon Sports.
In the NBA, athletes like Chris Paul, Monta Ellis and Ron Artest are arguably are some of the most talented players in the game. In the NFL, Steve Young, Brett Favre, Aaron Rodgers and Tim Tebow, are the top quarterbacks of the past, present, and future. In the NHL, Marian Gaborik and Sidney Crosby are a couple of the top scorers in the league. Aside from being some of the best at their respective sports, all of these have one thing in common that is often forgotten after the stat sheet is filled. Each of these athletes has suffered a concussion, and for some it’s happened more times than once.
In recent weeks even, there has been another Hall-of-Fame quarterback speak up about the long-term dangers of concussions. Terry Bradshaw, who is now 62 years old, seems to be suffering some long-term effects that he believes is due to the six (known) concussions he suffered during is legendary career. There is no doubt that he, along with countless other athletes at every level of competitive sports, suffered more than what is accounted for.
A concussion is an alteration in brain function that is typically temporary. It can show in many different ways, such as short term memory loss, headaches, and other physical symptoms like impaired vision, speech, or thinking. There is no doubt that concussions should be a serious concern for athletes, parents, and coaches. How to identify and manage them in athletes, however, can be even more difficult to understand than concussions themselves.
Axon Sports has created a simple online tool used in the management of sports-related concussions. It is called the Axon Sports Computerized Cognitive Assessment Tool (CCAT). Athletes establish Baseline or “snapshots” of their brains’ speed and accuracy. Repeating the same tasks After Injury helps identify any cognitive changes from the Baseline, which when interpreted by a qualified medical provider can be invaluable information. It takes only a short amount of time to take your first ‘Baseline’ test which, depending on whether you’re an athlete, parent, or coach, can be shared and organized in a variety of ways. For instance, coaches can group their athletes together by team if they wanted to do so, by creating a group for each team and adding their athletes to the group, and making it easy to find and reference when needed. Axon makes it easy to share the results with coaching staff, athletes or family as well, by simply adding an email address to the list and sending an Easy Link of the results to whomever needs it.
After I registered for my account on www.axonsports.com, it took me about ten minutes to go through my baseline test. By the time I clicked out of the testing window my results were compiled and waiting for me. It’s interesting to see the results from the various tasks that are measured, including Processing Speed, Attention, Learning and Working Memory. The system is easy to use and very straightforward. My one suggestion would be to make sure you are free from distractions. A cell phone, TV, radio or people around you are much more distracting than you might think.
For coaches and parents, Axon Sports has set up everything right to provide an easy and effective way to keep up with your children, students and young athletes. For athletes themselves, the results are intriguing and a helpful way for you to not only learn about yourself, but make sure you are prepared before competing. The Axon Sports mission of protecting and training the athletic brain and the Concussion Testing is a great resource to help keep athletes safe, on the right track, and by sharing the results with your medical provider you can use it to better understand an athlete’s cognitive function.