The first two installments of this “Concussions in Lacrosse” series detailed what a concussion really is and why we should care about them. We covered a number of potential consequences of concussions (Post-Concussion Syndrome, Second Impact Syndrome and Chronic Traumatic Encephalopathy) to outline why it is important to pay attention to them and protect ourselves.
Photo Credit: Tommy Gilligan
In this third and final post, I am going to address what we should do about concussions as lacrosse players, teammates, coaches, and parents, to decrease the likelihood of further injury and/or long-term consequences.
First and foremost, there are a few things we can do to limit or prevent concussions. An obvious solution is to limit exposure to head hits. This idea has gained steam in football leagues at all levels, where the NFL and certain NCAA conferences like the Ivy League and Pac-12 have limited the number of full contact practice days. Another is to teach proper hitting technique, which has been implemented with programs like Heads Up Football and can certainly be applied to youth and high school lacrosse leagues. In lacrosse, this means staying on your feet and leading with the hands or shoulder, rather than with your head (which should get you a spearing penalty anyways). It is already a topic that US Lacrosse is talking about.
A common myth in lacrosse, and other contact sports, is that there are certain “concussion proof” helmets or that some gear is better-suited to prevent concussions. A study recently presented at the American Academy of Pediatrics (AAP) National Conference and Exhibition reported that no specific brand of football helmet or mouth guard led to fewer concussions in kids that used them. Though I have not seen this type of study done specifically for lacrosse, the message still applies – no helmet is going to stop concussions altogether. Therefore, we simply must know how to manage them effectively.
It starts on the field with the athlete. Players who think they have sustained a concussion in a game or practice must be immediately removed from play and be evaluated on the sideline. I know, as much as anyone, that it can be extremely difficult to remove yourself from an important game, but if you keep playing after a concussion, you risk further injury because you are more prone to subsequent concussions. Additional injury can prolong your recovery time and result in even more missed games. Even worse, you are putting yourself at risk for Second Impact Syndrome, which can cause permanent disability or death.
I mentioned in part two of this series that the best thing we can do for ourselves after a concussion is to rest until all symptoms have cleared, including those that resurface with strenuous mental or physical activity. This means that you should not return to your sport until you can consistently exercise with absolutely no symptoms (including headaches, dizziness, blurred vision, vomiting, or difficulty concentrating or remembering). It also means that student-athletes often need time to recover before returning to the classroom where reading, thinking, watching projectors, or just hearing the loud noise of a school hallway can stir up concussion symptoms.
Neurosurgeon and concussion guru Dr. Robert Cantu’s Return to Play Guidelines:
*No headache, dizziness, or impaired orientation, concentration, or memory during rest or exertion.
After experiencing a concussion and sitting out from practices or games, it can be difficult to stand up to coaches or teammates if you are not ready to return to play. There is constant pressure to get back out there for your team. This pressure can lead to players lying to themselves or others about their conditions. In some cases, athletes may even be cleared to play by athletic trainers or physicians before all of their symptoms have subsided. In the event that you are still not symptom-free, and therefore not ready to return, here are some things you can tell coaches, parents, or teammates:
“I still don’t feel ready for full contact.”
“Since that hit, I’m still feeling/experiencing [symptoms]…”
“I want to recover now so I’ll be 100% for the playoffs.”
In reality, only you know when you are symptom-free and feeling ready to go. However, teammates play an important role in looking out for each other in light of concussions. As I mentioned before, it can be hard to pull yourself out of a game if you think you’ve had a concussion. Therefore, as a teammate of someone you think might have had a concussion, it is imperative that you report it to your coach or athletic trainer, now that you know they should not stay on the field.
For example, if your fellow defenseman takes a hit and on the next play can not remember a slide package or an assigned matchup, they might be having confusion or short-term memory loss from a concussion. In that scenario, it is better for their health, AND for your team’s success, to tell someone and get them off of the field.
Similarly, the protection of our athletes is a responsibility shared by coaches and parents. As a coach, if you have a player who you think has had a concussion in a game or practice, you need to get them off of the field for evaluation whether they say they are okay or not. Before an athlete returns to play after sitting out with a concussion (whether it’s a matter of days, weeks, or months), you should also ask him/her about how they are feeling. It is worth it to preserve that player’s health and make sure they can perform at their full potential before putting them back in.
The same goes for parents. You can be attentive to your child’s physical, cognitive, behavioral, and emotional state and detect any concerning differences – probably better than anyone else in their life. If something seems off and you think they might have suffered a concussion, talk to them about it and have a medical professional examine them. As adults, parents can also stand up to coaches when a player is being pressured to return before they are ready – that can make a huge difference.
The bottom line is we do not completely understand concussions or have the ability to prevent them in the sport of lacrosse. We do know that the best things you can do as a concussed player are to remove yourself from play, tell a coach/athletic trainer/parent/teammate, get examined by a doctor, and give yourself physical and mental rest before returning. Rest is the only way to let your brain recover (that we know of now), prevent long-term consequences, and assure that you can continue to carry on our beautiful tradition of lacrosse.
The structure of this concussion series was based on the Sports Legacy Institute Community Educators (SLICE) presentation, which provides kids with interactive concussion education through a number of national chapters. If you are interested in learning more about SLICE, having SLICE present at your school/organization, or launching a SLICE chapter in your area, please visit the link below: