received a head injury. The test involves a section the athlete
fills out on post-concussion symptoms, grading them from 0
(none) to 6 (severe). The second part is filled out by a qualified
healthcare professional. It involves scoring signs and symptoms,
cognitive assessment and neurologic screening and, finally, a
return-to-play recommendation. Examples of these tests can
be found on the Internet.
So, why are adolescents having an increase in concussions?
First and foremost is the increased level of competition. Today,
most parents want their children to grow up healthy and happy.
But, with the influence of increased pressure to participate and
win, we have a tendency to overlook the environment in which
we may be placing our children. Another consideration is the
lack of properly trained healthcare professionals at adolescent events. Think of how many coaches there are for youth
programs. Typically, they are moms and dads who want to be
involved with their children, but who may know little to nothing
about proper mechanics of the sport or have no training in first
aid and CPR. Many youth organizations are starting to change
this and make it mandatory for all coaches to have training in
first aid and CPR, and it’s more common to have a defibrillator
as part of the equipment mandated at events.
We mentioned that forces can be transmitted to the brain.
We know that the heel-strike portion of the gait cycle produces
transmitted forces that can travel the length of the neuromus-
culoskeletal system. To help improve these forces, you can:
recommend the use of custom-made orthotics, make sure that
the foot is going through a normal biomechanical heel-to-toe
transition, and recommend the use of a good athletic shoe to
help absorb and distribute shock. The use of mouth protectors
has also been considered in helping reduce forces transmitted
to the brain.
A 1980 graduate of Palmer College of Chiropractic,
Dr. Kirk Lee is a member of the Palmer College of Chiropractic Post Graduate Faculty and Parker College of
Chiropractic Post Graduate Faculty. He has lectured
nationwide on sports injuries and the adolescent athlete,
and currently practices in Albion, Michigan.
1. Consensus Statement on Concussion in Sport, 3rd International Conference on Concussion in Sport, Nov 2008, Clin
J Sport Med 2009; 19:185-200 TAC
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