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UPMC/University of Pittsburgh Schools of the Health Sciences
Director
Telephone: 412-586-9771
Michael Collins, Ph.D.

Michael Collins, Ph.D.
Biography

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UPMC Sports Medicine Doctors Caution High School Athletes, Parents And Coaches About Dangers Of Mild Concussions

PITTSBURGH, September 10, 2004 About one in 10 local high school athletes in contact sports will sustain a concussion during this fall sports season. And, many athletes, coaches and parents do not know how serious the effects of a seemingly mild concussion can be. That lack of awareness may result in allowing an athlete to return to play too soon following initial injury, placing him or her in danger of further, more serious injury, according to doctors at the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program.

Our biggest concern is that some people may take the effects of what might appear to be a mild concussion too lightly, said Mark R. Lovell, Ph.D. , a neuropsychologist and director of the UPMC program. Too often we hear people trivialize the injury and refer to it as just a bell ringer or a ding, not realizing its actual severity and that it is not safe to return such athletes to play during that particular game. Dr. Lovell's concerns are based on recent UPMC clinical research showing that even seemingly mild concussions can have long-term serious effects on some of the brain's neurocognitive functions and that the effects of multiple concussions can be cumulative.

We've been seeing 30 to 40 high school athletes each week in our sports concussion clinic during this fall sports season while doing an additional 100 or so consultations by phone with athletic trainers and team or family physicians. And were talking to a lot of concerned parents, said Dr. Lovell, who aren't quite sure of their child's symptoms or when it is safe to allow their child to return to play.

Most important for everyone to know is that the best way to prevent problems with a concussion is to properly manage it from the beginning. Generally, an athlete who sustains an initial concussion can fully recover as long as they do not sustain a second concussion before the brain has had time to heal from the first one. Problems occur when the athlete plays through the symptoms and are not taken out of the game when they should be taken out. Research has shown that returning a mildly-concussed athlete to play too soon before the brain has healed puts him or her at greater risk for a second concussion and more severe, longer-lasting neurocognitive damage, said Dr. Lovell.

We know and respect the fact that competitive athletes want to play through injury, but because the symptoms of mild concussion can be so subtle, we see many athletes who may not realize that, by continuing to play with this injury, they are risking their season or even more by allowing themselves to be more susceptible to further, more serious injury, added Michael Collins, Ph.D., assistant director of the UPMC program. Education and understanding of concussions by athletes, coaches and parents has been poor. That's partly because prior to 2003, there was not one published clinical study concerning concussions in high school athletes, said Dr. Collins. But, since then, the UPMC program has published eight clinical studies examining the effects of concussions specifically in high school athletes.

Here is what Drs. Lovell and Collins say that all high school athletes, coaches and parents need to know about concussions:

A concussion is any change in mental status that results when the brain is violently rocked back and forth inside of the skull due to a blow to the head, neck or upper body. Symptoms may include amnesia, confusion, disorientation, not feeling right, fogginess, headache, nausea, uncoordinated hand-eye movements and, in some cases, loss of consciousness. Symptoms are not always definite and vary in severity and longevity.

An athlete with a suspected concussion should NEVER return to play during the practice session or game at which he or she was injured, no matter how mild the injury appeared and regardless of the severity or longevity of symptoms.

A concussed athlete should NEVER return to practice or play until all symptoms have disappeared and are not present during physical exertion and at rest.

Needed recovery time varies with each individual. Each concussed athlete should be evaluated individually rather than with traditionally used general evaluation and return-to-play guidelines.

An athlete with a suspected concussion should always be evaluated by an athletic trainer, team or family physician, or neuropsychologist before returning to play or practice. Athletes, coaches and parents should never self-diagnose or self-evaluate a concussion, regardless of how mild the injury or symptoms appear to be or to have been.

The student-athletes' teachers should be made aware of the injury as well as the possible lingering effects and symptoms, which also can affect academic abilities, Dr. Lovell said.

The UPMC Sports Medicine Concussion Program is an ongoing clinical service and research program that focuses on the diagnosis, evaluation and management of sports-related concussions in athletes of all levels. Because of the uncertainty surrounding the diagnosis and evaluation of sports-related concussions, UPMC doctors over the past decade have developed the first computerized concussion evaluation tool called ImPACT (Immediate Post-concussion Assessment and Cognitive Testing). ImPACT, the most widely used concussion evaluation system in the world today, objectively measures actual neurocognitive brain function along with reported symptoms to help determine injury severity, recovery and when it is safe to return to play. ImPACT is used by more than 400 high schools, 180 colleges and universities, 18 NFL teams, several major league baseball teams and numerous other organizations.

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