May 8, 2009
It’s not uncommon to witness an athlete take a blow to the head. It’s also common to see the same athlete return to the field or court mere minutes after being cleared for visible trauma.
Whether it’s football, soccer, skiing, snowboarding or any other sport, many athletes view concussions as an inherent risk of playing the game. Even some parents and coaches share the mentality that hitting your head isn’t a big deal.
However, according to Melinda Roalstad, MS, PAC, a physician’s assistant at the Coalville Health Center, there are serious risks and long-term effects associated with sustaining concussions, especially for athletes under the age of 21. Second Impact Syndrome occurs in athletes who have not completely recovered from a previous concussion. The second injury can be very mild and may not even involve head trauma, but can cause the brain to swell rapidly, resulting in severe disability or death.
Furthermore, Roalstad adds, effects of multiple concussions are cumulative, and may include memory loss, mental and cognitive defects, and early onset of dementia and Alzheimer’s. An athlete with one concussion is four to six times more likely to sustain a second concussion.
On Tuesday, Roalstad presented new technology regarding concussion management to a group of local coaches, trainers, parents and community members.
Roalstad started working as a physiologist with members of the U.S. Ski Team in 1991 and later became the medical director. One of the major issues she encountered while working with the team was determining when it was appropriate to allow concussed athletes to resume training.
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Concussions are one of the most common medical problems among youth athletes, but they are difficult to diagnose and therefore often go untreated, Roalstad explained. Traditional tests such as CTs, MRIs and EEGs do not detect the subtleties of concussions. New tools have been developed to help evaluate concussions and take the guesswork out of return-to-play decisions.
In 2003, Roalstad become certified to use ImPACT neurocognitive testing and she implemented the program with USSA skiers and snowboarders. ImPACT is computer software that helps diagnose concussions, provides information on the severity of the injury and evaluates an athlete’s recovery post-injury so that they may return to the game within an appropriate timeframe.
In the past few years, Roalstad has helped programs around the state begin concussion management programs. Park City is one of the few areas that has not established concussion protocol within its high school or club teams, she said
"There’s a total shift in how we think about this injury," Roalstad said. "I think [neurocognitive testing] will become a standard of care."
With the ImPACT program, athletes would undergo baseline neurocognitive testing, preferably before their season begins. Then, if an athlete does sustain a head injury, the coaches/trainers complete an on-field assessment and follow concussion management guidelines to determine if post-injury ImPACT screening would be advantageous.
Baseline testing is generally not covered by insurance, and costs approximately $30 per athlete in a group setting. Post-injury screening is covered by insurance and may be conducted online from any location. ImPACT is applicable for kids ages 10 and up, and Roalstad says it has been useful for kids as young as seven.
"It’s easy to implement, it’s easy to repeat I think it’s one of the best tools out there that is substantiated by research," she said.
Michelle Demschar’s son, Dominic, a 16-year-old alpine ski racer with the Park City Ski Team, sustained his fourth concussion this past winter. The Demschars were familiar with the ImPACT program and Dominic had completed baseline testing prior to the injury. He was retested and the results showed the areas where his brain was not functioning as it should be.
"As parents, we’re all worried about them breaking their legs and arms, but they mend their brain can affect them for the rest of their lives," Michelle says. "[The testing] is convenient, you can do it from home — I cannot believe that everyone’s not racing out to do this."
For more information about ImPACT and other forms of concussion management, contact Melinda Roalstad at (435) 640-6497 or email@example.com , or contact the Think Head First Concussion Management Program at the Coalville Health Center at (435) 336-4403.