Video: ReThinking Concussions – Who’s at Risk? (Part 4)
Experts at the UPMC Sports Medicine Concussion Program can explain why some concussion patients suffer prolonged symptoms lasting weeks or even months, while other patients recover more quickly. There are some pre-existing conditions that increase your chances of sustaining a concussion and/or having a longer recovery than most. Hannah Storm and Dr. Micky Collins discuss these risk factors and more in this video.
Read the full transcript from ReThinking Concussions: Who’s at Risk, with Hannah Storm and Micky Collins, PhD:
Hannah Storm: Do you have an example of an athlete that people watching this might recognize, that has been here, that came in with a measure of despair maybe about their condition that was able to be healed?
Dr. Collins: Yeah, I mean there’s a lot of cases that have come through here across a lot of different sports and, I’m not going to get into specific names, but we have patients whose, their livelihoods have been affected by this and they’re having significant, more than their livelihood, they don’t feel well. And they’re having chronic problems with their thinking, and headaches, and sleep, and dizziness, and vision changes, and problems that no one would ever want to go through. What’s amazing is the patients that come in there feeling those things, once we get them in the right treatments and match the right problem to the right protocol, and we take an active approach to this, what’s so fulfilling to me is as a clinician is the end of that, when they’re feeling normal. Them looking at you and saying, “Wow, what a ride that’s been”, because I think a lot of them don’t realize there’s treatments and there are. And to have that influence on a patient is very powerful and is something we take a lot of pride in here at UPMC.
Hannah Storm: Well we’ve talked a lot about the amount of fear that’s associated with concussions. Why do you think that is?
Dr. Collins: I think the conversations are focused right now on what are the potential long term effects of this injury. Whereas I think we need to talk about the fact that we actually understand now that this injury is, can present in very specific ways, and we have specific treatments to get patients better. I think if people focus more on that, there wouldn’t be as much fear. And if you can have patients come through here and actually see their child get better, there’s a confidence in getting kids back to play safely that happens all the time here. Kids get back to the sports they love and parents feel good about it because they’ve been treated the right way.
Hannah Storm: Football is the sport that’s always top of mind when you talk about concussions. In realty, what sports do you see the most?
Dr. Collins: You know, we’re in the middle of football season here and I think I saw 20 something patients this morning so far and I think only maybe two or three football players.
Hannah Storm: Wow, what about the rest?
Dr. Collins: A lot of soccer.
Hannah Storm: Soccer.
Dr. Collins: A lot of basketball, a lot of hockey. You can get concussed in a lot of different ways. If there’s one thing I’ve learned in this job, you can get a head injury in many different ways. We talked about horse riding, we talk about MV, motor vehicle accidents.
Hannah Storm: I got hit by a camera once.
Dr. Collins: There you go. There’s a lot of things that can happen to cause a head injury and I think football for whatever reason, that’s the, a lot of people’s focus right now, but the reality is that this affects kids across all sports and across all recreational activities, you know? I mean, it’s a very common injury. There’s 1.8 to 3.6 million concussions occurring per year in this country.
Hannah Storm: Wow.
Dr. Collins: Yeah.
Hannah Storm: Wow.
Dr. Collins: 1.8 to 3.6.
Hannah Storm: Is it always obvious that it’s a concussion?
Dr. Collins: No, we talk about the vestibular system for example. If that system decompensates, you actually may not see symptoms until the car ride home when they’re in a very demanding vestibular environment, or in a busy environment, you know? So, it’s very tricky to see this in real time in some instances. In some instances it’s easy, they lose consciousness, or their, just major balance problems, and those patients need to be taken out of play obviously. But the kids that, it’s more symptoms than signs and it’s very subtle. It can be very tricky.
Hannah Storm: So, what should parents know if anything seems a little bit off, have them evaluated for a concussion? Or what would be your best advice in that regard?
Dr. Collins: One of my best piece of advice is and many people don’t realize this, but if you have dizziness, you’re 6.4 times more likely than any other symptom to take a month or longer to recover from concussion. It’s the most severe symptom you can have as it relates to outcome, dizziness. You’re actually more likely to have poor outcome than losing consciousness, if you’re dizzy.
Hannah Storm: Wow.
Dr. Collins: Subtleties, dizzy, foggy, feeling detached, obviously headache, nausea, light sensitivity, noise sensitivity, environmental sensitivity, like busy places bothering people, fatigue, cognitive problems, vision problems, any of those signs, or symptoms, could indicate a different type of concussion and you don’t want to play through that stuff. We actually just did a study, where we looked at 160 kids that had symptoms of a concussion, ‘kay? Half the sample, the minute they had that, the second they had that symptom that got recognized, they got taken out of play, half the sample didn’t come out of play, they played on average 22 minutes beyond the point of their symptoms, this group that got taken out of play immediately recovered in 18 days, this group took 44 days. 22 minutes of extra playing time, resulted in a double outcome time. That’s how, you got to be really careful in making sure, you know, when in doubt, sit them out. Make sure kids get out of play, understand the subtleties of the injury, understand things that we just discussed, like the dizziness thing, and be conservative. And then make sure you get to a clinician that knows how to manage this stuff.
Hannah Storm: So, that’s how to rectify that right away, on the field of play, because it can take a while as you said, it might not happen until the car ride home. Are the people who are there, you know, in some kind of medical capacity at these games down in the grade school, and the high school level, what’s the level of education, in terms of concussions? Do we still have a way to go?
Dr. Collins: I think we’re so fortunate here in Western Pennsylvania. We are one of the few places, well, in the country, there’s no better place for athletic trainers than Western Pennsylvania. Every school has one and those people, those professionals are our eyes and ear for the injury, and they’re such an important con to it, to making, because they’re educated in this stuff. Athletic trainers know the subtleties to this. They know how to look at it, they get the kids off the field, and get them into clinic to be seen. So, it does worry me in high schools and schools out there that don’t have athletic trainers. We need professionals that are trained in this stuff to be your front line and to work with places like this to get kids to for treatment. We’re very lucky here in Pittsburgh to have that coverage.