Concussion Controversy: All About Recognition


Carly Mattson PT, DPT, OCS and a physical therapy aide demonstrate standard concussion cognitive testing. Photo by Elisabeth Oster.

Elisabeth Oster, Senior Staff Writer

In the media and sports world, there is a puzzling mystery surrounding the state of concussions. Rates of concussions are on the rise—at the same time, hundreds of organizations and thousands of medical professionals are working to increase awareness and prevention measures.
According to Tria Physical Therapist Carly Mattson, PT, DPT, OCS, a concussion is either caused by an injury or impact to the head or neck. Though it was once believed that concussions always caused unconsciousness, that is not always the case, Mattson said.
“A concussion can manifest itself in a lot of different ways. The athlete could feel nauseous after the first impact—headaches, light-headedness, and dizziness,” said Mattson. “Some people can also feel relatively okay afterward, but several hours later one can feel symptoms too.”
“The greatest effect concussions have had on me is memory loss. Amnesia is a scary experience,” said Ben Utecht, former tight end for the Indianapolis Colts, the Cincinnati Bengals and the Minnesota Golden Gophers.
Utecht has had five diagnosed concussions, but he said he most likely had many more.
Although there is not enough research to show the exact effects of multiple concussions, it has been proven that an athlete that has not fully recovered from a previous concussion is more susceptible to a concussion from a low-impact injury.
Mattson believes there is “definitely more awareness” rather than an increase in incidence of the injury.
“I think we are really starting to think about how we can protect our youth, athletes, pro-sport athletes, and people in general so that they can return to what they want to do. When we know how to manage it, we’re are not just avoiding the topic and setting them up for re-injury,” Mattson said.
Trent Christensen, MD, CAQ, a Sports Medicine Specialist at Sports and Orthopaedic Specialists, said he felt that there is more awareness of concussions, causing an increase in reported concussions.
“Likely the increase in the number of diagnosed concussions is a result of an improved ability to recognize symptoms of concussion by athletes, parents, and medical professionals,” Christensen said.
“More awareness will change how we play sports by making them even safer,” Mattson said. “I think it will also create a focus on research so that we can have more answers to determine how many concussions is too many and what the best protocol is for rehabilitation.”
Football and hockey are the sports that cause the most concussions. Swimming and soccer are high on the list as well, according to Mattson and Christensen.
According to Christensen, both media and healthcare are responsible for the improvement in awareness.
“My message has always been: ‘pro-brain, pro-game,’” said Utecht. “We need to continue celebrating sports while making the brain priority number one.”
Minnesota Statute 121A.323 (2011) put into place information and training detailing the risks of concussions, signs, symptoms, and behaviors consistent with concussions, and the proper medical direction that must be taken before an athlete returns to play.
Mattson suggested the most important prevention method is simply playing smart, but there are other simple improvements that reduce concussion susceptibility.
“Ensuring proper fitting of equipment, correct hitting/tackling techniques, and enforcing game rules can all decrease the risk of getting a concussion,” said Christensen.
“I think becoming more educated and aware of what a concussion is and what to do if you or someone you know has a concussion will greatly help,” said Utecht.
According to the Wayzata Football Website, when a concussion is suspected the athlete is first removed from play and signs and symptoms are looked for.
Info must then be recorded for a healthcare professional to evaluate the athlete, including the cause of injury, any loss of consciousness, memory loss, seizures, and the number of previous concussions. The athlete is treated accordingly and does not return to play until approved by a medical professional.
“People recovering from a concussion need both physical and cognitive rest while symptomatic from the injury. It is important not to practice while experiencing symptoms of a concussion,” said Christensen. “Usually concussions do not affect athletes later in life. Rarely, repeated concussions may lead to depression, memory issues, and neurologic diseases later,” Christensen said.
According to Mattson, the majority of people fully recover in 2-3 weeks, but there are special cases. In order to determine if an athlete has fully recovered, a psychological assessment is taken to test cognitive skills before and after treatment.
Youth athletes require a significantly longer time to recover from a concussion, according to Christensen.
“Sometimes people don’t know what to do or don’t recognize the concussion so they send that person back in [the game]. That person is more at risk for a worse situation,” Mattson said. “Recognizing and understanding the assessment of concussions and treating that appropriately has to be practiced in sports.”
“Concussions are an externality of contact sports so there really is no way to stop them. This is why we need to be educated so that we can make smart decisions for our brain health if in fact you ever face a concussion,” Utecht said. “Make sure to be forthcoming if you ever face a concussion,” said Utecht. “It is not an injury that you want to hide.”