A new report from Michigan State University shows just how long it takes high school athletes to recover from concussions, also known as “silent injuries”.
Both male and female players from all sports can get them and everyone recovers differently.
“Not every athlete is going to have the same timeline,” said Abigail Bretzin, a post-doctoral research fellow at the University of Pennsylvania.
Bretzin got her Ph.D. at Michigan State and took part in a recent study looking at concussions. She helped analyze and interpret the data involving high school athletes in Michigan.
The MSU study in the Journal of Athletic Training looked at roughly four years of data from 2015 through 2019.
Concussion reports from administrators, coaches and athletic trainers, showed recovery trends among high school athletes.
“Our overall finding was athletes took a median of 11 days to recover,” said Bretzin. “So, about half of them took shorter than that – and half of the athletes took longer than 11 days to recover.”
In the past, the recovery was thought to take 7 to 10 days. Some can take more than two weeks.
“If you think about different sports like swimming and diving, if you think about gymnastics and soccer, all those concussions are going to happen in different ways and that can also influence their recovery outcomes,” said Bretzin, “and so we have to be inclusive about how we think about males and recover and females and how they recover and how they occur, the mechanism that cause the injury.”
Bretzin also co-authored this report showing girls and young women have an increased risk of concussion. They looked at more than 80,000 Michigan athletes who played soccer.
“There’s many different reasons that are being explored for that – from anything that we’re born with as males and females in our anatomy – access to care – so there’s a lot of different things being explored between males and females and so I think that’s important to look at as researchers and clinicians,” she said.
CONSTANTLY CHANGING FIELD
“This is a field that is constantly evolving and we’re learning something new every day,” said Dr. Michael Lawrence, Division Chief of Neuropsychology for Spectrum Health.
He’s part of the NFL concussion lawsuit settlement and works with the Redwings and Griffins – focusing the last 15 years on concussions.
“And I can tell you that I’ve cleared athletes that have 15-20 of these and I’ve seen athletes that have one to two and I say, ‘you should never play again,’” said Lawrence.
Dr. Lawrence works at Spectrum’s Concussion Clinic which has been operating now for 10 years assessing athletes and their conditions.
“What we know and what is challenging about concussions is only about 10% of athletes blackout,” said Lawrence. “Those 10% are easy. We know that they had a concussion. It’s the other 90% that are more challenging.”
The only way to diagnose concussions is through detailed clinical interviews. Blood tests and imaging can’t detect it, so doctors have to rely solely on patients and their symptoms.
“So, the energy demand is extensive and because of that, like a car, your brain enters overdrive it runs out of gas and that’s why the most common symptom with concussion is fatigue,” said Lawrence. “Athletes tend to be exhausted and want to sleep. You can also have symptoms like headache, dizziness, light and noise sensitivity, sleep problems, irritability, imbalance, and emotional changes.”
Most people may think about men and football or wrestling when it comes to concussions, but female athletes get them too and often take more time to recover.
“Part of that we think is related to just chemistry,” said Lawrence. “Part of that we think is related to body development. And so, what we see in sports is, especially for female, soccer, gymnastics, and cheerleading tend to be high concussion sports and part of this is because the danger of hitting your head but also whiplash-type effect.”
The state of Michigan mandates a five-day return to play protocol. It’s the same standards used for pro and college athletes, and they don’t start until the athlete is asymptomatic at rest.
MHSAA CONCUSSION RULES
According to the Michigan High School Athletic Association, roughly 175,000 athletes compete across the state every school year.
Head injury reports have been mandated since 2015 and all schools have to submit them for tracking.
They have to include the sport being played if the athlete is freshman, JV or varsity, and if the injury happened during practice or competition.
During the first five years of the study, there were 18,627 head injury reports.
Students have to be released by a medical provider.
If they’re not and they still play, they’ll forfeit the competitions and be ineligible. Athletic programs are also placed on probation for that and eventually can be barred from future tournaments, suspended or be expelled from MHSAA membership.
“And what we know is, athletes lie and part of that is because athletes want to compete and then there’s pressure,” said Lawrence. “There’s pressure from coaches, sometimes there’s pressure from parents, sometimes there’s pressure from peers.”
As much as athletes may want to play, it’s key to pay attention to the warning signs.
“Most often you’re going to recover from your concussion so that’s awesome news,” said Bretzin. “But there is chances that some athletes will have longer recovery times after they experience a concussion.”
Dr. Lawrence says, “when in doubt, sit out”.
Most of the time the best treatment for concussions over the first 48 hours is to rest and sit in a dark room.
You don’t always need to go to the ER.
But, he says if athletes are sleeping and their parents can’t wake them, vomiting multiple times, or if their mental status starts to decrease – that’s when a trip to the emergency room is encouraged.
It’s also important that athletic trainers and coaches watch out for signs as well.