Current essay examines concussions-sport injuries and specifies anatomy of such issues. Pathology of injures is evaluated, as well. Mechanism of the injury and predisposing factors to the injury are determined and the study also evaluates the injury at different stages. Key directions of treatment are also outlined in the paper and the rehabilitation process is analyzed and relevant recommendations are made. The paper also presents approaches to determining the expected recovery time and the essence of neuro-cognitive rehabilitation. The methods of encouraging the patient’s memory, cognitive abilities and attention are specified. The most widespread medication is outlined. Current paper also determines the role of antidepressants, as well as the short- and long-term effects of rehabilitation. The strategy of determining the intensively of activities is outlined and the main risks that may emerge during this process are presented. The study also specifies the significance of psychological factors, as well as the necessity of effective integration. The approaches to evaluating the results of rehabilitation are presented.
Current paper is devoted to the investigation of concussions-sport injuries. Anatomy of the injury should be specified. Sports issues take place in athletic activities and they may be a reason of trauma or significant athletic pressure. Concussions in sport refer to the injury of the brain where some external force disrupts the typical functioning of the brain. Concussions are one of the most significant and dangerous injuries of this kind. Pathology of the injury should be evaluated, as well. Concussions may vary from mild to severe and they negatively affect the productivity and creativity of the brain. Neurophysiological problems may emerge that will cause additional difficulties associated with one’s attention, memory, behavior and planning abilities. Some problems may not be immediately evident for trainers, coaches and parents. Mechanism of the injury and predisposing factors to the injury may be different. Such brain injuries may be caused by a blow to the head that leads to negative effects that cannot be neutralized by one’s internal system. The brain functioning is strongly affected and effective long-term treatment strategies are typically needed. Additional risks are associated with second-impact syndrome that may occur when an individual suffers the second concussion, while some of the consequences of the previous concussion are still present. Such concussion leads to even greater threats and may cause the death of a person in some cases. Although the majority of concussions do not lead to the loss of consciousness, their long-term effects may be highly negative.
Evaluation of the Injury
Concussions should be properly evaluated as it includes both on the field evaluation and off the field one. Additional diagnostic testing is often needed, as well. The initial evaluation of concussions includes the following steps: in relation to obvious head injuries, assessment should begin at the site of injury and all main threats should be determined; if the person is unconscious, cervical spine injuries may be present; then, the neurologic examination of the symptoms should be provided; the need for hospital evaluation should be assessed.
Further evaluation may occur off the field. Some subtle changes that are the result of concussion cannot be properly understood with the help of traditional testing and typical orientation techniques. A deep physical examination of a patient is needed in order to specify the necessary measures. Additional monitoring that investigates the possibility of deterioration during several hours may be reasonable. It is necessary to determine the existing dynamics of the athlete’s key brain characteristics. If the fact of a concussion is determined, he/she should not return to play as it may create higher risks and lead to worse situation.
The hospital evaluation may be even deeper and be based on the use of the latest technologies and assessment tools. One of the most serious questions is determining people who require advanced neuroimaging. Imaging is often used; however, it is not always rational to implement it as neuroimaging per se may not largely contribute to solving of concussion problems. At the same time, in some cases, imaging and other procedures are necessary as they allow understanding the key aspects of problems if the situation is untypical and uncertain. Computed tomography is generally used during the first stage of evaluation as it provides the reliable information that may be used during the subsequent stages of treatment. It is necessary to specify other methods of diagnostic testing that are widespread in the context of concussions. Magnetic resonance imaging (MRI) is also may be used in some cases as it allows specifying the characteristic features of the prolonged problems. It is a medical technique that allows investigating the anatomy and functions of the brain and body (Napadow 172). The functioning under normal conditions and after the disease may be compared. MRI is an effective tool because it offers high-quality visualization of the brain state. It contrasts grey and white matter that allows determining of all relevant aspects. MRI may help to demonstrate a number of anatomical structures and pathologies. The equilibrium state is determined on the basis of interaction of T1 and T2. On this basis, the repetition and echo time is determined. X-rays may also be used in some cases associated with concussions. It is a form of electromagnetic radiation, which may be used for receiving the tomographic images of the brain. On this basis, the relevant conclusions and recommendations can be made. Low-dose ionized radiation may help outline the areas under interest. Some tissue masses are not seen through the conventional X-rays. For this reason, other assessment techniques should be implemented, as well. The comparison of uninjured brain with that after concussion.
The comparison of uninjured brain with that after concussion
Bone scan is widely used in such cases, as well. It refers to a nuclear scanning test that allows determining key abnormalities in bones. The patient is injected with some dose of radioactive materials. Then, he is scanned with a gamma camera. Around 50% of radioactive materials are localized by the human bones. If the significant bone turnover is present, the higher degree of radioactive materials will be seen. All abovementioned assessment techniques should be used in a complex way. They should be adequately integrated that will contribute to the most efficient use of all available resources. In fact, all these techniques may help to examine all relevant aspects of the problem. On this basis, the ultimate treatment strategy may be outlined and realized.
Treatment of the Injury
Treatment of concussions is a very important and significant stage of the entire process. There are some emergent measures that should be realized once the threat for such type of injury has become evident. Emergent measures include splinting, removal from the field, etc. Splinting may be used in those cases when additional significant injuries are present. It may allow immobilization of the person and minimizing pain and other immediate symptoms. Safe transportation may be realized in such way, as well. All sportsmen that are injured should be removed from the field, and doctors should investigate their problems. Until the situation is not clarified, they should not be allowed to participate in the game. After the deep investigation of the issues is provided, the optimal surgical procedures should be determined. In some cases, acute surgical procedures will be sufficient for achieving the desired outcome. However, sub-acute surgical procedures may be necessary in other (more difficult) cases. In fact, the type of treatment should correspond to the previous stages of the problem evaluation. In any case, the concussed brain should enjoy rest for a comparatively long period of time. No physical exercises that may cause higher heart rates are allowed. Such athletes should avoid difficult mental work that requires additional concentration. The period of complete brain rest may be introduced in order to restore the strengths and the physical and mental potential of the person. Symptoms that should be addressed in the process of treatment.
Symptoms that should be addressed in the process of treatment
As the brain activities improve, the cognitive abilities may become closer to the normal level for the given individual. Only when the brain demonstrates high productivity and necessary abilities in the state of rest, some training procedures may be introduced. If concussions are typical and do not have any complementary symptoms, 7-14 days may be enough for the complete recovery. If the cases are difficult, much more time and efforts may be needed in order to restore the person’s health potential. Some severe traumas may not allow the individual to enjoy the previous level of mental abilities even after the long-term treatment.
Even in the case when situation seems to be typical, it is necessary to be alert to subsequent symptoms. If the state of brain changes the treatment techniques should be modified accordingly. The most common symptom that requires medication is post-concussion headache. The characteristics of headache are usually similar to that experienced before the trauma. They may be primarily attributed to myofascial injuries and muscle spasms that may emerge during the sports activities. Statistical research demonstrates that individuals that had concussions in the past are more likely to experience them in the future (Johnson 49). At the same time, it is generally recognized that the key to successful treatment is preventive measures. If all of them are timely taken, then the possibility of negative outcomes tends to be minimal. Depressive symptoms may also be present in such cases. For this reason, cognition, mood, general and visual somatic symptoms should be evaluated. It is possible to determine the effects of actual treatment processes on all these groups of factors. Then, such results may be summarized and systematized (Nerrmann et al. 181). People with concussions should be treated differently in comparison with those who experience only depression. The feelings of frustration and impatience may be present especially among those groups of people who have not been faced with concussions before. Therefore, the psychological part of the treatment process is crucial, as well. It may allow integrating all internal resources of patients. In this way, the potential of the person in dealing with his health issues will increase. Thus, the patient should not be viewed as a merely passive recipient of treatment; all his internal reserves should be encouraged.
Rehabilitation of the Injury
Rehabilitation in a broad sense includes the period from time of injury and to return to sport. The rehabilitation process is directly related to the clinician’s ability to select the optimal option among different conditions associated with the post-concussion syndrome. It is generally recognized that a period of cognitive rest is necessary for the effective implementation of the rehabilitation objectives. However, the period of rest should be correctly chosen as prolonged rest may lead to additional psychological problems, such as reactive depression and fatigue (Leddy et al. 150). It is necessary to forecast the expected recovery time; compensatory strategies should be selected accordingly. Neuro-cognitive rehabilitation should include specific tasks that may encourage the cognitive abilities of the patient, as well as his/her memory, attention and overall functioning and performance. Although medication is widely used at this stage, there are no 100% evidences that medication contributes to faster or more efficient results of rehabilitation (Leddy et al. 150). Antidepressants may be used in order to minimize the negative psychological effects in the short run. The upper cervical spine has the largest risks of receiving significant traumas associated with sports activities as it is the most flexible element. Numerous post-traumatic symptoms and problems may originate in this context. Physiologic disequilibrium may be often present in such cases. The activities in this period should be adequate to the mental and physical state of the patient. In this way, the recovery process may be promoted and optimized. Concussed patients may demonstrate the highest rates of progress if their recovery is organized in a stepwise way. In the beginning, the person should enjoy a complete rest; then, some aerobic activities may be introduced. Aerobic activities may include different actions, which depend on the stage of the process. Such activities may differ from stationary cycling and walking to work-specific and training activities. They may be included as such patients are very responsive to sport-related activities that may lead to the positive results in the sphere of their psychology. Rehabilitation and functional progression are two aspects of the same process. It is important to encourage one’s internal forces and evaluate the progress. On the basis of individual characteristics, some modifications to the initial strategy may be done. Functional bracing may be introduced in order to determine the optimal pattern of rehabilitation for the given person. Statistical information and regression analysis may be used for the determining the general and average tendencies within the given group of sportsmen. At the same time, every individual should be viewed as a unique person and no unrealistic assumptions or over-generalizations can be made.
The rehabilitation process
The rehabilitation in a broad sense should include some educational aspects. In particular, it is important to explain the theoretical foundation of such problems prevention. Some strategic and tactical issues may be explained that are supposed to minimize risks in the future (Alsalaheen 90). However, the professional sport is characterized by numerous threats that cannot be effectively addressed by any form of education. The rehabilitation process may face additional difficulties in case if multiple concussions may be observed. Cognitive problems may emerge if the person has no experience in dealing with such situations. Therefore, the psychological factors should be addressed during the first stage of rehabilitation and treatment. Multiple concussions may create additional difficulties because such situation may not be adequately presented as a mere sum of effects of different concussions. The human body and brain perceive all aspects as the components of the integrated process. Therefore, both medication and physical exercises should address the same issues in a complex way. If the plan of rehabilitation is implemented in accordance with previously agreed plans, the intensity of physical and mental activities may be gradually increased. Thus, running and biking may be used at following stages. Then, moderate non-contact activities may be implemented. In particular, sprinting may be the optimal option for the majority of sportsmen. Then, some types of contact activities may be introduced. However, all of them should be adequately controlled and evaluated. The final stage of rehabilitation should allow full participation in usual sports activities for the given sportsman.
Conclusion
Concussions are very widespread among modern sportsmen. Such injuries constitute significant problems for their treatment and rehabilitation as they include numerous physical and mental issues that should be adequately addressed. The evaluation of the injury may include a number of stages. In the beginning, on the field evaluation should take place and the general situation should be understood. Then, off the field evaluation may be provided in order to specify all relevant aspects of the injury. A number of sophisticated techniques related to diagnostic testing include MRI, X-rays, Bone scan, etc. Treatment of the injury includes emergent measures, such as splinting, removal from the field, etc., as well as acute and sub-acute surgical procedures. No physical exercises and mental activities are allowed during the first stage of treatment. The period of rest should be significant in order to restore one’s physical and mental potential. The feelings of frustration and impatience may exist among those athletes who cannot psychologically absorb all effects of the situation. Therefore, the psychological influence is very important for the long-term positive effects. The rehabilitation progress should encourage people’s functional progression. The intensity of physical and mental activities should depend on the stage of rehabilitation and the state of the sportsman. On this basis, the optimal rehabilitation strategy may be determined.
