Why multiple concussions in sports are dangerous

Fredy Revilla, MD

Neurology

When the game is on the line, athletes might be hesitant to sit out because of a concussion. Is the risk of playing after “getting your bell rung” really that great? Neurologist Fredy Revilla, MD, explained what can happen if a concussion is not allowed to heal before returning to play – and why multiple concussions in sports are dangerous.

What happens if you have a concussion and continue playing?

A concussion is a traumatic brain injury, which can cause brain problems if not treated appropriately. “It can cause lesions in the brain that can be detected by a CAT scan or MRI,” Dr. Revilla said. “We also have learned that even when the imaging studies are normal, concussions can have some consequences at the cellular level in the brain. Most importantly, we have also learned that repeated blows to the head, even if they are considered relatively minor, can have long-term consequences in the brain and in the cognitive function of the person.”

This condition, called chronic traumatic encephalopathy, or CTE, causes chronic problems in the brain over time. Symptoms include behavioral issues, personality changes, mood abnormalities and cognitive dysfunction, sometimes even leading to a diagnosis of dementia.

There’s also the danger of a more serious condition, called second impact syndrome, which occurs when there’s a second hit to the head before the first one has completely healed.

“Even if the second injury is less severe, a person may suffer more because there are changes at the cellular level,” Dr. Revilla said. “This can result in brain swelling that is not easy to detect through imaging.”

How can these conditions be prevented?

“Protocols for identifying concussions need to be in place and respected,” Dr. Revilla said.

This involves looking for potential symptoms, such as:

• Headache
• Dizziness or seeing double
• Sensitivity to light
• Nausea
• Mood or personality changes

If symptoms aren’t obvious but the athletic trainer suspects a concussion, they might ask the athlete to jog, sprint or jump and test them again.

Once a concussion has been diagnosed, steps are followed to remove the athlete from play, further evaluate them, and rehabilitate them so they can return to play. Recovery from a concussion usually takes about 2–3 weeks among children and teens. However, about 1 in 4 have a longer recovery, taking months or even years.

It’s also important to wear the appropriate protective gear for your sport, such as a helmet, and make sure it fits correctly. Although there are no completely concussion-proof helmets, they can prevent life-threatening injury such as bleeding in the brain.

What if the athlete wants to return to play after experiencing a possible concussion?

Multiple concussions in sports are dangerous, often in ways that aren’t immediately obvious and can worsen significantly over time. The brain is just too important to risk, so listen to your athletic trainer if they recommend sitting out. Follow the motto, “When in doubt, sit out.”

“Prevention is key,” said Dr. Revilla. “We can prevent serious injury by being very aware of concussions of any type. Even if it’s minor, it’s better to take it very seriously. Get the necessary rest for the brain to heal and, by all means, avoid a second concussion.”