The Olympics and Traumatic Brain Injury Mindfulness


As the XXIV Olympic Games in Beijing are set to begin, anticipation rises to follow the greatest athletes in their sports as they compete on an international stage. Ice hockey, speed and figure skating, skiing, luge and snowboarding are among the sports popular to viewers.

As these athletes put their training to the test, they also put their bodies on the line in the quest for gold. With guts comes glory, but it may also end in injury. Dislocations, separations, fractures and tears can affect shoulders, knees, feet and ankles, wrists and more as a result of competing at high speeds, enduring collisions and just overuse.
Another body part often enduring major injury is the brain. 

"If you fly off your sled going hundreds of miles per hour and bump your head, it's not a good thing," says Andrew Guidry, M.D., a sports neurologist and neurology director of the LifeBridge Health Sports Medicine Institute. "Most of these sports involve high speeds, and when you think about figure skating, they are doing maneuvers at high speed and force to their bodies."

Locally, ice hockey and skating are popular with leagues for juniors, and add in other winter sports like wrestling, indoor soccer and basketball at the youth, high school and collegiate levels, there's opportunity for major head injuries. Although many athletes wear protective helmets during competition, blows to the head still can result in serious injury in spite of the protection.

Aside from cuts and bruises, blows to the head can result in a concussion. Differing opinions exist in the medical community as far as defining the condition, but Dr. Guidry says, the explanation in use most often today hails from British experts. Diagnosis and treatment for sport-related concussion continues to evolve but centers around the immediate and transient symptoms of traumatic brain injury (TBI) caused by force, whether from a direct blow to the head, face, neck or another part of the body that causes transmission of force to the head. Sudden impact to the head can cause the brain to move rapidly back and forth inside the skull, and can result in neurochemical changes, contusions, barrier breakdowns or nerve damage.

Practitioners use a sideline tool called SCAT5, developed by the international Concussion in Sport Group, to evaluate for concussion, looking for red flags:

  • Neck pain or tenderness
  • Double vision
  • Weakness or tingling/burning in arms or legs
  • Severe or increasing headache
  • Seizure or convulsion
  • Loss of consciousness
  • Deteriorating state of consciousness
  • Vomiting 
  • Increasingly restless, agitated or combative 

According to Michael Ebbert, D.O., a sports neurologist and neurology fellow with the LifeBridge Health Sports Medicine Institute, a concussion often involves some form of memory loss.
"You'd be surprised at the number of people who don't remember the sound the impact made but a teammate shared that they heard it across the field or on the sidelines," Dr. Ebbert says. 
Despite the indicators, Dr. Ebbert says careful consideration goes into determining a concussion diagnosis, which is sometimes a misdiagnosis that can prevent admission to the military or the acquisition of a college scholarship. Discussing the patient's full medical history is part of the process, including a headache history.

"What's very common in teenagers, for instance, is that they may have actually been having migraines that were never diagnosed," he says. "Or maybe they're having stress headaches or no headaches at all and then we have a comparison of how they were feeling before they got hurt."

Following impact to the head that is not emergent, Dr. Guidry suggests 48 hours of rest. Get as much sleep as desired during that time, taking off from work or school, he says. Unlike how concussions were previously treated, in dark, quiet rooms for extended periods of time, Dr. Guidry recommends resuming activity after the 48-hour period and adding cardio after about five days.

"By getting back into your social environment and starting activity like cardio, it actually speeds up the healing process of a concussion," Dr. Guidry explains. "

If you or a family member sustains an impact to the head during a sports activity, contact the LifeBridge Health Sports Medicine Institute for a sports neurology consultation at 410-601-PLAY.