How are concussions treated in college football

Athlete's brains shaken

"We filter out risk players"

Why has the sensitive issue of concussion been neglected in Germany up to now?

The index sport for this is American football. But in Germany there is neither a large lobby nor spectators for this. However, in our ice hockey game, incidents have increased over the past two years and the issue is attracting more attention from players, coaches and the media. The case of ice hockey player Stefan Usdorf, who gave up his career in March 2013 due to poorly cured concussions, is still quite topical.

Do such negative incidents lead to heightened awareness?

Yes absolutely. Recently, on the initiative of the German Ice Hockey League, there has been a medical task force that deals with the risks. We are in contact with the association doctor of the league and will support them. Nevertheless, in Germany, concussions are an underestimated danger in very large areas. Because the symptoms such as headaches and concentration disorders are very unspecific and are therefore often overlooked or misinterpreted. After that, however, an athlete has a higher risk of suffering another head injury. Many people in charge do not yet know enough about these typical symptoms and about the necessary treatment measures.

King football rules with us. How often do you get headaches there?

There are no exact numbers. But with 78,000 games on the weekends, more will certainly happen than in ice hockey, where the risk of a head injury is higher. In professional ice hockey, 20 percent of all injuries affect the head.

How well looked after are football players in Germany?

A large number of Bundesliga soccer teams have a sports psychologist, and it is estimated that half of the top division clubs also have tests carried out to check the players' mental performance and ability to concentrate. In addition, the world football association Fifa has organized four world conferences on the subject of concussions in team sports since 2001. At a conference in November 2012, I and a colleague were only two out of a total of just three German representatives in this field. That's actually sad.

Does this knowledge then also reach the soccer players?

A British study has just examined whether the guidelines for dealing with concussions that have been in place for ten years - for example a gradual return to training - are actually being implemented. It turned out that a third of all clubs in the 1st and 2nd Bundesliga had never heard of it. It won't be any different with us.

How do you and your four employees intend to change that?

We go to sports conferences and events and try to reach as many officials as possible there. In addition, we examine and train individual top athletes as well as entire handball, basketball and soccer teams. More than 100 athletes are in our database. We recently trained a U23 team from a Bundesliga soccer team and also carried out so-called baseline tests.

What happens in such "baseline tests"?

We use it to determine the cognitive performance of the athletes before the start of the season, so that we have baseline values ​​in the event of a head injury. The tests take about an hour. In addition to the medical history, we determine the attention and concentration performance, reaction speed and speed. At the same time, information processing and changes in attention as well as learning and memory performance are checked.

Has your baseline data already proven useful?

Yes, there were several players who were suspected of having a concussion and where we determined, based on the comparison values, to what extent the mental performance corresponded to the previous data. Based on this, it was decided whether the player was allowed to go back to training. In addition, we use it to filter out “risk players”: We examined ice hockey players with 10 or 15 concussions and pointed out that a new incident could lead to the end of their career. You never know which concussion is too much, after which the player can no longer get rid of his impairments.

In the USA, such tests are already being carried out on youth teams. Recreational trainers must also be trained there in dealing with concussions. How about that in Germany?

Very thin. As far as I know, there are no baseline tests in children and adolescents. As a result of the last Fifa conference, however, a screening process specially tailored to children and adolescents was published. However, this has yet to be made public.

How well do you rate the care in Germany for patients with a concussion, regardless of whether they are sport-related or not?

The acute medical treatment in Germany is very good. After all, this affects 240,000 people every year. However, further care is often problematic and depends on how well the attending physician is familiar with the associated cognitive, physical and emotional impairments.

If there was one thing you could want to know about concussion, what would it be?

How high the number of unreported cases is and how many people there are who have long-term consequences after several events. With this knowledge, we could develop better treatments. •

The interview was conducted by Désirée Karge

Compact

Multiple concussions encourage the development of CTE - a disease with symptoms similar to Alzheimer's or Parkinson's.

· Athletes in contact sports such as American football, boxing or ice hockey are often affected. In the US, players are now demanding better protection.

more on the subject

Internet

Online guide to traumatic brain injuries: www.schaedelhirntrauma.net

Good to know: concussion

Concussions, also known as traumatic brain injuries, often occur in accidents, for example in traffic, at home or during sports (for example boxing, see graphic on the right). They are characterized by an injury to the skull, including the brain. In addition to nausea, dizziness and headache, typical symptoms are also impaired motor reactions, memory loss and loss of consciousness. Depending on the type and extent of the symptoms, the doctors differentiate between three degrees of severity, which are based on the so-called Glasgow Coma Scale. Two Scottish neurosurgeons developed this scale for assessing impaired consciousness in 1974. The ability to open one's eyes, speak and react to painful stimuli are crucial.

April 15, 2014

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