Heads Up

October 14th, 2013 | By Katie No Comments

In collaboration with Tara Merritt, M.D.


Recently, there has been a great deal of media focus on the dangers of concussions and the impact they can have on a person. Much of the attention has been on the NFL and college football, but concussions are common in many sports at all levels, from kids’ t-ball to adult basketball. Concussions are not limited to sports, either. They can occur in traffic accidents, on playgrounds, and at worksites, and may not even involve a blow to the head. Young kids are especially susceptible to concussions because their brains are still growing and developing.
The reality is that concussions are much more common than we think because most people don’t recognize the signs and symptoms and they can’t see the injury like they can with a cut or broken bone.

Many concussions can lead to long-term or even permanent brain damage, but the risks are much higher if treatment is not started right away. The risk of really serious damage increases dramatically with what doctors call the second impact syndrome, which is when there is a second hit or concussion on a brain that is already injured. This can cause severe swelling of the brain and even lead to death. Second impact syndrome happens most often when athletes do not tell their coach that they don’t feel right or a coach/parent does not pull a kid from play when they suspect that they could have received a concussion. You do not ‘shake off’ a ‘ding or dizziness’ because you got your ‘bell rung.’ It is not a rite of passage or a badge of honor to get a concussion. It could be a possibly life-threatening brain injury.

To help address the growing concerns about concussions, the CDC has launched a program called Heads Up – Concussion in Youth Sports. They have great resources on their website at www.cdc.gov/concussion, including the following list of signs and symptoms:

Signs Observed by Others

  • appears dazed or stunned
  • is confused about assignment or position
  • forgets an instruction
  • is unsure of game, score or opponent moves clumsily
  • answers questions slowly
  • loses consciousness (even briefly)
  • shows mood, behavior, or
  • personality changes

Symptoms Reported by Athlete

  • headache or pressure in head
  • nausea or vomiting
  • balance problems or dizziness
  • double or blurry vision
  • sensitivity to light or noise
  • feeling sluggish, hazy, foggy, groggy
  • concentration or memory problems
  • confusion
  • feeling “not right” or feeling “down”

This Spring, the Georgia Legislature took steps to reduce concussions with the passage of House Bill 284, also known as The Return to Play Act of 2013. This law takes effect January 2014; it is designed to increase the awareness and education about how to identify potential concussions and it requires athletes to be immediately pulled from play until they are assessed and cleared to return to play by a licensed medical professional. Actions required by the law include:

  • All schools and youth sports organizations must inform parents and legal guardians of the nature and risk of concussion and head injury.
  • Schools must adopt and implement a concussion management and return to play policy. Recreational departments and youth sports organizations are strongly urged to do the same.
  • If a youth athlete exhibits symptoms of having a concussion, that athlete must be removed from the game, competition, tryout, or practice and be evaluated by a health care provider.
  • If a youth athlete is deemed by a health care provider to have sustained a concussion, the coach or other designated personnel cannot permit the youth athlete to return to play until the youth athlete receives clearance from a health care provider.

M.D.Dr. Tara Merritt is one of the Athens area medical professionals who has been raising awareness and advocating for policies and programs on concussions. As both a pediatrician and sports medicine specialist, Dr. Merritt has seen and treated many concussions. She is a big supporter of the CDC Heads Up program and the Return to Play Act, but feels that “we can do even more to accurately diagnose and treat concussions.”

Her goal is for every school to have what is called Baseline Impact Testing, similar to what collegiate and professional sports teams use. The test measures an athlete’s memory, attention and concentration, problem-solving abilities, and processing speed, down to the millisecond.  From this testing, Dr. Merritt and others trained in the program are able to determine the level of functioning prior to any brain injury. When athletes sustain a head injury, they are re-evaluated within a few days to see if there is a concussion and to determine the severity of the injury. Dr. Merritt has already implemented Baseline Impact testing at Cedar Shoals High School and says that the cost for eight high-risk sports was under $500.

As part of their new Sports Performance and Rehabilitation Center, Athens Orthopedic Clinic has introduced a concussion program. Their team of sports medicine providers designed the program to allow local area athletes to obtain a baseline neurocognitive evaluation as well as a computerized balance assessment. This testing is open to both teams and individual athletes. In the event of concussion, an athlete’s baseline results are compared with additional post-injury assessments.  These results, along with a detailed physical exam, and a monitored return to play protocol, allow the athlete the opportunity to return to play safely.

For more information about local baseline testing for concussions check out www.athensactivekids.com and

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