Head injuries in athletes resulting in concussions occur more frequently than previously thought. We are learning more about the problem and the important consequences. 

Each year more than 300,000 U.S. athletes suffer some form of traumatic brain injury. High school athletes comprise 60,000 of these injuries. The consequences vary a great deal and can be physical, emotional and intellectual.

Traumatic brain injury can result in short-term symptoms as well as problems that are more serious which may not surface until several years later. What kind of problems develop depend on what portion of the brain is affected, the severity of the blow, the number of repeated blows to the head, pre-existing conditions of the individual, and personality traits of the injured person.

The more blows that happen to the head - even small ones - increase the risk for mental deficiencies. Significant head trauma to an individual player occurs hundreds of times a week during practice and games.

A study in 2000 surveyed 1,090 former NFL players and found more than 60 percent had suffered at least one concussion in their careers. Twenty-six percent had three or more. The survey revealed that players who had concussions reported more problems with memory, concentration, speech impediments, headaches, and other neurological problems than those who had not. Because these professional players had spent many prior years playing football in high school and college, the frequency of head trauma is likely under-reported.

Other common medical problems being linked to football concussions are depression, insomnia, attention deficit and personality changes. These kinds of problems have been found to be more frequent in those who had even one episode of head trauma.

It is widely accepted that concussion symptoms can reappear hours or days after the injury, indicating that the player had not healed properly from the initial blow. This requires strict guidelines that conservatively allow adequate time for healing to occur. Immediate symptoms that require removal from sports activities include amnesia, poor balance, headaches, dizziness or other neurologic deficits, regardless of how quickly they subside on the sidelines. Long-term problems may take several years or more to fully develop.

But the question remains - how much healing time is enough? A health care provider should be involved in examining and investigating these head injuries to ensure the best outcome. Even one episode of head trauma makes the athlete at risk for serious consequences and more vulnerable for the next episode, which in many contact sports is inevitable.

Both professional and college sports authorities are changing their recommendations regarding contact sports. Foremost is reducing the numerous head blows by enforcing rules that involve more no contact practices. Research has shown the number of head blows during a college football season totals in the thousands for an individual player. Many football collisions have forces comparable to driving a car into a concrete wall at 40 mph.

Repeated head trauma is a serious issue for football players of all ages - and needs to be more closely monitored. A good start would be teaching better techniques to reduce the head leading contact in tackling and blocking, and making equipment changes to help reduce the possibility of head injuries.

• Dr. Bruce Kaler is a family practitioner with U.S. HealthWorks.

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