#tbt Post: Mild Concussions

13 Mar

Originally Posted January, 2011…

Hogwash!  There is NOTHING mild about a concussion, period.  However media, teams, players and even medical staffs continue to use this nomenclature with this injury.  It is simply counterproductive to label this injury with a “mild” tag, and hampers the effort of everyone trying to increase awareness.

Granted, those that have extensive training in the area of injuries, and particularly head injuries, understand the term “mild” when it is in concert with concussion.  This subset of the population is not the one that needs the education, rather it is the general public, which includes players, coaches and parents.  A common problem amongst people who are educated in a particular field is that they forget about both who they are servicing and the education level of people other than their peers.  It’s a fine balance to educate without talking down to others, but understanding the stigmas of the topics help with that effort.

One serious stigma is the “mild” tag that is placed on concussions.  Those that watch and participate in sports are so used to using that clarification when assessing and addressing injuries as a whole, that perhaps it carries over to the traumatic brain injury just sustained by the athlete.  We as athletic trainers and doctors need to reassess how we describe this particular injury.

During my public speaking I often relate being “mildly” concussed to being “mildly” pregnant…  You are either concussed or not, just like you are pregnant or not.

Some may say that “the symptoms are mild”, or that the “prognosis of the injury is mild”, in terms of being sidelined.  The first may be correct the second is a slap in the face of those that study and deal with concussions on a daily basis.  So the symptoms are mild; no headache, slight vision issues, just “foggy”…  SO WHAT!!!  The insult to the brain that occurred has created a problem, a problem that we currently in the medical field cannot “fix”, not with tape, pharmaceuticals, or surgery.  And anyone that has ever dealt with a concussion or handles them in a management role (this guy) knows that traumatic brain injuries do not recover at a pre-set rate.  It is not a broken bone that will heal in 4-6 weeks, we are talking about the brain.  A frontier that both research and education have not even scratched the surface on.  For everything we know about the human brain there are about 1,000 things we have no clue of, making this injury much more than “mild” in any form.  Counterproductive.

Others say may say “everyone understands mild is about the symptoms”, um WRONG.  Being in a high school setting we deal with parents all the time and when a player is concussed there are a lot of instances where the parent will say “It’s just a mild concussion, right?”  ARGHHHH.  Then I have to spend the next 10 minutes telling the parent why, even though his/her kid feels “OK”, that this is a problem that we must stay on top of.  My other favorite is “Well ‘insert NFL’er here’ had a concussion and was out only 3 days, his was mild, may son/daughter doesn’t have a headache only has problem with loud noises/bright lights.”  ARGHHHH again!  Using terms that diminish what is actually happening with the injury makes the job a lot harder.  Constantly dealing with the stigma of “bell rung” is one thing but dealing with expectations due to a simple term of “mild” is outright maddening.  If we all remember Sidney Crosby was listed as a mild concussion as well; he missed five months.

Finally the term “mild” also has connotations of ease, when it comes to recovery.  As mentioned above concussion recovery is very dynamic, and as I have posted before, instead of a liner recovery it is more like a sinus wave.  Those dealing with concussions will have good days and bad days then great days and feel recovered only to be back to about “square 3″ after a stressful day at school/work.  The 3rd International Conference on Concussions in Sport dismissed and took out the terms “simple” and “complex” when describing this injury, just for that reason alone.

For the sake of confusion and simplicity why don’t we all just use the term “concussion” for now.  I do believe that Traumatic Brain Injury is more descriptive, and a post for another day.  If you know of someone who is concussed and were told it was “mild” let them know that is not the case for most.  Then find the MD/DO, health care provider that told them that and forward this post to them.  It is one word, carries along with it a certain level of seriousness and along with current educational efforts means more now than every before.  Putting the tag of “mild” on it only makes all efforts in vain.

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5 Responses to “#tbt Post: Mild Concussions”

  1. Phil Colwell March 14, 2014 at 13:53 #

    mild concussions now are what we oldtimers ( 57 years old ) only called head dingers and went right back out there or you were not a man; it was not the total KO,s as i call them that i worrry about so much for brain damage as i only remember about half a dozen; it is all the dings to the head that worry me about my time in the CFL as they are countless; especially on kickoff cover and return where both players collide at full speed head on head!

  2. Paul Cuetara March 20, 2014 at 06:36 #

    There is a lot of good stuff for athletes. What are we doing for amateur high school and college umpires? A foul tip on the face mask is not much fun. Most of us “shake” it off but that is not a good response. The full helmet offers better protection and is required to be worn by catchers.
    The helmet is designed with all surfaces curved. This deflects the impact and offers better protection. In my 5+ years using the helmet not only are the potential forces reduced, the line of sight is my greater that with the traditional mask.
    Paul Cuetara, NHBUA

  3. Aaron Milloy April 21, 2014 at 21:52 #

    I don’t know if there’s much practical use to categorizing concussions at all anymore. There are so many variations in symptoms and durations that it can be difficult to lump concussions together as being around the same “severity”. People like things to be neatly categorized so that they can assess just how bad the injury was and how long to expect symptoms to last. That is why Grading scales became so popularized I believe. People just seem to still be stuck believing that when someone experienced a “bell-ringer” that it was actually safe to go back into the game when the symptoms seemed to go away. They view these “types” of concussions as “mild”. Even when I played football in high school from 02-05, it seemed as if everyone viewed concussions that way. I’m almost happy that the concussion I experienced had PTA and other symptoms that lasted the rest of the evening, that way I never went back into the game, and was held out of play for a couple of weeks.

    I believe a huge part of the problem is with coaches. Many may just be uninformed, but some I believe want the parents and players to view their concussions as mild so that they are not so worried about their own health, and they’ll push to try to get back onto the field as quickly as possible. This may potentially lead athletes to ignore “mild” symptoms and not report them (so as to be cleared to play), leading to a potentially dangerous situation on the field. I feel I even experienced this pressure from coaches when I was in high school.

  4. Kim April 30, 2014 at 09:04 #

    Hey! We have been living with intense pressure from grandparents with visitation rights refusing to acknowledge post concussion syndrome. They have refused to follow guidelines instructions regarding symptom management etc. I have been accused of everything from manipulating symptoms to manchusens syndrome etc. currently in litigation for contempt filed against me for modifying visitation schedule based on what my son needs. I guess my question is has anyone out there heard off or been in a situation where you are forced to engage legally to protect your child’s recovery from unnecessary risk of harm??
    I can’t be the only mommy going through this I’m sure…..any advice?

  5. lynnemelcombe May 8, 2014 at 14:13 #

    Thank you for this! I write not from the perspective of an athlete or a parent but as a mother who had her bell rung HARD while attending a parent-teacher meeting 10 years ago. It was called a mild concussion by the ER doctor. My own GP said it was not a concussion at all because I had not lost consciousness, just “a bit of whiplash.” Yet 10 years later, I still have vision problems and headaches. I not to let them stop me: I’m currently doing a master’s degree in creative nonfiction writing for which my major project is the first draft of a book about my experiences, not only with the concussion specifically but with the whole 3-ring circus of treatments, and insurance, and lawsuit afterward. And I’m doing that while sustaining my business as a freelance writer and editor (thank goodness for an understanding and supportive husband who has taken over the household and garden while I’m snowed under). Still, while I’m very lucky in many ways, I am reminded daily of this so-called “mild” injury and how I was repeatedly told just to get back at things, which for me included long days at a computer, which I know now was exactly the wrong advice.

    Sorry, I’m ranting. My point is not only to thank you but also point out to you and your readers that I’ve started a Facebook page called Concussion Memoir (URL: https://www.facebook.com/LynneMelcombeAuthor, don’t ask me why it doesn’t match the page title!) I use it as a place to gather and share information I come across in the news everyday about both concussion and whiplash (as they seem to me to be very closely related, in terms of how they happen, symptoms, and gender differences). Thanks for the post, thanks for the opportunity to vent, and I hope someone will drop by and get some benefit out of my page. (Blog to come when I have time, assuming my husband continues to be understanding and supportive!)

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