Home Pro Three Sides to Every Coin: Dealing with Sport Concussions

Three Sides to Every Coin: Dealing with Sport Concussions


It is often said that there are two sides to a coin – presented by heads and tails. But there are times that the edge of a coin must be represented. Although thin in depth and size, the edge does encompass the entire body of the coin.

One of the most discussed and controversial issues occurring in the sport today is that of concussions and its head-banging blow to young athletes in this country.  Most of the media is concerned with the alarming rise in the rate of the number of concussions being seen in high school level sports.

On one side of the coin we are seeing the sports healthcare community coming together to re-assess past definitions, recommend new assessment tools, devise a new standard care and management protocols, and create new “return to play” rules and guidelines based upon new found  research.  On the other side of the coin we see the sport industry coming together to review administration and staff (coaches) responsibilities, equipment changes and game rule changes to make sport safer.

But as stated earlier we must not forget third side of the coin that needs to be addressed – the athletes and parents/guardians.  All athletes and their parents/guardians need to be informed and educated about the severity of getting a concussion and how it affects their physical and mental health.  The athletes and parents/guardians need to learn the symptomology of a concussion and the importance of reporting these symptoms as soon as possible to get proper care.

Physical activity and sport by their very nature include inherent risks leading to injuries for many individuals who participate. Most sports injuries encountered by young athletes are minor in nature, and present an identifiable time period and protocol for management and recovery before the player can return to play.   Because of the varying magnitudes and locations of impacts resulting in a concussion, as well as other factors such as the frequency of sub-concussive impacts and number of prior concussions, it is plain to see this kind of sport injury has a mind of its own.

It is difficult to establish the damage based upon previous number of hits for concussive injuries. Each athlete responds differently to the various forces during a head injury. No two concussions follow the same recovery patterns and two milder injuries (sub-concussive impacts) may do more damage than one severe one. This makes it difficult to diagnose and treat.

With this kind of difficulty in reporting, assessing, diagnosing, and treating of this kind of injury —- it is imperative that all involved be educated with the most updated information so that everyone is on the “same page” as for the management of such an injury.  All “three sides of the coin” must be addressed to consider the most prudent care in managing a concussion.

THE HEAD: Sports Healthcare Community / Sports Medicine Research

  1. Re-assessing Definitions & Terminology
  2. Recommending New Assessment Tools
  3. Devising New Standard of Care / Management Protocol
  4. Creating New “Return to Play” Rules / Guidelines

THE TAIL: Sport Industry / Sport Safety

  1. Administration / Staff / Coaches – Responsibilities
  2. Equipment Changes
  3. Game Rule Changes

THE EDGE /SIDE: Athletes / Parents / Guardians

  1. Informed & Educated on Concussive Injuries due to Sport
  2. Understand the Severity of a Concussion (Short Term & Long Term)
  3. Know the Symptomology of a Concussion
  4. Know the Importance of Reporting Symptoms ASAP


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  • Stanmyre, M. & Friedman, J. (2010, January 4). Kids and concussions: The effects of head injuries in young athletes. Star-Ledger. Retrieved from http://blog.nj.com/hssportsextra/2010/01/kids_and_concussions_-.html
  • The Associated Press, (2009, December 3) “NFL Changes Return-to-Play Rules.” Retrieved November 15, 2010, from http://sports.espn.go.com/nfl/news/story?id=4707604
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  • Washburn, L. (2010, September 8). Federal guidelines to protect student athletes from concussions pushed in congressional hearing. Retrieved from http://www.northjersey.com/news/health/090810_Concussion_in_high_school_younger_athletes_focus_of_hearing_today.html
  • Washburn, Lindy (2010).  Concussion Law Puts Safety First.  The Record, Pg. A1.

Dr. Enrico Esposito
Dr. Esposito is the Chair of Sports Medicine at the United States Sports Academy. He has an extensive background in sports medicine, sports chiropractic and sports performance coaching at various levels from Pee Wee to Professional/Olympic caliber.  He is a chiropractic physician with professional certifications in athletic training, strength and conditioning, rehabilitation, exercise physiology and sport safety.

Editor’s Note
Dr. Esposito conducts ongoing research in human athletic performance and has a special interest in studying new ways to help prevent concussions, especially among young athletes.  Anyone interested in this topic can read more by clicking on the links below.  Dr. Esposito teaches courses on sports medicine at the United States Sports Academy.  For more information go to http://www.ussa.edu.


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