March is Brain Injury Month and while it has passed and spring is here, bringing attention and support to an issue often overlooked in the Black community continues year-round.
The Brain Injury Association of America (BIAA) reports that “every year, an estimated 2.8 million Americans suffer from a traumatic brain injury (TBI),” leaving “more than five million Americans with permanent brain injury related disabilities.”
Dr. Rebecca Timko, of the Clarity Brain and Body Clinic in Bethesda, Md., works with athletes, people who have been in car accidents, employees who have experienced workplace injuries and those who have suffered brain trauma from domestic violence or military service.
“[ABIs] are a broad group of injuries, encompassing anything that is an injury to the brain after birth. It encompasses both non-traumatic brain injuries and TBIs,” said Dr. Timko. “Non-traumatic brain injuries are caused by internal body factors: strokes, tumors and infections. The ABI category encompasses TBIs caused by external forces to the body and to the brain.”
And then there are concussions.
“There is nothing mild about a concussion,” said Dr. Timko.
“It doesn’t mean the effects on the individual are mild at all–that is just how it is categorized.”
According to Dr. Timko, concussions are diagnosed based on a range of symptoms. A series of tests are set with patients.
The BIAA listed headaches, blurred vision, dizziness, loss of consciousness, ringing in the ears, slurred speech and nausea as just some of the symptoms of a concussion. Cognitive and behavioral dysfunctions may occur as well such as mood swings, brain fog, lack of concentration and slowed reaction time.
“It’s not diagnosed on things like imaging. An x-ray, CT or MRI in a mild concussion won’t show anything…the brain cells are disrupted and that can cause problems with the communication between cells and disruption of pathways. Unless it’s a more severe type of injury with some sort of fracture or brain bleed, [nothing] will show up on imaging,” said Dr. Timko.
As more Black and brown students and adults branch out into sports outside of the traditional football, basketball and baseball offerings, doctors are stressing the importance of safety on the soccer field.
“Concussions occur in different sports. [The] most well-known are hockey and football, but soccer is in the top three. The top rate of concussion is male football. The number two right now is [women’s] soccer. Not a lot of people talk about that,” said Dr. Timko.
She explained that women’s soccer has the second highest rate of concussions among players because women have “less strong musculature in their necks,” making the impact much more severe compared to men.
Dr. Jamil Neme, who directs the Concussion Clinic at SSM Health St. Louis University Hospital and is an associate professor in the SLU medical school’s family and community medicine department, told St. Louis Public radio, there is a bias when it comes to concussions and women playing soccer.
“We know that the boy is going to get into rough things and want to play contact sports. We’re going to want to make sure that we give them the right information. We just don’t expect that from our girls, but that’s certainly changed a lot,”
Timko said, “Men are generally more physical but have lower rates of concussion compared to girls’ soccer because of that anatomy.”
“[Generally], in most sports, women suffer higher rates of concussions due to those factors; neck muscles, hormones and different ways to play the game.”
“The research is showing ‘heading’ is a big discussion in the soccer community. Making contact with your head, anytime you’re in the game puts yourself and your brain at risk. Concussions happen from player-to-player contact. “
Dr. Timko urged athletes with a concussion to connect to concussion providers “who have education within the neuroscience field.” Athletes should adhere to the “return to play protocol.” Seeing a provider early leads to “better outcomes and fewer long-term symptoms” in the future.
“The best way to recover as an athlete from a sports related concussion or TBI is what’s called a ‘return to play’ protocol,” said Dr. Timko.
“It is a six-step protocol with a health care provider. Each step lasts at least 24 hours. It is a gradual return to activity, ultimately sports related activity and then full gameplay at the end.”
This protocol on average takes about a week but some players may be on for longer depending on the severity of the injury and its symptoms.