Doctor: Youth concussion law could put kids at risk

Experts say inexperienced physicians allowed to "clear" athletes

ORLANDO, Fla. - Florida's new student concussion law delivers a tough mandate for coaches, parents and students. But the head of one of the leading sports concussion programs in Central Florida says it leaves room for misdiagnosis.

The new law, set to go into effect Sunday, requires removal of any student athlete from a game if he or she is suspected of having sustained a concussion.

The new legislation, signed by Gov. Rick Scott earlier this year, also requires written authorization from a "medical professional" before the injured student athlete can participate in that sport again.

Dr. Melvin Field, founder of the Sports Concussion Program at Florida Hospital, says the term "medical professional" is too vague.
According to Field, both MD's and doctors of Osteopathic medicine  fall under that umbrella.

In his view the state's concussion law should specify clearance only be issued by professionals trained in concussion management including neuropsychologists.

Field says Md's and Od's are skilled but may not have the specific training or experience to treat or determine if a concussion or traumatic brain injury (TBI) patient has fully recovered.

"If they were to have a second impact, a second hit while the brain is recovering, they could have a massive stroke or even die," he said.

Student concussions on the playing field have become a hot topic.
Recent studies estimate anywhere between 1.6 and 3.5 million student concussions are reported every year in activities ranging from football to volleyball and cheerleading.

15-year-old Jordan Armstrong was injured during a local volleyball club contest in March. Armstrong says she has endured severe headaches and lack of concentration since that injury.

"I'm not completely sure when I hit my head," Armstrong said.
"My feet wouldn't move whatsoever, my brain said go and my feet wouldn't go."

Armstrong was diagnosed with a concussion by doctors at Arnold Palmer Hospital after another facility diagnosed a rare muscle and brain disease.

Dr. Greg Olavarria, a pediatric neurosurgeon with Arnold Palmer Hospital, says student athlete concussions have become a silent "epidemic."

"We really don't have enough public awareness as to concussions, what are the red flags, what are the symptoms and when to bring a child to medical attention with a concussion," he said.

The symptoms can be subtle in fact, doctors admit a concussion usually doesn't show up in an MRI.

Doctors say the structure of the brain isn't damaged , instead it's the brain's function that is impaired. Symptoms of concussion include: headache, dizziness, amnesia and confusion.

The Mayo Clinic reports these symptoms can last "for days, weeks, even longer."
Dr. Dawn Comstock of the Research Institute at Nationwide Children's Hospital, recently completed a 20-sport "injury surveillance" for the 2008-2010 academic years.

The report published in the American Journal of Sports Medicine (Jan.27, 2012) found 1,976 concussions were reported in that time frame.100 high schools participated in the study.

Comstock agrees that anyone examining a student from coach, to trainer to physician needs to be able to recognize "the signs and symptoms" of concussion.

"When in doubt, sit them out," Comstock said.
For more information on concussions go to the Mayo Clinic.

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