Ask the Jock Doc

I’m on the varsity football team at my high school. I got hit in the head during a tackle and the referee took me out and didn’t let me play the rest of the game. He said something about a concussion.  I didn’t black out and it was frustrating that he wouldn’t let me play. Why would he say that I had a concussion and why wouldn’t he let me play?

A concussion is when either a direct or an indirect impact to the head that leads to a temporary disruption of brain function. This means that when you got hit in the head your brain got “jolted” and the brain cells were “shaken up” a bit; they needed time to recover in order to return back to normal. Although many people associate a concussion with blacking out or loss of consciousness, many concussions don’t involve blacking out or losing consciousness.

Natalie Voskanian, MD, sports medicine doctor at UC San Diego Health System says, “Symptoms from a concussion can vary. The concussed athlete often ‘just doesn’t feel right’. He/she may not be able to think clearly (‘feel foggy’) or might get easily confused. There might be balance issues, memory loss, difficulty concentrating, feeling extra tired, being moody, feeling anxious or depressed. There may be ringing in the ears, nausea, dizziness, blurry vision, headache, or extra sensitivity to light or noise. The symptoms can last hours, days, or sometimes even weeks.”

A concussion is a serious injury that is commonly seen in contact sports.  Advances in science have changed our understanding of concussions and the way that we treat them. It’s critical that any athlete who gets hit in the head and then feels “out of it”, or has any signs suggestive of concussion, speak to the athletic trainer, team physician, referee, or coach ASAP and get out of the game to be evaluated. This is because playing with a concussion can lead to serious consequences and long-term problems such as chronic fatigue, headaches, poor concentration, depression, and memory issues.  In other words the symptoms may never go away if you don’t give your brain a chance to recover.

The treatment of a concussion is a period of rest from sports, as well as from all stressful mental and physical activities.  Only return to exercise when you feel completely back to normal. This may take days, a week, or sometimes longer. Rarely a head injury can result in bleeding in the brain, which is even more serious than a concussion, and can be deadly. So it’s important that if you have any type of head injury, or if you get a severe headache from a sports injury, you get evaluated ASAP by a medical professional.  Don’t play through it! Your life and brain off the field are just as important as your life on the field.

I’m going into my senior year in high school and my last year on the varsity football team. I’m able to power clean 225 and squat 330. However, during one weightlifting session I might’ve done something wrong and pinched a nerve. It’s been about a month and it’s getting worse to the point that I can’t really practice or play without pain.  Any ideas before I decide to see a chiropractor?”

This kind of traumatic episode, resulting in prolonged (e.g. one month) symptoms that significantly limit your performance and get progressively worse, should be evaluated by a medical doctor.

Doug Chang, MD, PhD, a spine specialist at UC San Diego Sports Medicine says “The problem sounds more significant than a simple “strained muscle” in your back. It could be a vertebral disk herniation in the spine, a tear/rupture of the hamstring or gluteal muscles, or even a fracture of parts of the vertebral bones (e.g. spinous process, transverse process, pars interarticularis).  The first step in getting better is getting the right diagnosis, which will guide your treatment and rehabilitation.”

“Once certain medical conditions are ruled out, you’ll be able to safely work with a physical therapist, athletic trainer, chiropractor or coach to gradually resume activity,” Dr. Chang adds.  Proper static and dynamic posture can help you position the spine to best handle loads that are placed upon it.  Learning to engage your core musculature to support the spine during movement is an important part of any program for back pain.   A visit to the doctor is the first step on your road to recovery.

Q. I’m going into my senior year in high school and my last year on the varsity football team. I’m able to power clean 225 and squat 330. However, during one weightlifting session I might’ve done something wrong and pinched a nerve. It’s been about a month and it’s getting worse to the point that I can’t really practice or play without pain.  Any ideas before I decide to see a chiropractor?”

This kind of traumatic episode, resulting in prolonged (e.g. one month) symptoms that significantly limit your performance and get progressively worse, should be evaluated by a medical doctor.

Doug Chang, MD, PhD, a spine specialist at UC San Diego Sports Medicine says “The problem sounds more significant than a simple “strained muscle” in your back. It could be a vertebral disk herniation in the spine, a tear/rupture of the hamstring or gluteal muscles, or even a fracture of parts of the vertebral bones (e.g. spinous process, transverse process, pars interarticularis).  The first step in getting better is getting the right diagnosis, which will guide your treatment and rehabilitation.”

“Once certain medical conditions are ruled out, you’ll be able to safely work with a physical therapist, athletic trainer, chiropractor or coach to gradually resume activity,” Dr. Chang adds.  Proper static and dynamic posture can help you position the spine to best handle loads that are placed upon it.  Learning to engage your core musculature to support the spine during movement is an important part of any program for back pain.   A visit to the doctor is the first step on your road to recovery.

Q. I get nervous before games.  Is there anything I can do to calm me down?

Every athlete has to find his or her own way of coping with the stress of competition.   You want to be psyched and ready for peak athletic performance, but not overly anxious or tense.  There are many psychological techniques that have been used effectively, including progressive relaxation and breath control, positive and rational thinking, and visual imagery.

For example, move to a quiet corner, close your eyes, and begin to take slow deep breaths, first filling up your stomach and then expanding your chest.  Inhale to a count of 4 and exhale to a count of 8.  Repeat several times until you start to feel more focused and calm.

Now think of a movement or task that you’ll perform during the game.  Start off with skills that you’re particularly good at.  Visualize yourself performing the movement skillfully, easily, fluidly and powerfully.  Think about how it FEELS in your body to do the movement well.  Imagine whatever senses connect you with the feeling of performing confidently and successfully: the sights, sounds and body sensations.  If there are certain challenges that are likely to come up during the game, imagine yourself handling those with ease.  Mentally walk yourself though effortless, powerful, skillful athletic moves.   Perform imagery techniques for 5-10 minutes either 1-2 hours before a game, right before a game or whenever is most helpful during the week.

Some athletes play certain music on their iPods to either help them relax, tune out distractions or get pumped up, whatever is needed.  Work with your coach or a sport psychologist to find what techniques work best for you.

Ask the Jock Doc is brought to you by the sports medicine experts at UC San Diego Health System – Sports Medicine.  Let us help you get back in the game.  Call 858.657.8200.  For answers to your sports injury or performance questions email jockdoc@spotlightsportsmag.com.