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Tackling concussions

Spots-concussion.jpgYour daughter landed the perfect back handspring at a gymnastics meet; your son made a touchdown-saving tackle at the football game—it can be a moment of great pride to see your child succeed in athletic competition. It can be equally terrifying to witness your child suffer an injury, especially a head injury. What if your gymnast lost her footing on that back handspring and hit her head? What if your son’s tackle was helmet-to-helmet at full speed?

JP Stowe, ATC, CSCS, certified athletic trainer and program manager for Eastern Maine Medical Center’s Sports Health program, knows what to look for in high school athletes complaining of concussion-like symptoms. “I had a soccer player come in earlier this fall. He got caught in the chin with a cleat, experienced symptoms that night, and reported to me the next day,” JP explained, talking about one of the concussion cases he has seen this fall.

Eastern Maine Medical Center’s Sports Medicine Program is relatively new, but is growing steadily. It now has one dedicated sports medicine orthopedic surgeon and eight full-time athletic trainers who contract with 11 area schools. “It’s really grown exponentially over the last three years from where we started with one school and one athletic trainer,” JP said, attributing much of that growth to increased awareness and liability concerns with concussions and other injuries.

Locally, liability concerns stem from a 2012 Maine law that requires a student suspected of having a concussion or concussion-like symptoms during a game, practice, or activity, to be removed until he or she receives written medical clearance. The student can then begin a protocol referred to as, “Return to Play” once they are symptom-free and have returned to school fulltime. “You have to explain it to them that this isn’t an ankle sprain, it isn’t a quadriceps strain, this is your brain,” JP said.

There has been national interest in concussions in recent years following the releases of the 2013 PBS Documentary, “League of Denial: The NFL’s Concussion Crisis” and the 2015 movie “Concussion,” starring Will Smith. More recently, a study released in July by the Journal of the American Medical Association examined the donated brains of deceased former football players and received widespread publicity.

Duska Thurston, MD, one of the lead physicians at the Eastern Maine Medical Center Concussion Management Clinic, says her practice works to bring the conversation out into the community. “We not only recover a patient for a particular sport, but work with local schools and colleges regarding return-to-learning plans in addition to giving presentations in the community.” 

The Aroostook Medical Center (TAMC) is also seeing growth in its Orthopedic and Sports Medicine program. Nicole Payne, MD, a physiatrist, fellowship trained in sports medicine and invasive pain procedures, and ImPACT certified, specializes in the treatment of musculoskeletal and neurologic conditions. “We really just want to have a one-stop location so our patients can receive coordinated care in one place,” Dr. Payne explained. 

Dr. Payne recently took a trip to South Portland for the Brain Injury Association of America 2017 Maine Conference. One of the focal points of that conference was how to make "return to school and play" decisions for student athletes who suffer concussions. It focused on methods physicians could use to inform their decision, including when to use imaging, or when to bring in more people to make those decisions. Dr. Payne says that it’s not uncommon for players, parents, or coaches to think student athletes are ready to play before they are fully healed. “There is definitely pressure on physicians,” Dr. Payne said. “We have a responsibility to the overall health and well-being of the athlete. That is our primary job.”

Dr. Payne believes it truly takes a village to recognize, treat, and rehabilitate concussed athletes and to return them to good health. She and JP both agree that there is more interest in learning about concussions, which they hope will help to increase awareness of the signs and symptoms.