That’s a Red Card!

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Most of the globe is currently watching the World Cup and although football gets the lion’s share of the headlines about concussions, the June 19 soccer game between Uruguay and England is sure to land FIFA in some hot water. During the second half of the match, Álvaro Pereira, one of the stars of Uruguay’s national team, laid unconscious (below) on the field after taking a knee to the head. He fell to the turf and took at least 15 seconds before he showed any signs of consciousness.

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Richard Heathcote / Getty Images

It was clear to everyone—the players, the referee, the TV commentators—that Pereira was unconscious. At this stage, there’s no further diagnosis necessary. You will often read that doctors disagree about when to diagnosis a concussion or mild traumatic brain injury but once there is a loss of consciousness all doctors agree that a concussion or mTBI has occurred.

Pereira should not have been let back onto the field. His coach, his team physician and the FIFA physician all should have stopped him. But Pereira insisted on returning to play for the remainder of the game over the objections of his team’s doctor, while FIFA doctors didn’t even examine him until after the game was over.

Sure, any player would be upset but irritability and mild aggression are normal responses following a head trauma. Pereira should have been lead off the field and if the team didn’t get him off the field, they should have been issued a yellow card.

FIFA needs to do more in terms of educating international coaches, players, fans, and their medical staff. Mr. Pereira was cleared an hour after the game by FIFA physicians as being apparently concussion free; no return to normal cognitive activity and no return-to-play protocols needed. That’s a red card!

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Keeping It Simple is the Best Medicine

by Daniel Pokrifka, ATC/L
HeadFirst Concussion Care Program Administrator

No matter the type or severity of an injury or illness, the basics of healing are the same: A good night’s sleep, a warm bowl of chicken soup, a walk in crisp, clean air, and a cup of tea can heal all your troubles…or so, Grandma used to say. Well, Grandma now has some science to back her up, even when it comes to recovering from a concussion.

Your Brain Needs Time to Rest
The National Sleep Foundation recommends that adults get seven to nine hours of sleep per night for optimal mental health. The brain needs this time to perform the necessary function of memory consolidation and other essential processing. Without this, one’s mental faculties suffer. While healing from a brain injury, your brain needs more rest to perform these essential functions as well as promoting further healing from the injury. This increase in sleep is only recommended for the few days after the injury. Beyond this, a return to a normal sleep pattern is recommended to allow the body to adjust back to the normal circadian rhythm.

Feed Your Body Well for a Balanced Mind
The human body relies on healthy foods for optimal functioning, growth and healing. A regular diet rich in nutrients not only fuels the body for daily activity, but also it fuels the brain. Daily intake of good foods can also avert long-term problems with depression and anxiety that can arise with a prolonged injury. Colorful fruits and vegetables that are high in antioxidants are also especially good for strengthening blood vessel walls, including those in your brain.

Regular Exercise Promotes Faster Healing
Regular exercise boosts your good cholesterol and reduces your bad cholesterol, both of which keep your blood flowing smoothly and promote healing. Light exercise or therapy after an injury helps reduce pain, increase range of motion, and rebuild healthy muscle tissue. Gentle exercise after a concussion also elevates your brain’s secretion of serotonin, which can make you feel happier and more relaxed. This acts as a natural combatant against post-injury depression and anxiety.

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Water is the Source of Life
Proper hydration helps all body process to function properly. Without it your body cannot begin the process of healing. Clear, nonalcoholic and non-caffeinated drinks are best. For variety, add a squeeze of lemon or lime, or drink seltzer water. There is no magic number for the amount of water to consume but don’t wait until you’re thirsty — at that point, you’ll already be on the the way to dehydration.

While a concussion is a complicated injury, healing from it doesn’t have to be. Taking steps that include rest, nutrition, hydration and gentle movement will help heal your brain faster. With all the complexities of medicine it’s nice to know sometimes simple is best.