March is Brain Injury Awareness Month and the Brain Injury Association of America‘s campaign for 2015-2017 is “Not Alone.” Brain injuries can be hard to diagnose, treat, and recover from, often leading the affected person to feel isolated and depressed.
Since Roller Derby is a contact sport, concussions are unfortunately a common injury but show themselves in many different ways. Today we will focus on some concussion education and highlight the importance of knowing the symptoms and how they might affect you and your recovery.
Roller Derby thrives on being an accessible sport that anyone can join, provided they can purchase a list of protective gear and learn the basic skills involved in playing. We teach each other how to skate, how to fall, and what to wear to protect our bodies. However, as an amateur sport, most teams likely don’t have a full staff of coaches and trainers as well as a medical team dedicated to injury prevention and rehabilitation. A lot of that responsibility falls on the individual, or on the team to come up with their own safety protocols. (Check out WFTDA’s Risk Management Guidelines.)
One of the biggest topics floating around in contact sports today is concussions, but this “invisible injury” may also be one of the most misunderstood injuries that plague a sport like Roller Derby. Often times this topic gets addressed after a fall or hit to the head, and there is little focus on preventative measures or education beforehand. It’s in the aftermath that people tend to take notice of concussions. Suddenly a skater shows up with a hockey helmet or face shield after getting a bad hit or they give up derby altogether due to the horrible effects of a bad fall they had.
First, let’s start with a bit of anatomy. The brain is like a jello mold surrounded by fluid within the skull which protects it from the normal bumps and jiggles of everyday life. Forceful blows or jolts can cause it move around violently, and anytime there is trauma to your brain, it can alter the way it functions. According to the Centers for Disease Control and Prevention, Traumatic Brain Injuries (TBI) can have effects lasting from days to becoming lifelong disabilities, and nearly 30% of brain injuries result in death. A TBI could happen from a car accident, a penetrating injury (think gunshot wound), or blow to the head and of the leading causes, 40% are from falls. In a contact sport like Roller Derby, falling or having another fast, moving object collide with you are a high possibility.
The concern is often about head protection as a preventative measure, but a hard outer shell isn’t going to keep the jello mold from moving around. Trauma can happen without any contact to the head at all. Any movement that causes the brain to “slosh” around could result in a concussion. The way this could happen in Roller Derby, or any contact sport is when a sudden hit causes the head to whip unexpectedly.
Brains are a complex organ and are unique to the person they belong to. That means people will likely obtain head injuries in different ways, react to them in different ways, and have varying recovery needs. Concussions aren’t all the same either, according to the University of Pittsburgh Medical Center, there are six different kinds of concussion trajectories that affect people differently.
Cognitive – Think of this one as your batteries are constantly on low; you’re tired and you’re having a hard time focusing on the news on TV in the background while three different people are pinging you on Facebook and you’re trying to look up a recipe on Pinterest. Or maybe putting that presentation together for work has become a chore because you keep forgetting that piece of information you just looked up, and a co-worker keeps poking their head in your office, completely destroying the ounce of concentration you had on the one task in front of you.
Vestibular – This one is about movement and balance which are big parts of roller derby, and you know, everyday life. You might become confused or dizzy by watching the dog run back and forth in front of you, or you see double as you move your head to try and follow him. These types of symptoms would greatly impair your reaction time and coordination which could result in another injury if you return to play too soon. This is why it is so important to take time off after getting your bell rung on the track. Symptoms don’t always show right away, or you may not recognize them at first, and heading back onto the track could become dangerous.
Ocular – This can be similar to Vestibular but has more to do with your eyes and how they interpret the information in front of you. Your “binocular vision” is affected, in other words, the way your eyes work together to see things in front of you. This could mean having a hard time focusing on particular objects, or difficulty with tracking, which would greatly affect the way you read.
Post-Traumatic Migraine – These sorts of symptoms are maybe the more typical things associated with Concussions and can take the longest to recover from. It includes headaches, nausea, or light sensitivity which could become greatly debilitating for your everyday life. Most people have jobs or activities that involve looking at a screen which could mean time off work for an extensive period and lots of quiet, unstimulated time.
Cervical – Concussions often bring the focus to just the head and brain, but the spine can play a role in this injury and induce headaches as well. If the spine is compressed during an impact, it could cause tingling or numbness in your hands and feet momentarily or up to 24 hours after injury. This type is more common in football where there are many head on collisions, but could still happen in a sport like roller derby, despite there being rules against contact with the head. Injury to the spine can also come from the head snapping forward or back, like whiplash.
Mood – Symptoms from this category would manifest in anxiety, the inability to shut off thoughts, and becoming worried or concerned – probably how one might be expected to feel anyways after a serious head injury. This is where concussions can greatly affect the personality of a person, not just their physical life. Knowing the difference between a concussion that affects someone’s mood rather than their cognitive abilities would influence the treatment of the injury and how recovery would go.
Just as the brain is very complex, the varying ways it shows symptoms and needs treatment is very complicated. UMPC has done extensive research on these different concussion trajectories and how to help people recover according to what symptoms they’re experiencing.
In 2015, the Women’s Flat Track Derby Association produced an informative Concussion Educational video showing real life instances of the different ways one could suffer a concussion on the track. They also highlight how symptoms can present immediately or later on, and that a skater doesn’t have to lose consciousness to have a concussion.
Another myth related to head injuries is that you should keep the affected person awake for 24 hours after a concussion. It is good to keep tabs on the injured person since there are many dangerous symptoms that can occur, but rest is an important part of recovery after a head injury. In all cases, make sure the injury is checked by a medical professional.
“athletes and participants suspected of having a concussion should be removed from play immediately.” – WFTDA safety Protocol.
Concussions can be hard to diagnose or be taken as seriously as they are. One study showed that About 9 in 10 Americans cannot correctly spot a concussion, which is a scary statistic. Popular culture may also affect the way we look at head injuries by making light of concussions or romanticizing things like amnesia. Check out some more myths and facts about concussions in an article Elektra-Q-Tion wrote for us last year.
With more and more young skaters joining Junior leagues, it’s even more important to take care with their noggins, as they may not be able to adequately convey or understand how they feel if they are experiencing a concussion. In a contact sport, it is very important to get checked out by a doctor and be cleared before returning to play. Getting another concussion before the first one has ended may result in swelling of the brain that can be fatal.
Repetitive brain trauma can lead to Chronic Traumatic Encephalopathy (CTE), the progressive degenerative brain disease which so far can only be diagnosed during an autopsy. It has been made more widely known after many football players have died at a young age from CTE and many from suicide. The movie Concussion helped highlight the discovery of this disease, inspired by the GQ article about the difficult road Dr. Bennet Omalu had to travel to bring the disease to light in the NFL.
If you have a story about how you have been affected by a concussion, please send us an e-mail: firstname.lastname@example.org.