Gear can’t prevent it; you don’t have to pass out

Helmets are great for preventing skull fractures.

Mouth guards are great for preventing broken teeth.

But regardless of how they are marketed as ways to prevent concussions, no credible medical evidence indicates that they do.

“That’s one of our big concerns — that people are relying on outside equipment to protect themselves, or getting a false message about what that equipment can do,” Dr. Rachel Coel, director of sports medicine at The Queen’s Medical Center said. “While people should keep wearing helmets, a lot of the protective gear out there is protective, but it’s protective for one type of injury and not concussion.”

In some sports, head gear can create a false sense of security or even be used as a weapon. This has been addressed in football with changes such as the “targeting” rule that penalizes players who strike opponents head-first.

“I think more important is the teaching of proper technique,” Coel said. “You can fix a shoulder. It’s much, much harder to fix a brain.”

Helmet safety is one of the focal points of the HEADS UP Concussion in Youth Sports Initiative developed by the Centers for Disease Control and Prevention.

Another myth is that concussions are always accompanied by a loss of consciousness.

“(Many athletes) think you have to lose consciousness. They say they have a little bit of a headache and they’re dizzy. But when it doesn’t go away, that’s when you know there may be a concussion,” Dr. Jill Inouye of the University of Hawaii said. “We had (an athlete) who was getting headaches and nausea once in awhile. It went on for two weeks before she told anyone. She kept practicing, trying to fight through it.”

People who get concussions and do not take a break from activity that could cause another run the risk of second impact syndrome, which is rare, but can be deadly.

Second impact syndrome is when a patient is still experiencing concussion symptoms and not fully recovered and receives another hard hit or jarring episode to their head or body, causing a second concussion and possibly worse, such as brain bleeding and swelling, Coel said.

“I guess (I’m) lucky. From what I understand it could’ve been a lot worse,” said Troy Furutani, who suffered a concussion without realizing it when he was a high school basketball player in the 1980s.

He went up for a dunk during practice, was hit in the legs by another player and landed flat on his side. At that time, his school, Maryknoll, practiced on outside asphalt courts.

“Then I didn’t remember anything for a little while,” said Furutani, who is now the manager of the Hawaii Concussion Awareness Management Program. “I didn’t remember where I was. But then I just got up and continued running and playing. For a few days after that I couldn’t focus and stuff. But I never thought it was a concussion at that time.”

The fact that he landed on his side, and not his head, underscores another myth about concussions.

“That’s a common misconception that you have to get hit in the head to get a concussion,” Furutani said. “Actually you can get hit in the body and if there’s an impulsive force where your head moves, that can cause a concussion.”

Although significant advances are being made in awareness, diagnosis, management and treatment, there is no cure for concussions. There also is no surefire, easy way to diagnose them, either.

“There’s no Breathalyzer, there’s no magic swab,” said Coel, who suffered two concussions as a Punahou athlete in the 1980s, one playing soccer and one while canoe paddling (one resulted in loss of consciousness, the other did not, she said). “We’re making exciting advances, but there is no cure for concussions. That will hopefully come from the next generation of researchers.”

Concussions Statistics by Honolulu Star-Advertiser on Scribd