Getting Back in the Game

Story by Dr. Jennifer Reesman, Supervising Neuropsychologist for the Deafness Related Evaluations and More (DREAM) Clinic, and the multi-disciplinary Sports Neurorehabilitation Concussion Clinic.

ChrisMost soccer players, especially goalies, are known for their fearlessness. Unfortunately their aggressive play and love for the game can translate into time spent off the field, recovering from a concussion.

I first got to know Chris–a charming, hard-hitting soccer goalie who also loves the guitar–after he was sidelined by a concussion. He was hit in the head when, while blocking the goal, he dove to the ground, and the ball struck him in the face–hard–as he made the save. Because of the severity of the blows and his neurological signs, he was airlifted off the soccer field and flown to the Johns Hopkins Hospital, as his stunned teammates, spectators and parents watched.

A short time later, Chris came to see us in Kennedy Krieger’s Sports Neurorehabilitation Concussion Clinic. He came cheerfully, even though he was still experiencing symptoms of his concussion. Still, he wasn’t his usual ball of energy, and he was bothered by frequent headaches. As you can imagine, he was eager to return to the game—but in a safe way–and his parents needed help figuring out when Chris could safely return to the sport he loves.

In clinic I had the chance to see how Chris’ brain was dealing with the effects of his injury. We did computer based-testing, the ImPACT (Immediate and Post-Concussion Assessment and Cognitive Testing), traditional paper and pencil neuropsychological testing, as well as looked at his balance and motor skills. The computer tests helped us to look closely at his memory and his speed of doing different things – like how quickly he could search for specific targets on the screen. We learned that he was having a tougher time completing thinking tasks as quickly as he normally would. And although his memory looked great and he was clearly making progress toward recovery, he still had a little ways to go before he could get back on the field.

It’s always really tough for me to tell a young athlete that he or she can’t play the sports that they live and breathe, but my job is to protect their brain so that they can continue to play well into college and beyond. Even though it was tough for Chris to sit on the sidelines while his teammates played on, I reminded him of a mantra we often use in clinic: “It’s better to miss a game than the whole season.”

Our team worked with Chris and his family to guide him through a gradual return to play, where he first started doing low intensity activities, like stationary biking and helping his dad coach the younger soccer team. It made me really proud to see how seriously Chris took our recommendations. During Chris’s last visit to my clinic, so that I could check his neurocognitive functioning again, his headaches were gone and his response times were as quick as normal. Chris was able to “graduate” from the Sports Neurorehabilitation Concussion Clinic, and you’ll find him on the soccer field now. Of course, his mom tells me that she wishes there was a way to cover her son in bubble wrap, but I know that she is as happy as I am to see Chris safely return to the sports he loves. I think that Chris is a kid who will now make any soccer field that he is on safer. His intelligent questions in clinic showed me that he was clearly interested in understanding what happened to his brain, as well as learning more about the effects and warning signs of concussions. I’m sure that he will take care of his teammates if they ever face a similar injury.

In our clinic, we often have only short-term relationships with our patients. Even though I don’t have the opportunity to get to know patients like Chris very well, working with them is actually one of the most satisfying parts of my job. Seeing our kids quickly “graduate” from the clinic and safely return to the game motivates all of us to give our best selves to these young athletes. While the short window of recovery can be difficult, I know that parents and kids feel better knowing that they’re not alone. And it sure beats wrapping your kids in bubble wrap. 

 

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