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football player

by Tyler Rust
Published on February 27, 2019

Estimated read time: 4 minutes

When playing sports in the past, “getting your bell rung” and then getting back in the game was a rite of passage and show of toughness. Nowadays, those hard impacts to the head are looked at differently and are strong indications that an athlete may have a traumatic brain injury (TBI).

An estimated 2.8 million people in the U.S. get a TBI each year, and sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents. The immediate implications of a TBI, including headaches, nausea, dizziness and tiredness, can impact an athlete’s day-to-day functions. Research on the long-term impact of repeated traumatic brain injuries is ongoing, but studies have already shown relationships between TBIs and degenerative brain disease, depression, dementia and neurocognitive impairments.

Problems with TBI identification and tracking

Identifying and tracking sports-related traumatic brain injuries through the different stages of life helps providers recognize trends and improve the quality of care. In many instances, identification of a TBI relies on neurocognitive assessments that may take place on paper or in an application that is unconnected to an athlete’s medical record. Additionally, mild traumatic brain injuries may be identified and resolved outside of the athlete’s longitudinal record.

Depending on the level of the sport or the where the injury occurs, the identification and tracking of the TBI can be limited. While emergency department visits for traumatic brain injuries increased by 47 percent from 2007 to 2013, some athletes may choose to not report the injury. Youth and recreation leagues often have limited or no sports medicine care providers onsite during activities.

At the collegiate level, the sports medicine staff watches for TBIs, but the applications and protocols for tracking TBIs may still be paper-based or simple, unconnected records. Even at the professional level, lack of identification and intervention when dealing with repeated concussions can be extremely impactful to an athlete’s health.

Steps are being taken to reduce the number of sports-related traumatic brain injuries, including rule changes, concussion protocol requirements and knowledge saturation. In 2016, U.S. Soccer banned heading for children 10 and under. The National Football League (NFL) made recent rule changes to reduce helmet-to-helmet hits and athletes initiating tackles with their heads. The National Collegiate Athletic Association (NCAA) and professional leagues, such as the National Basketball Association (NBA), have concussion protocol requirements that include immediate responses as well as return to play procedures. The Centers for Disease Control and Prevention (CDC) has the HEADS UP program to inform parents, providers and schools about traumatic brain injuries and best practices.

How the EHR can advance TBI treatment

Even with the changes to rules, protocols and increasing knowledge, additional steps are needed to ensure that traumatic brain injuries are accurately recorded in athletes' health records. Neurological assessments—whether documented via paper or applications—and TBI events need to be connected to the medical record. They must be available at all levels of play, comprehensive and easily accessible for care providers.

By ensuring assessments and TBIs are captured in the electronic health record, the common paper management issues are reduced, and the athlete is provided with a lifelong file. Through tracking this information, it can be easier to see when an athlete has returned to a neurocognitive baseline and to establish a new baseline. Regular baselines and assessments can help identify trends in a person’s brain health.

Many sports medicine providers, specifically athletic trainers, are caring for hundreds of athletes across multiple sports, so ensuring those providers have the right solution to quickly and accurately record TBI events and rehabilitation is important. These providers may need a more specific health management system that streamlines the data entry and management of an athlete’s records, while also connecting to the athlete’s main medical and longitudinal record. By providing the right solution, more details can be captured on both major TBI events that require a hospital visit as well as minor TBI events that can be resolved without those visits.

Through complete tracking of TBIs, additional data points are available to go deeper into the management of TBIs and return to activities. These data points also assist providers in gaining a greater understanding of the long-term impacts of TBIs on brain and mental health.

As sports continue to be a key activity for people of all ages, tracking when a TBI occurs is crucial in empowering providers to evaluate and properly care for potential health risks that can impact an athlete's present and future.

HealtheAthlete is a secure, web-based health management platform that helps you and your athletes track their health and care throughout their lifetime. Learn more here.