January is National Winter Sport Traumatic Brain Injury (TBI) Month. As the weather gets colder, many people participate in sports such as skiing, snowboarding, ice hockey, snowmobiling, ice skating, and sledding. While these activities can be very enjoyable, they also pose a risk of injury, including TBI. It is important to know about the risks and how to stay safe.

What is TBI?

Traumatic Brain Injury is damage to the brain caused by a bump, blow, or jolt to the head, which disrupts normal brain functioning. The impact causes the brain to crash against the skull and causes injury such as bruising, bleeding, and tearing of nerve fibers. Later, the brain may swell, which causes additional harm. Depending on the symptoms, the severity of the TBI is classified as either mild, moderate, or severe. Types of TBI include concussion, contusion, diffuse brain injury, second impact syndrome, subdural hematoma, and epidural hematoma. Winter sport athletes can get a TBI during a fall or collision.

TBI Prevention

Winter sports are a lot of fun and can be very beneficial for your physical and mental health. Taking steps to prevent TBI can help to keep them as healthy entertainment.

There is much debate about the effectiveness of helmets to protect from TBI. Some studies show no significant difference between the injuries of those who wear helmets and those who do not. Other experts say that skiers and snowboarders who wear helmets reduce their risk of head injury by about 35%. Either way, more and more winter sport athletes are wearing helmets. Helmet usage is not required in most places, but that is beginning to change. In 2011, New Jersey passed a law requiring skiers and snowboarders under the age of 18 to wear a helmet. The National Ski Areas Association has a Lids on Kids campaign to promote increasing safety for skiers and snowboarders, which includes education about helmet usage. Helmets need to fit correctly and be worn properly in order to provide maximum protection. If you do get into an accident, it is important to replace your helmet. The impact may have damaged the structure of the helmet, which means that it may not be able to protect you in the future.

Taking lessons in a sport such as ice skating, skiing, or snowboarding can not only increase your skill, but it can also reduce the likelihood of falling and teach you how to fall safely so you can avoid injury. Other precautions are sport specific, but often include less aggressive playing such as prohibiting body checking in ice hockey. Knowing your environment is also beneficial. Being aware of where other players and potential obstacles are can help you to avoid them.

Every state in the US has its own laws about concussion in young athletes, although the specifics vary by state. These laws require education for coaches, parents, and athletes, as well as protocol for when a head injury occurs and when a player may begin playing again. It has led to more athletes reporting when they have symptoms of a concussion and less athletes returning to their sports while they are still exhibiting these symptoms. The Center for Disease Control and Prevention has a program called Heads Up which provides education and training about concussions in an effort to treat and prevent them.

Dealing with TBI

When someone has a head injury, it can be difficult to determine whether or not they have a traumatic brain injury because there may not be any visible symptoms. It is important to observe their behavior and pay attention to any symptoms that the injured individual may report. Signs of concussion can include confusion, losing consciousness, clumsiness, memory problems, and behavior or personality changes. The injured athlete with a concussion may experience headache, nausea, light or noise sensitivity, drowsiness/sluggishness, difficulty concentrating, dizziness, or double/blurry vision. Some of these symptoms will not appear immediately but will become evident over the next few hours or days. Anyone suspected of having a concussion should stop participating in sports and receive immediate medical attention from a health care professional. They should be taken to the emergency room if they exhibit severe symptoms including, but not limited to, loss of consciousness, convulsions or seizures, different size pupils, or slurred speech.
Once a TBI has been diagnosed, it is important to understand the full extent of the injury and its symptoms so that the individual with the TBI can receive treatment specific to these symptoms. A neuropsychologist conducts various tests and will also interviews the individual and the family to ascertain a full picture of the individual’s current level of cognitive, behavioral, and emotional functioning and skills, and how they differ from prior to the injury. These neuropsychological evaluations will look at cognitive skills such as attention, memory, information processing, visual-spatial abilities, motor and sensory abilities, and executive functioning. The emotional and behavioral changes can include irritability, depression, and impulsiveness.
Once all evaluations have been completed, the neuropsychologist will compile all of the information and create a report showing these findings, as well as making recommendations for what can be done to help the individual recover. The neuropsychological report shows the individuals current strengths, weaknesses, and limitations. Rehabilitation, such as cognitive exercises, may be a necessary part of the recovery process. Psychotherapy may also be suggested to help deal with any emotional side effects of the TBI. Having a TBI be recognized and explained can be of great value to the affected individual. It can be difficult to understand what has happened and the impact that the TBI has had on their everyday functioning. And as TBI is an invisible disability, those suffering from one may look the same as before the injury, so it can be difficult for others to understand and to accommodate their needs. The results of a neuropsychological examination can be used to explain the condition to others so that they can be appropriately supportive.
Remember, be safe when participating in winter sports or any other sport. Head injuries need to be taken seriously. The cognitive damage that TBI can cause needs to be addressed, and the injured person needs to be given time to fully recover while avoiding further injury. Neuropsychologists can help those with TBI to get on the best path to recovery.

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Resources

https://www.nationwidechildrens.org/research/areas-of-research/center-for-injury-research-and-policy/injury-topics/sports-recreation
https://www.cdc.gov/headsup/index.html
http://sportconcussionlibrary.com/wp-content/uploads/2015/10/CDC-TBI_factsheets_PARENTS-508-a.pdf
https://www.cdc.gov/headsup/pdfs/helmets/headsup_helmetfactsheet_ski_508.pdf/

References

https://mayfieldclinic.com/pe-tbi.htm
https://ksi.uconn.edu/2019/01/25/national-winter-sports-traumatic-brain-injury-tbi-awareness-month/
https://www.usfsa.org/content/Concussion_Education_Information_9-21-13_-_BOD_reviewed_and_final_logo.pdf
https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Sports-related-Head-Injury
https://www.biausa.org/brain-injury/about-brain-injury/diagnosis/neuropsychological-assessments
https://www.pivotphysicaltherapy.com/news/national-winter-sports-tbi-awareness-month-tips-safety/
https://ksi.uconn.edu/emergency-conditions/traumatic-brain-injury/
https://www.cdc.gov/headsup/pdfs/youthsports/magnet-a.pdf
https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968
http://sportconcussionlibrary.com/wp-content/uploads/2015/10/CDC-TBI_factsheets_PARENTS-508-a.pdf
https://www.bcmj.org/articles/neuropsychological-assessment-mild-traumatic-brain-injury-clinical-overview
https://www.brainline.org/article/guide-neuropsychological-testing https://www.psychologytoday.com/us/blog/the-wide-wide-world-psychology/201306/invisible-disabilities