Mind Games: Concussions, CTE and Sports

Melissa Womble, PhD, is a neuropsychologist with specialized training in concussion management. She is the director of the Inova Sports Medicine Comprehensive Concussion Center.


The Journal of the American Medical Association (JAMA) recently reported on a study that analyzed the brains of deceased former high-school, college and professional football players. In the sample of 202 players, 177 had evidence in their brains of chronic traumatic encephalopathy (CTE). Some 99% of NFL players in the study had brain changes associated with the disease.

CTE is currently thought to be a long-term, neurodegenerative brain disease associated with repeated concussions and blows to the head. Some experts suspect the disease could cause problems with mood and behavior, though it is not currently known to what degree these symptoms relate to the brain changes specific to CTE.

There’s still a lot we don’t know about CTE. But in the last 2 or 3 years, we’ve made significant progress in treating and managing concussions.

If you or your child is active in sports, here’s what you should know.

Are Contact Sports Too Dangerous?

Not necessarily. I often remind worried parents that there are a lot of benefits to playing sports. No sport or activity is risk-free. But contact sports aren’t necessarily a ticket to CTE.

The current study only looked at players who donated their brains for study, so it was a biased sample. (People who were experiencing problems such as depression or memory problems might have been more likely to participate.)

And other studies have surveyed living athletes and found those who played high school and college-level contact sports were not more likely than others to experience depression, anxiety and cognitive problems.

That doesn’t mean athletes shouldn’t take precautions. Concussions should be taken very seriously. Some athletes might be tempted to hide signs of concussion to finish a game or a season. But that decision can have serious consequences.

Research on football players has shown that there’s nearly a 9 times greater risk for a prolonged recovery if someone plays for even 3 minutes after suffering a concussion. And returning to play before a concussion has fully healed can increase the risk of future brain injury.

If an athlete experiences signs of a concussion, he or she should seek medical treatment right away.

Managing Concussions

Five years ago, the recommended treatment for concussion was lots of rest in a dark room. Now we know that “active rest” is best. That includes a focus on regular sleep, regular meals, adequate hydration and trying to keep stress levels low. We also now recommend a gradual return to normal activities, such as school and physical activity, even when mild symptoms are present.

We also have more specific treatment than we had in the past. People who experience dizziness after a concussion may need vestibular therapy. Those who complain of blurred or double vision may benefit from vision therapy to retrain the eyes to work together as they did prior to the injury.

The Inova concussion management program can help diagnose and treat concussions in people of all ages. Our team includes a neuropsychologist, athletic trainers, primary care sports medicine specialists, and specialists in vestibular therapy and neuro-optometry. We all work together to help patients with a concussion get back to regular activity as quickly as possible.

We also provide baseline testing for athletes ages 5 and up. We can test each athlete’s cognitive and vestibular/ocular-motor functioning before an injury occurs. That gives us a baseline to compare to if we have to test for or treat a future concussion.

When it comes to protecting your brain, awareness is key. Don’t hide symptoms of a concussion, and don’t play through them. The right treatment can help you heal and get back to the activities you love.

To schedule your athlete’s in-person Concussion Baseline Test, register online or call 703-970-6427 to make an appointment.

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