HEALTH MATTERS Experts say good conditioning can reduce sports injuries, including concussions

Sep. 4—JOHNSTOWN, Pa. — As high school sports' fall season moves into high gear, doctors and athletic trainers are working with athletes not only to care for injured players, but also to prevent injuries in the first place.

Preventing injuries starts even before the season begins, said Kelly Adams, a nurse practitioner with Chan Soon-Shiong Medical Center at Windber's walk-in orthopedic clinic.

Good conditioning, improving muscle balance and addressing small issues before they become aggravated can help keep youth sports players active, Adams said.

"We start with a safety plan to get them acclimated and get them back into the swing of things," she said. "We do a lot of work with them before the school year starts so they don't have issues."

Windber offers its DARI Motion Analysis for organizations to plan individual conditioning plans. The computerized video scanner tracks athletes' movements while exercising to identify "musculoskeletal asymmetries and poor movement patterns that impact performance and lead to injury," the hospital website says.

Good stretching and knowing one's limitations are important prevention tips, Adams said.

"You need to warm up and stretch before you play a sport," she said. "And don't try to play through the pain. Sometimes the pain is there for a reason and you need to come in and get checked."

Working with athletic trainers, physical therapists and orthopedic specialists, student-athletes may have to sit out a few weeks, but can be ready to play the next sport, she said.

"We try to get them rehabilitated as soon as possible to get them returned to the team," Adams said.

Rehabilitation is a little trickier when it comes to concussions.

Conemaugh Memorial Medical Center's concussion clinic works with schools to identify potential concussion injuries and plan a response. Dr. John Baker is the clinic's medical director and Tom Causer is the clinic coordinator.

"We want to make sure they can get back to school and return to both athletics and academics," Baker said. "They go hand in hand."

Schools reach out to the clinic when trainers suspect a concussion, also known as a mild traumatic brain injury. The clinic begins with a neurocognitive test and impact test.

"Then we put together a plan," Baker said. "Each plan is individualized."

The clinic works with teachers to adapt lessons for any short-term neurocognitive issues, while also working with coaches and athletic trainers on fitness and conditioning.

Although most people associate concussions with direct impact on the skull, brain injuries are actually caused by the brain moving inside a cushion of fluid. When the movement is sudden, the brain can strike the skull inside, causing the concussion.

"You don't even have to get hit in the head to get a concussion," Causer said. "Those are the types of concussions where we can help lessen the severity."

Signs of a concussion include headache, dizziness, loss of balance, confusion, nausea, ringing in the ears and blurred vision.

Like Adams, the concussion clinic staff say prevention starts with good conditioning — especially when it builds core strength, Baker said.

The core is a group of muscles that stabilizes and controls the pelvis and spine, with influence on the legs and upper body. Strengthening the core can allow athletes to brace against severe jarring caused by being hit or colliding with other players, Baker said.

"The stronger your core, you don't get the whiplash effect," he said. "You don't get thrown around as much. Muscle in the core protects the head."

Causer said the clinic works with athletic trainers to emphasize mobility, agility, strength, stability and flexibility.

"We integrate those exercises into their normal workout," Causer said.

Baker said other keys to preventing or treating concussions include education about concussion signs, hydration, nutrition, proper equipment and technique. He gave the example of cheering, in which good technique can help prevent falls during lifts and throws.

When it comes to equipment, Causer said helmets are important — if they fit properly and are appropriate to the sport.

"We love helmets, but helmets don't prevent concussions," he said. "It's a layer of protection."

The brain can still be knocked around while in a helmet, but the equipment can help prevent a more severe traumatic brain injury, Causer said.

Overall sports injury prevention advice includes warming up, stretching and resting, Adams said.

"You don't have to play all year, every day," she said. "Know your limitations."