Minor head injuries require major attention
DEAR DR. DONOHUE: My son is the quarterback for his high school’s football team. My husband believes he’s good enough to win a scholarship to college, something that would be a godsend for us. In his last game, he got blindsided and was on the ground for a few seconds. He says he was awake all the time. The coach took him out of the game and won’t let him play for another week. My husband thinks this is going to ruin his scholarship chances. Is this overkill on the coach’s part? It wasn’t a concussion. — L.L.
ANSWER: Be grateful that your son has a coach who is concerned with his players’ health. Even minor head injuries can have a profound effect on the brain, and the effect might not be seen until later in life. Loss of consciousness doesn’t define a concussion. Acting confused, moving slowly, dizziness, drowsiness, a headache and the inability to remember (amnesia) what happened before the hit and the inability to retain information after the hit are some of the signs that make a head injury a concussion.
If a player hasn’t fully recovered from a concussion and sustains another head injury before the brain has healed, the second injury can be a disastrous one. Some experts feel it takes a full month for complete recovery from a concussion.
The Cantu guidelines provide coaches and team physicians a way to evaluate the seriousness of a head injury and the time that should be taken before a player is allowed to return to play. A grade 1 injury occurs without any loss of consciousness but with some memory impairment or other sign of brain malfunction, and these signs last less than 30 minutes. A player can participate again in one week if he shows no lingering signs. With a grade 2 injury, the player loses consciousness for less than one minute or has a sign of mental dysfunction for more than 30 minutes but less than 24 hours. The player with a grade 2 injury should not return to play for two weeks, and then, only if he or she has had no signs for seven days. A grade 3 injury is one with loss of consciousness longer than one minute but less than 24 hours. This player needs a full month to recover and should be examined by a neurologist.
DEAR DR. DONOHUE: I understand that you burn more fat by exercising at a low level of exertion. I love this news. I got it from people who know lots about nutrition and exercise. They call it our fat-burning zone. Please say it’s so. — K.J.
ANSWER: It is true that lower-intensity exercise turns to fat for fuel. For high-intensity exercise, the major fuel source is stored carbohydrates — glycogen. Once glycogen reserves are depleted, the body then turns to fat for energy.
This makes it sound like the “fat-burning zone” is a reality. However, the total amount of fat burned depends on the total number of calories expended. Many more calories are burned with exercise of high intensity. Therefore, more fat is burned with high-intensity exercise.
DEAR DR. DONOHUE: What exactly is a hamstring pull? I think I might have one. It happened when I was playing basketball with my sons. The back of my right thigh suddenly began to hurt, and it still does. What do I do for it? — J.M.
ANSWER: The hamstring muscles are the ones on the back of the thigh. They bend the knee. The front thigh muscles are stronger than the hamstring muscles. If the front muscles contract before the hamstrings have had time to fully relax, the stronger front muscles will tear some of the hamstring muscle fibers. That’s a hamstring pull.
The standard RICE treatment is the treatment of choice — Rest, Ice, Compression with an elastic wrap and Elevation. You’re past the icing stage. You now should be using a heating pad or hot compresses for 20 minutes at a time, three times a day. A small tear heals in five days. A large one takes three or four weeks.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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