“Dr. Flinders’ new office at Tanner Clinic is awesome. He listens to my concerns and takes great care of my family. His medical assistant is awesome too.” — RateMDs.com, Feb. 26, 2015
“Irecommend Dr. Flinders to everyone I know. He is a great doctor. He listens to you, does all the tests needed to come to an accurate diagnosis. I was very upset when he left my North Ogden clinic because my insurance won’t cover him now. I have not been able to find another doctor like him. — Vitals.com, Jan. 12, 2015
“In a world where, unfortunately, doctors seem to have less and less time to spend with individual patients, it has been refreshing to have Dr. Flinders as my primary care physician. He is knowledgeable and honestly cares for his patients. I have been extremely impressed with him and his staff.” — Vitals.com, April 12, 2012
Concussions are all about our gray matter. Many of us think of the injury as a jolt to the head that causes minor brain trauma.
But here’s where all the gray area comes in. What specifically defines when a concussion has occurred? What is the short-term damage? Long-term damage?
The question that spurs Dr. Flinders’ interest is: How upfront are high school football athletes about reporting concussive symptoms, such as headache, memory loss and dizziness.
In research presented to the American Medical Society for Sports Medicine, Dr. Flinders reported this answer: not much.
“If you come off the field saying you have a headache, what’s the coach going to say? ‘Oh yeah, you better sit out’, or ‘Seriously? You have a headache?’” he said.
Teens don’t understand long-term effects
Dr. Flinders began his concussion research after hearing a lecturer explain how doctors were catching many more concussions. “I could tell this guy had never played football,” he remembers. “He has no idea. People aren’t telling him half of what they feel.”
After playing football for Roy and Fremont high schools, as well as cornerback for what’s now Dixie State University, Dr. Flinders knows that boys are likely to brush off any head knocks and the resulting headaches and confusion.
Why? Dr. Flinders explains, “No. 1, teenagers don’t necessarily think in terms of long-term. Two, they don’t want to be seen as a wuss. And No. 3, no one wants to be unable to play.”
Part of Dr. Flinders’ research was interviewing high school football players. The athletes were asked whether, following a game, they had experienced such symptoms as forgetfulness, headache or loss of consciousness. The answers, he says, “were overwhelmingly yes.” In a follow-up question he asked if these symptoms were reported to trainers? And the answer? No.
More than a single blow
Dr. Flinders says concussions can be easy to diagnose if a loss of consciousness has occurred, but the diagnosis becomes less clear with other symptoms. Newer technology has helped evaluate an athlete’s balance and cognition at baseline, which can be later be used to aide in the diagnosis of a concussion.
Concussions can result from head bumps, but also, he said, from abrupt, jolting stops.
“When you stop suddenly, your brain is still going forward,” he said. Helmets and other gear can help against the actual blow, he says. “But it doesn’t mean the acceleration and deceleration of your brain doesn’t occur.”
Here’s another gray area: How many concussions does it take for significant brain damage to occur? The greatest danger, Dr. Flinders believes, is from chronic repetitive trauma. “It’s not so much that this one event caused the concussion,” he says. “It’s hitting your head over and over again that leads to chronic changes to the brain (called chronic traumatic encephalopathy, or CTE).”
Are concussive injuries overblown?
Dr. Flinders is often asked if the issue of concussions is being overblown. There’s one camp that says, “People have been playing sports and hitting their heads for a long time, and they’re OK;” while another camp says, “Newer data suggests possible long-term complications, not to mention the short-term risk of second impact syndrome.”
As a young football player, says Dr. Flinders, “I used think it wasn’t a big deal.” These days, however, he is reluctant to let his son play football, especially at a young age.
The primary offense against concussion injuries is education.
Trainers, coaches and parents are learning more and more about the dangers of concussion. And Dr. Flinders offers that education to his own patients.
The good news is that concussion training is being widely implemented. And we’re seeing more legislation, such as the Utah law titled The Protection of Athletes with Head Injuries Act.
The 2011 law requires that a child who receives a head injury must be removed from play and may only return after getting clearance from a health provider who has been trained and certified. Dr. Flinders will be one of those certified physicians.
The law applies to amateur sports organizations and schools (ski resorts are exempt from the law). They are also required to adopt and enforce a concussion and head injury policy and to get written approval of the policy by parents/legal guardians before their child participates in a sport activity.
— Tanner Clinic staff
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