One of the best things I get to do as a sports medicine physician, while taking care of athletes and athletic injuries, is answer their questions about the world of sports injuries and injury prevention.

No topic has been as popular recently as head injuries and the possible long-term effects of those injuries. Part of this interest is fueled by press coverage of athletes dealing with head injuries, both current and past.

The majority of interest is being generated from the emerging research regarding head injuries and the knowledge that they are likely much more subtle than we realized.

I get a lot of questions from mothers, wondering if participation in specific sports is putting their child at risk and whether they should allow sports participation at all. So let’s set the record straight and talk about what we do know about sports and head injuries.

The high speeds and quick decelerations of a collision can actually create the possibility for the brain to impact the inside of the skull. Since the brain consists of a vast network of delicate neurons, this impact can disrupt thought processes, remove memories and even in extreme cases, create swelling of the brain itself.

The symptoms of brain injury, such as headaches, memory loss, confusion and vomiting or blurry vision from brain swelling, were historically lumped together under the diagnosis of “concussion.” Recent evidence has emerged that a concussion can occur even without the usual symptoms.

In fact, studies looking at the brains of athletes indicate that subtle concussions can occur without the athlete even recognizing that any significant trauma took place. This new knowledge has changed the way we are diagnosing brain injuries and concussions and giving us a better idea about how to treat athletes after injuries.

Common sense would say that contact sports such as football, hockey, rugby and lacrosse would be the sports with the largest risk of head injuries.  While these sports do carry a risk, injuries can occur with almost any sport.

A recent study looked at soccer players and found that even repeatedly heading the ball can cause some of the subtle effects of head injuries after several months.

So how do we protect athletes? New rules for play, including those that limit collisions are already being implemented. Equipment design and technology has had a surge in interest for the first time in years and is producing better protection.

Scientists and doctors are developing more reliable tests to diagnose even subtle injuries and to monitor recovery. All of these measures will help, but the most difficult change will come in our attitudes towards those who have been injured. The emphasis on return to play will need to be radically altered for many of these athletes who may seem physically intact from the outside, but are still recovering from head injuries internally.

Parents, coaches and athletes alike will need to change expectation and grant more recovery time in order to reduce the pressure for an athlete to return to play earlier than is safe.

With these changes, we can all continue to pursue active lifestyles without paying a high price in the future.

Dr. Jason Boyer is an orthopedic surgeon specializing in sports injuries, musculoskeletal injuries and cartilage replacement.  He can be reached via appointment at (425) 820-1221 or at orthowashington.com.