Tag Archives: symptoms

Introducing Concussions

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This past 2011 season, US Lacrosse stepped up concussion awareness by making educational material and tightening up rules on hits to the head. Across all youth sports, we have come a long way from the days of sending a kid back into the game after “getting their bell rung.” Since Atlanta Youth Lacrosse operates under US Lacrosse youth rules it is important that we offer our members the information that US Lacrosse provides on concussions.

This week each post will focus on concussions in lacrosse, and actions that leagues across the country can use if a player shows concussive symptoms. I will clarify that these are not directions by me about how to handle concussions. I am relaying this information from far smarter people than me.

The following video from US Lacrosse in this post covers the following:

  • What is a concussion?
  • Is every concussion alike?
  • What symptoms occur when concussed?
  • What should you do if you have a concussion?
  • How can I recognize symptoms?
  • How are concussed players evaluated medically?

Atlanta Youth Lacrosse definitely subscribes to the video’s mantra of: if in doubt – sit them out. Stay tuned to the blog this week for further analyses of concussions. Plus, if we have any M.D. readers out there who would like to lend their expertise, feel free to comment below.


High Quality H20

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Humans need water. If your car needed fresh oil as regularly as your body needs water, you would get an oil change every day just to keep it running. Twice a day if you want it running well. An average person surviving in a moderate environment and not exerting himself, can expect to last three to five days before dying of dehydration. If you are exceptionally healthy, tack on an extra day. If it is hot, you will be hurting well before day three.

Dehydration occurs when you lose more water than you take in. The first measurable sign of dehydration is thirst. That’s right, if you are thirsty right now you are mildly dehydrated. The second measurable sign is urine color. Yellow urine is a sign of dehydration, and dark brown urine is a sign of serious dehydration. Athletes who participate in sports during the summer months should try to keep their urine color in the 1, 2, 3 range of clear to slightly yellow. This is a solid self-check to determine how hydrated your body is before playing a game in 95+ degree heat.

Urine Chart

Urine Chart

“It is not uncommon for athletes or soldiers to lose 2% to 5% of body weight during physical activity,6–9 and make up the short-term water deficit by drinking during rest periods and at meals” (Borden Institute). Two to five percent does not sound like a big deal. So long as an athlete is drinking water during rest they replenish the water lost through exercise. The trouble starts when the athlete forgets to drink because it only takes a little water loss to start showing symptoms of dehydration.

In a joint study, the US Army and Borden Institute state that “regardless of the specific process, water deficit or dehydration can reduce the ability of soldiers to perform mission-essential tasks in a timely and effective manner, thus increasing their likelihood of becoming medical casualties.” That boils down to: soldier doesn’t drink = solider doesn’t fight.

The study found that a 2-3% water loss leads to:

  • flushed skin
  • heat oppression (feeling heat is worse than it is)
  • weariness
  • sleepiness
  • impatience
  • anorexia

By four percent, individuals present with fatigued muscles, vomiting/nausea, and general apathy. At six percent the symptoms expand to:

  • dizziness
  • headache
  • dyspnea (shortness of breath)
  • tingling in limbs
  • very dry mouth
  • indistinct speech
  • inability to walk
32 Ounces of Water

32 Ounces of Water

All of these symptoms come at a faster rate in hot and humid climates. In fact, the daily water intake requirements for US soliders is roughly 5 Liters per day in temperate environments and up to 10 Liters per day in extremely hot environments.

  • 5 Liters = 179 Fluid Ounces = 5.5 Nalgene bottles of water per day.
  • 10 Liters = 358 Fluid Ounces = 11 Nalgene bottles of water per day.

That sounds like a lot of water to drink, but no one is doing it in one sitting. Soliders are required to sip water all day, every day. This constant hydration restores the water lost throughout the day without endangering the individual with hyponatremia.

I planned writing this post right before June for all of our players going to tournaments or summer camps, but I had to move it up because one of our own succumbed to serious dehydration this weekend. My friend and fellow lacrosse official Andy Halperin had four games to ref starting at 1:50pm.  By the third game, his partner injured his foot and Andy was left to officiate the game solo with the sun still hanging high.

The head official on site informed me of Andy’s plight and I rushed over to help. I got to the field and did not notice two early signs of dehydration coming from Andy. He was impatient to get the games going, and he was a bit apathetic. From the list above, he was probably around three to four percent dehydrated. We wrapped up the third game and prepared to get through the fourth. The field we were on was more sand than grass, and on nearly every play Andy and I were inhaling sand particles and dirt. To me this was a minor inconvenience, since I had drank water through the whole day, but Andy mentioned that he had not taken a water break since he started. The sun, sand, and heat were doing far more to him than they were too me, which is another symptom – heat oppression.

We ended the fourth game and slowly made our way back to the salvation of Coyote Tent City. Where there was water, gatorade, and a delightful assortment of fruits. I started downing Gatorade while Andy mentioned that his legs were cramping up. He drank up and everyone thought the cramps would subside. We packed up, said our goodbyes, and headed to the hotel. Andy went back to his car and his muscles seized up. He couldn’t make his legs climb into the car or make his hand grasp his cellphone. Fortunately, a trainer was nearby and noticed Andy’s serious condition. Using his phone, they called my dad to come pick Andy up and take him to the hospital. He arrived shortly, but Andy was in even worse shape so 911 was called and an ambulance got dispatched to the park.

Andy was taken to the local ER and pumped full of fluids and electrolytes. The doctors informed him and my dad that if the ambulance hadn’t picked him up and started treatment, that Andy would have spent a few days in the ICU recuperating. The quick response from the EMTs and the care of the doctors kept Andy from having to stay overnight, but his muscle cramps were so severe that he tore his calf muscle.

Fortunately for the AYL community, Andy is going recover, but why did he buckle to dehydration? He focused so much on officiating the games that he forgot to keep drinking water. This is both admirable and foolhardy. Admirable that he directs all of his attention to the field when he officiates, but foolhardy that he did not leave a little bit of attention for himself.

So to all players, learn from Andy’s misfortune and remember to drink regularly before the big tournament weekend. Then continue to drink water or a sports drink throughout the day. Oh, this applies to parents on the sidelines too. Water requirements for people “performing primarily sedentary activities can increase from approximately 2 to 3 L/d to 5 L/d” (Borden Institute). That equals about three to five nalgene bottles just for cheering on the sidelines.

Featured Image Credit – www.themoviedb.org

Drink Up,