It's no mystery why Summit County has 17-times more traumatic brain injuries (TBI) per capita than the national average: because we like to do fun things and take part in a lot of head-knocking activities.

But what are the dangers of repeatedly bumping our heads, and what's being done to treat the injuries in Summit County?

Concussion is a type of TBI, often related to sports, that has historically been overlooked by coaches and athletes. As the danger of concussion has become a hot topic in the media and medical communities, athletes at the professional and amateur levels are taking new steps to treat and prevent the injury, Summit County included.

In May, St. Anthony Summit Medical Center hosted two seminars featuring the REAP Project, which is expanding across Colorado as a model program for community-based concussion management.

The REAP Project (which is an acronym for reduce, educate, accommodate and pace) started after a serious concussion ended the life of Grandview High School student Jake Snakenburg while playing in a high school football game in 2004. To further their efforts, Colorado Gov. John Hickenlooper signed into law the Jake Snakenberg Youth Sports Concussion Act, making Colorado one of the dozen or so states to enact legislation.

The law requires that coaches receive education about concussions, that a student athlete is removed from the field of play if a concussion is suspected and that the student be signed off by a physician before returning to play.

Some of the symptoms of a concussion are headaches, sensitivity to light and noise, nausea and vomiting, balance problems, fatigue, blurred and double vision, mental dullness, mood swings, memory loss and depression — all of which can persist in the short- and long-term. Multiple concussions can have an additive effect on athletes, so with each additional concussion, the vulnerability becomes greater, the symptoms get worse and the recovery period gets longer.

Dr. Phil Freedman, medical director for St. Anthony's Copper Mountain Clinic and co-chair of the Head Injury Committee at the medical center, said Summit County treats roughly 1,500 head injuries per year; it's the most common trauma diagnosis at the three clinics and hospital.

One year ago, St. Anthony's formed the Head Injury Committee with three goals: reduce the number of CAT scans being performed due to the cost and radiation associated with the procedure, set up consistent management for in-hospital care of head injuries and, most importantly, develop a head-injury management program for patients after they are discharged from the hospital.

“Concussions are a huge deal,” Freedman said. “Most people think, ‘Oh, I bumped my head. I'll be better in a day or two.' It actually takes a lot longer than that to resolve your concussion.”

Adolescents are most vulnerable; SHS takes new steps

The Jake Snakenberg Youth Sports Concussion Act will take effect January 1; however, Summit High School began following the new procedure at the beginning of the fall sports season, school officials say.

“There's new information that has really just been discovered in the last three or four years,” Freedman said. “The adolescent brain is a lot different than either a child's brain or post-adolescent brains. … For adolescents, there's a danger; there's something about the adolescent brain that's more susceptible and takes longer to recover.”

Freedman also said females have a more difficult time recovering from a concussion than males.

Steve Sedlak, athletic trainer at the high school, said HIPPA laws prevent him from disclosing how many concussions have been sustained at the high school, but hospital officials said they have treated roughly 15 concussed SHS students so far this school year.

“I'm required to teach coaches to be aware of the signs and symptoms of a concussion,” Sedlak said. “We do a seminar here at the high school before each season. It's not necessarily for diagnosing concussions … but for recognizing the symptoms.”

The Associated Press reports the number of athletic children going to hospitals with concussions is up 60 percent in the past decade, a finding that is likely due to parents and coaches being more careful about treating head injuries, according to a new federal study.

Bicycling and football were the leading reasons for the kids' brain injuries, but health officials said that could be at least partly related to the popularity of those activities. For example, it's possible many more kids bike, so a larger number of bike-related injuries would be expected.

“I always tell the kids, ‘You'll know it if your bell gets rung. You won't feel right. You'll feel like you're in a daze,'” Sedlak said. “We want to know if (a student) is feeling something after a hit. Really, it's about communication between athletes, coaches and myself.”

Dr. Freedman said he likes the new law. “I think (the new law) is a step in the right direction. I think anything that makes people more aware of the significance of a concussion is a step in the right direction,” he said.

Walk it off, kid

Ten or 15 years ago, athletes at all levels were usually encouraged to keep playing after a concussion. An athlete's toughness might have been brought into question if he or she spoke up about a knock to the head. That mentality has definitely changed, Sedlak said.

“That's why it's such a big topic right now: because practitioners, coaches and doctors are much more aware, so of course there's going to be an increase in concussions,” Sedlak said. “These kids aren't getting paid to play; they're playing for fun. … On a national level, everyone is much more cautious now.”

The increased awareness has made its way up onto the mountain, where athletes of all ages are vulnerable. Chris Carson, freestyle director for Team Summit, said he's aware of the new law, but the additional responsibilities have concerned some coaches.

“USSA originally brought this to our attention over the last few years,” Carson said. “We've got to be much more diligent about pulling kids out of training or competition even if there's a remote chance they've had a minor (head) injury.”

However, he said there is definite concern among the coaches, who don't necessarily interact with athletes as frequently as, say, a football coach might, due to the vast nature of the skiing and snowboarding arena.

“That's what's concerning coaches,” Carson said. “A lot of the liability seems to be coming down on us. We can't see everything at all times. … We're aware of the signs and symptoms, but I don't think everybody really has the training and the tools to evaluate it on the hill.

“We're not doctors, and a lot of the time we get pressure from parents to keep the kid performing,” he added. “There are a variety of personalities out there, parents who are adamant that their kid tough it out. We've got to be backed up if we need to argue with a parent. But that's the reality — we've got to do it.”

Prevention and treatment

A very light blow to the head can cause a concussion. Take a look at the Baltimore Orioles' Brian Roberts, who has been rehabbing for more than a year after sustaining two concussions — the first of which he self-inflicted by tapping his bat on his helmet after striking out. Meanwhile, hockey star Sidney Crosby has been sitting out since January — they're not even sure which hit caused his concussion.

Helmets are great, but the best prevention is good judgment, Freedman believes.

“I'm a big supporter of helmets,” Freedman said. “Helmets don't prevent concussions, but they do reduce the severity.”

Urban legend tells us not to let friend or family member fall asleep after a concussion. That myth has officially been debunked (unless the brain is bleeding, which is a much more serious thing). The No. 1 remedy for a concussion is physical and cognitive rest until symptoms go away — that could be in a few days or a few years.

“The most important thing after a concussion is give the brain a chance to heal,” Freedman said. “It needs oxygen and glucose — generally those are not a problem. But most importantly it needs rest. Classically, we're driven to get back to our activities, whether it's sports or academics. But if the brain isn't ready, it takes longer and longer for the brain to heal.”

— The St. Anthony's Summit Medical center public relations office contributed to this report