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Making an impact: Prompt recognition, treatment speeds concussion recovery

Brian Rieger, PhD, director of Upstate's Concussion Center.

Brian Rieger, PhD, director of Upstate's Concussion Center.

Blurry vision. Dizziness. Ringing in the ears. Headaches. Trouble with balance. Concussion can produce frightening symptoms.  

Brian Rieger, PhD, an assistant professor of physical medicine and rehabilitation who leads Upstate‘s Concussion Center, regularly speaks to school, athletic and community organizations. He is on a mission to raise awareness of concussion.

Rieger is also the parent of children who play contact sports. In his presentations, he strives to reassure. “I don‘t want to alarm parents unnecessarily or deprive children of participation in sports, because that has a lot of benefits,” he says. “If a kid suffers a concussion, if it‘s properly managed, we shouldn‘t expect long-term consequences. A concussion is almost always a short-term event, when managed properly.”

Ignoring the symptoms of a concussion can delay healing. Overlooking a concussion, then suffering another, can be disastrous, with symptoms more severe and lingering for months or years.

The key is to recognize the injury when it happens. “The job of coaches, of athletes and of parents is to be suspicious,” Rieger says. That means removing an injured athlete from play until he or she is properly evaluated. And, that means encouraging athletes to be honest about their injuries.

Four Central New York families agreed to share how concussion has impacted their lives:


Concussion patient Alayna Slayton, 16, of Auburn with occupational therapist Kim Nemi.

Concussion patient Alayna Slayton, 16, of Auburn with occupational therapist Kim Nemi.

“My vision was affected, and now I have to wear glasses with prisms in them. It is affecting my reading and computer work,” says Alayna Slayton, 16, of Auburn. She also suffers headaches now, and she didn‘t before.

She was a midfield soccer player in September 2012 when she and another player collided head to head. She remembers “everything was sort of just spinning, and I saw the scoreboard in six different places.” She could not stand on her own.

Slayton was out of the game recovering for two weeks. In the first game of her return, a player kicked a ball that struck her head in the same spot. Slayton fell face-first to the ground, suffering a second concussion – and ending her participation in contact sports.

“I‘ve played since I was 6 years old,” she says of soccer. “I‘ve played with these kids forever. But my health is more important than the sport. The main thing I miss is being part of the team.”

Slayton plans to play golf in the spring. And she has hopes of becoming a trauma nurse.


Chris Goodman probably will not play contact sports anymore.

Chris Goodman probably will not play contact sports anymore.

Chris Goodman wears glasses designed to help his eyes work together. A series of four concussions lead him to develop a weakness in a nerve near his eye called sixth nerve palsy. “It‘s getting a lot better,” his mother, Patricia Phillips says hopefully.

Two of his concussions can be blamed on basketball: hard elbows to different parts of his head in different games. Another, he suffered when he and a friend were horsing around and he fell backward against a pole. The last one happened April 24, 2013 when a friend punted a football into Goodman‘s head.

The 16-year-old Syracuse boy was treated in the Upstate University Hospital emergency department, and then at the concussion center. Sixth nerve palsy is a condition that can affect hearing and facial weakness, in addition to causing abnormal eye movements. The affected nerve is the sixth cranial nerve, which innervates the muscle that pulls the eye away from the nose. When the nerve is impaired, the eye crosses inward toward the nose. To compensate, Goodman turns to see out of one eye.

He sees an occupational therapist, optometrist and neuro-optometrist for help improving his vision. He wears corrective lenses, which have helped. He missed some school but has caught up. “He‘s been cleared for gym,” Phillips says, “but they said he‘s kind of done with contact sports.”


James De Paul was injured more than a year ago.

James De Paul was injured more than a year ago.

For a long time after that soccer game on Sept. 25, 2012, James DePaul looked like he was high on drugs, or sick with fever, recalls his mother, Diane DePaul of East Syracuse.

She was watching from the sidelines and saw his head ricochet from side to side when a ball hit his head. His eardrum was perforated, his vision became blurry and he lost his balance. “For a 13-year-old who does karate not to be able to stand on one leg – that‘s bad,” she says.

DePaul drove her son to an urgent care clinic, which sent him by ambulance to Upstate University Hospital‘s emergency department. Many people who suffer concussions see symptoms abate within a few weeks, but DePaul wound up needing physical therapy and occupational therapy. He attended school only for half days until after Christmas. He still managed to make the honor roll, and he played baseball in the spring.

A year after the injury, his mother says “just because he looks OK doesn‘t mean he is OK.” For instance, she wonders whether his migraine headaches are because of the concussion or something else, like puberty, and she figures she will have similar concerns the rest of his life.

But one thing is for certain, she says: “He will never touch a soccer ball again, as far as I‘m concerned.”


Mikayla Frego was injured tending goal for her soccer team.

Mikayla Frego was injured tending goal for her soccer team.

Four years ago, Mikayla Frego was tending goal for her soccer team in Norwood. “I was going to save a ball, and I dove. Next thing I knew, I woke up in the hospital. It was kind of like I was in a dream, almost.”

After she was released from the hospital and back to school, she had headaches all the time and struggled to concentrate. Sometimes she passed out. But she didn‘t want to tell anyone because she wanted to keep playing.

Eventually she sought care. She received physical therapy to help with vision and balance. She improved enough that she returned to her soccer team for her junior and senior year.

Today Frego is a field player on an intramural soccer team at the State University of New York at Albany. “I feel great now,” she says. “Every now and then, I notice that my memory is not what it used to be. And I get headaches much more now.”

She is a biology major with plans to attend medical school – which she says was influenced by her concussion experience. Frego thinks she would like to become a neurologist, or pediatrician.

Rieger is interviewed about concussion in this HealthLink on Air radio segment.

10 things you need to know about concussions