For our special football preview edition, Sully talked with Dr. Brian Sokalsky of Jersey Shore Sports Medicine about some common injuries, how to recognize them, and what parents should be watching for throughout the season.
Sully: A lot of parents fear concussions. How common are they in football, and how do you know if a kid has sustained one?
Sokalsky: As far as how common they are, football, obviously, is up there near the top in terms of frequency, as far as how often you play, how many kids play and how often you’ll get them. Frequency-wise, when you look at different sports, women’s soccer and football are the top two. They are definitely something that parents and coaches need to be aware of. In terms of how you know when you have one, it’s all based on symptoms. You can take a hard hit, and it doesn’t necessarily have to be a hit to the head — it can be a hit to the body that causes a whiplash injury — and you look at symptoms. Headache, by far, is the most common. Initially, they may complain about some dizziness, light-headedness or sensitivity to light or sound; there may be some confusion, or it may just be one of those things where they just don’t quite feel right, or you’re looking at them and they just don’t look right. Any of those symptoms, or combination of them, you want to sit them out and take a closer look at them.
Sully: Back in the old days, they used to call it ‘getting your bell rung.’ Is there a situation where you can kind of get a stinger, but not really a concussion?

Dr. Brian Sokalsky has dedicated his life to developing his sports medicine and regenerative medicine services, and has offices in Somers Point and Lanoka Harbor, Ocean County. Check out his website, for more information. (Glory Days Magazine photo/Dave O’Sullivan)

Sokalsky: A stinger and a concussion are two different things. When you talk about getting your bell rung, sometimes, when you’re talking about helmet-to-helmet collisions, you get a headache because you got hit in the head, but it clears up in a couple minutes and you clear all the sideline tests. It is possible to get a hard hit to the head and not have a concussion. Stingers are injuries in the neck or arm. If you get your neck stretched or pinched to one side, you can kind of stun the nerve and it can cause a numbness or stinging, or even a burning sensation down the arm. As long as it only goes down one arm and resolves itself quickly, that’s what we call a ‘burner’ or a ‘stinger.’ As long as the strength and sensation come back right away you can go back into the game. If they don’t come back, that could be a more significant injury to the nerve, in which case they shouldn’t go back in.
Sully: One of the main issues kids have early in the season is cramping. Can those last a week or more and prevent a kid from getting back onto the field?
Sokalsky: True muscle cramps are just a severe muscle spasm and once you get it to release, you may have some soreness for a day or two after, but typically cramps don’t last that long, particularly if you are properly hydrating. The best way to prevent cramps is to properly hydrate beforehand, but if you do fall into that situation there’s not a whole lot you can do during the game. Once cramping sets it, it’s hard to prevent it from continuing to happen. Once the game is over you need to get them into a pretty rigid hydration program to make up what was lost and try to prevent it from happening the following week.
Sully: so if the pain is lasting more than a day or two, it’s probably more of a strain, right?
Sokalsky: Most likely.
Sully: What’s the treatment for a strain in the hamstring or calf, and how careful should an athlete be when that happens?
Sokalsky: The annoying part with a strain, particularly mid-season, is it’s very hard to treat and get you ready for the next game. In an ideal situation, you’re able to let that injured muscle or tendon start healing on its own for a couple of days, then start some strengthening exercises to get it back. Once the muscle is injured, it’s not as strong or flexible as the other side and you can develop imbalances. It can be a season-long injury because you’re constantly trying to get that balance back and prevent it from being reinjured every time you use it.
Sully: What’s the biggest misconception about hydration? I think some kids might think, ‘OK, I had a bottle of water in sixth period, I’m good to go.’
Sokalsky: The biggest misconception is not factoring in the big picture, like what kind of foods are you eating the day of a game, what kinds of foods are you eating the day before? What’s your hydration status the day before a game? If you go do a workout on Thursday and don’t properly hydrate, you’re already behind the 8-ball (for Friday night). And if you go eat a bag of chips during the day (Friday) or some other salty food, then you dehydrate yourself even more. You’re dehydrated before you even step onto the field. You have to factor in your diet, what foods you eat, what drinks you have. It’s really big picture, not just pound a bottle of water before the game.
Sully: Recently I heard about over-hydration. What does that mean?
Sokalsky: Over-hydration, typically, is more common in endurance athletes — marathon runners, triathletes — but you can overcompensate for the amount of fluid you’re losing through sweat. So if you drink more than you need, you can dilute yourself and cause electrolyte abnormalities in the other direction. You’re diluting your electrolytes and that can cause almost as severe problems as dehydration. For football athletes, that’s not all that common.
Sully: What are some quick tips for parents to help keep their football player healthy throughout the season?
Sokalsky: As far as parents go, one is just constant communication and being aware of how their son or daughter are moving. Are they favoring a body part or limping? Just kind of keeping on top of what is hurting, how long it’s been hurting, has there been any significant bruising? Little clues that might point to a more severe injury than the athlete is willing to admit. Obviously, the athletes are going to hide as much as they can because they want to play. From a diet standpoint, real simple things — diets high in fruits and vegetables, avoiding processed foods, getting good proteins with chicken and turkey, things like that. Early in the season lots of hydration and late in the season, when the cold weather sets in, making sure they have plenty of layers and making sure they are staying healthy. If they have a cold or flu, getting the proper rest. Just keep a close eye on them, even if they are not communicating well, pay attention to subtle signs that may indicate a significant injury.
To contact Dr. Sokalsky, call Jersey Shore Sports Medicine at 609-904-2565