"Actually, there are a lot of common terms that are used when head injuries occur," says Dr. Michael Alexander of the Beth Israel Deaconess Medical Center Cognitive Neurology Department and Professor of Neurology at Harvard Medical School. "Those terms have gotten a little muddy. A head injury is any trauma to the scalp, skull or brain. That encompasses anything from a cut on your scalp to a debilitating brain trauma that you might experience in a car accident. Concussions fall within that spectrum as a form of brain injury and can range from mild to quite severe."
Here in Boston we have seen the result of multiple concussions on an athlete's career -- Bruin Marc Savard and former Patriot Ted Johnson come immediately to mind. Football and hockey have a much higher incidence of concussion than baseball, as you might imagine. Fortunately, Beckett's concussion turned out to be mild, though it was the result of severe bad judgment.
While Beckett and several pitchers stood in the outfield shagging fly balls, assistant coach Ino Guerrero was nearby. Instead of tossing the batted balls back toward the infield, Guerrero was using a fungo bat to hit them. And one of those balls wasn't lined to second base -- it was lined off the side of Beckett's face. An accident for sure, but a preventable one.
"Traumatic brain injuries send about 1.3 million people to the emergency department each year," says Dr. Alexander. "Ninety percent of those are mild, the prognosis is excellent and most people recover fairly quickly. It sounds like Josh Beckett falls into that category."
Beckett reportedly fell to one knee after being hit, was obviously stunned and complained of a headache. After being examined by the team's training staff, he was sent home, re-evaluated the next day and reported feeling much better. The following day the Sox announced that Beckett would skip his scheduled start as a precaution, but he was fully cleared to resume baseball activities.
"There is no direct medical treatment for a concussion," explains Dr. Alexander. "First you want to make sure there are no symptoms when at rest. That may take five minutes, 15 minutes or a day or two. Then you have the patient exert themselves, and if they exhibit no symptoms from exertion, they can be cleared."
With the good weather coming, and kids about to resume such outdoor activities as biking and skateboarding, as well as such sports as lacrosse, soccer and baseball, it's a good time for parents to familiarize themselves with the signs and symptoms of a concussion. As the frequency of activity increases, so, too, does the chance of injury. You can find some good information about concussions on the BIDMC website, and the Brain Injury Association has some information specifically related to youth sports.
"People used to think that if you weren't knocked unconscious that you didn't have a concussion," Dr. Alexander says. "We know that is not the case. If your child receives a blow to the head and they show signs of confusion, loss of memory, dizziness, nausea -- if they complain of a headache, show sensitivity to light or you notice they have trouble paying attention or accomplishing simple tasks -- these are all signs of a concussion."
Like the physical recovery, the mental recovery takes time.
"I would put it this way; The day after you've suffered even a mild concussion would not be a good day to take the SATs or your driving test," says Dr. Alexander. "Fortunately, most of us don't participate in high-risk activities like pro football or pro hockey. There's a pretty good chance we'll be back to normal pretty quickly."
In Beckett's case, it was about three days. By then, any mental fuzziness was replaced by sharp wit. He wore a T-shirt over his uniform with the words "Don't hit me" printed on it, and he handed Guerrero a bright-orange construction vest with reflectors.
I'd say that's back to normal.
Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.