This is the second part of a three-part series on concussions. Today’s story is about prevention. Part three focuses on Second Impact Syndrome.

Diagnosing and treating athletic injuries is usually pretty cut-and-dry.

Sprain an ankle? Rest, ice, compress and elevate, doctors say.

Break an elbow? After surgery, put the arm in a sling until it heals.

But concussions are more complicated. Max Stearns, an Ohio State fencer who has suffered two concussions playing recreational soccer in the last year, said the emotional side-effects from concussions are worse than the initial shots to the head.

“Depression, anxiety and mood changes are common characteristics associated with having a concussion,” Stearns said. “I felt I was much more moody. It didn’t take much to get me angry. I just felt like I had a little less control of my emotions.”

Kelsey Logan, who treated Stearns and is the medical director of the OSU Sports Concussion Program, said her first priority is to guage brain damage after a head injury.

“What we look for mainly is whether or not (the patient) is what we call neurologically intact, that their brain is functioning normally,” Logan said. “Most of the time what an athlete will complain of is a headache or maybe dizziness, and they feel sick to their stomach. Generally they feel like they’re just not quite with it.”

Most of those symptoms can be cured in a relatively short amount of time, said Richard Rodenberg, a physician at OSU and Nationwide Children’s Sports Medicine.

“Fortunately, the majority of kids will resolve their symptoms in a fairly timely manner. But there is a certain percentage of the population that will have prolonged symptoms,” Rodenberg said. “They will have headaches and difficulty concentrating or being able to perform cognitive tasks in school. They have light sensitivity, noise sensitivity and difficulty sleeping.”

He said athletes can increase the likelihood of a speedy recovery by recognizing that they had a concussion and resting immediately after.

“We can help the kids, but the kids can help themselves far more when they have that transparency to say, ‘Hey, I’ve got problems, I need to rest,'” Rodenberg said. “Allow them to fully recover, and they tend to come back quicker. They tend to have fewer symptoms and do better.”

Doug Calland, the head athletic football trainer at OSU and head athletic trainer of all 36 varsity sports, said the football team has handled about five concussions this season, not including the last two football games against Wisconsin and Purdue.

Bigger, harder-hitting athletes and heavier reliance on equipment for protection puts football players in a precarious situation, said OSU wide receiver Dane Sanzenbacher, who suffered a concussion in 2008 against Wisconsin.

“I think the point it’s gotten to, with everyone being bigger and faster, the equipment’s bigger, you put these things on and you feel like you’re invincible,” Sanzenbacher said.

The football coaching staff and trainets at OSU make sure that players with concussions get taken off the field and any other activity that could aggravate the problem.

“No lifting weights, no film, no practicing, nothing,” said OSU offensive guard Bryant Browning.

Before players get back to training after a concussion, they have to go through tests to determine the injury’s physical and mental consequences.

The standard grading scale assesse concussion symptoms from zero to five, Calland said. Athletes must score zeroes in each category before they move on to the next step of recovery.

“After they go through the zero-symptom scale and go through the neurological-cognitive (testing), they have to be cleared, which could take two or three days or it might take two or three weeks, we just don’t know. It depends on the athlete and how long their symptoms last,” Calland said.

“They then do a cardiac workout, which is about 25 minutes of a pretty heavy cardio challenge. Then we’ll reassess them again, and once they get through all those stages and building up of activity, then they’re cleared to play.”

Calland said OSU has stayed ahead of the curve when it comes to concussion treatment.

“We’ve always done pretty well. None of this stuff for us is new. We’ve been doing all of these things for quite a long time and we’re very fortunate to have the OSU Medical Center and a lot of the resources that a lot of other schools may not have,” Calland said.

Stearns said he received top-notch care from Logan and her team.

“I really felt like I got the best treatment I could. They were very thorough in their examinations. (Logan) kept in close contact just to make sure that I was doing OK,” Stearns said. Logan “was very careful in making sure that I was emotionally stable.”