Concussion Management
- Concussion
- A complex pathophysiological process that affects the brain, typically induced by trauma to the brain. It can be caused either by a direct blow to the head, or an indirect blow to the body, causing neurological impairments that may resolve spontaneously. A concussion is considered a brain injury.
- A concussion is a mild form of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head. A concussion can also be caused by violent movement or jarring of the head or neck.
- Most sport-related concussions (more than 90%) occur without loss of consciousness.
- Most concussions happen in collision sports (i.e. football, wrestling, hockey), however, a concussion can be sustained in any sport and at any level of competition. Therefore, ALL those that are involved in athletics (i.e. players, 2 coaches, parents, officials, etc.) need to have a general knowledge of concussions and be aware of their signs/symptoms.
- After suffering a concussion, an athlete is 3-6 times more susceptible to suffer another concussion compared to an athlete who has not suffered a concussion.
- 78% of concussions occur during games (as opposed to practices).
- Current research suggests that there
is approximately 1.6 to 3.8 million recreational and sport-related concussions each year in the U.S. and the number of people being treated for these injuries has increased greatly in recent years. - A concussion is an "invisible" injury. The only way to check for a concussion is by assessing signs and symptoms and performing functional testing such as ImPACT testing, balance testing, oculomotor testing, etc.
- Kids generally require longer recovery time after sustaining a concussion due to the fact that their brains are still developing.
- Headaches (85%) and dizziness (70-80%) are most commonly reported symptoms immediately following concussions for injured athletes.
- Estimated 47% of athletes do not report feeling any symptoms after a concussive blow.
Text? & Image reference.
Signs
- Appears dazed
- Disoriented
- Confused
- Unsure of score
- Slow to answer
- Mood change
- Loss of memory (before and after the hit).
- Loss of consciousness
Symptoms
-
Headache - Nausea
- Balance Problems
- Blurred Vision
- Light Sensitive
- Sluggish feeling
- Confusion
- Lack of concentration
When in doubt, seek prompt medical attention!
Lots of people may have a headache or dizziness for a day or so and then recovery fully, but a very small group of people who sustain a concussion — five percent — can develop bleeding or a blood clot that can be life threatening if not promptly diagnosed.
Step 1: Complete Cognitive Rest
Complete physical and cognitive rest. 24 hours symptom-free at rest (+/- mental exertion) before Step 2.
Step 2: Light Aerobic Exercise.
- Goal: Only to increase heart rate.
- Activities: Exercise bike, walking, or light jogging *No weightlifting, jumping or hard running.
Step 3: Moderate Exercise
- Goal: Limited body and head movement.
- Activities: Moderate jogging or stationary biking.
Step 4: Non-Contact Exercise.
- Goal: More intense but non-contact.
- Activities: Running, high-intensity stationary biking, regular weightlifting routine, and non-contact sport specific drills.
Step 5: Practice
- Goal: Reintegrate in full contact practice.
- Activities: Restore confidence, assess readiness for return to play. Monitor for symptom return.
Step 6: Play
- Goal: Return to competition. However, if any symptoms return, please proceed to the previous step.
It is important to monitor symptoms and cognitive function carefully during each increase of exertion. Athletes should only progress to the next level of exertion if they are not experiencing symptoms at the current level. If symptoms return at any step, an athlete should stop these activities as this may be a sign the athlete is pushing too hard. Only after additional rest, when the athlete is once again not experiencing symptoms for a minimum of 24 hours, should he or she start again at the previous step during which symptoms were experienced.
The Return to Play Progression process is best conducted through a team approach and by a health professional who knows the athlete’s physical abilities and endurance. By gauging the athlete’s performance on each individual step, a health care professional will be able to determine how far to progress the athlete on a given day. In some cases, the athlete may be able to work through one step in a single day, while in other cases it may take several days to work through an individual step. It may take several weeks to months to work through the entire 5-step progression.
More information to follow.
Below is a list of educational concussion resources and training for coaches and club officers.