Coordinate and produce local community lectures to increase concussion awareness

  Coaches and Athletic Staff

Coaches: expect 5-10% of all your injuries to be concussion if you coach a contact sport.

Coaches of non-contact sports, a concussion can still occur even though permitted contact is not allowed, for example in a soccer game concussions account for 15-20% of injuries vs 2-5% in practice.

High school athletes who sustain a sport-related concussion, 15% report having symptoms lasting longer than 7 days, while 1.5% report symptoms lasting longer than 1 month.

How can I prevent a concussion from occurring?

At the moment, there is no way to completely prevent a concussion from occurring. Remember, a concussion occurs when the brain "shakes" inside the head from an acceleration-deceleration force. Helmets are designed to prevent skull fractures and bleeds within the brain, but they do not stop the brain from accelerating, decelerating and rotating in the skull.

Helmets and protective equipment (mouth guards) have their place, but please remind your athlete that just because they are wearing a "concussion marketed" helmet does not mean they are invincible. Many times, athletes will play more dangerously because they believe it is impossible for them to be injured because of their helmet or protective equipment.

Some studies have suggested that when an athlete is aware of an impending hit, they are able to properly prepare themselves for the impact. Unanticipated hits may cause larger acceleration forces to the head which may result in an increased risk of injury. Teaching proper hitting and tackling techniques as well has making sure athlete have increased neck strength and increased field awareness is that first step in injury prevention.

How does a student-athlete safely return to sport following a concussion?

A graduated return back to physical exertion after the athlete with a concussion has become symptom-free at rest is essential for the safe return to sports. During this graduated protocol it is important to have the athlete monitored by an individual (such as a certified athletic trainer) who can detect if symptoms that have been troubling the athlete return (i.e. headache, dizziness, nausea). If symptoms return at any time during this protocol, the activity of the day should be discontinued and the athlete should resume activity at the previous asymptomatic stage after symptoms have been absent for at least twenty four hours.

GRADUATED RETURN TO PLAY PROTOCOL
Rehabilitation StateFunctional Exercise at Each State of Rehabilitation
No activityComplete physical and cognitive rest
Light aerobic exerciseWalking, swimming or stationary cycling keeping intensity <70% MPHR; no resistance training
Sport-specific exerciseSkating drills in ice hockey, running drills in soccer; no hear impact activities
Non-contact training drillsProgression to more complete training drills, e.g. passing drills in football and ice hockey; may start progressive resistance training
Full contact practiceFollowing medical clearance, participate in normal training activities
Return to playNormal game play

McCrory et al (2009) "Consensus Statement on Concussion in Sport", 3rd International Conference on Concussion in Sport

Baseline Neurocognitive Testing

Computerized neurocognitive testing is one tool utilized by medical providers during the management of concussions. It has been shown that once an athlete becomes symptom-free from a concussion that their cognitive function may not have returned fully to normal. A step-wise return to play is very important in the safe return of a concussed athlete. By comparing baseline tests to post-injury tests, a physician can make a better individual assessment of neurocognitive function. The use of baseline neurocognitive tests is not mandatory for a safe recovery following a concussion, but baseline testing can enhance the effectiveness of computerized neurocognitive testing. Many computerized neurocognitive tests are available (ImPact, Axon Sports and Headminder) each has their pros. It is important to realize that no computerized neurocognitive test has been studied for returning an athlete safely to play. No decision on return to play should be made solely on the results of computerized neurocognitive testing.

There are several types of neurocognitive programs on the market; including ImPACT , Headminder and Axon Sport.

Many local colleges and high schools in the state offer baseline testing prior to the beginning of the school year for their student-athletes. Several members of the CCTF provide baseline neurocognitive testing for youth and non-athletes.

For additional information, please contact the individual clinics below:

NDTC, LLC www.sportsconcussionndtc.com
Elite Sports Medicine www.elitesportsmedicine.org