Concussions have been a topic which have been gaining awareness over the years. Many coaches and parents wonder how they should manage athletes who may have sustained a head injury. There are many useful tools which have been developed to help coaches and parents to identify potential concussions.
A concussion is an injury to the brain. It is a mild brain injury which does not show up on CT or MRI imaging. Concussions can occur from a direct hit to the head or from a whiplash injury where the head moves side to side or forward to back. It is important to remember that athletes may also have other injuries from these types of incidents to their head, teeth, neck and surrounding areas and may need to be managed for such.
The public is not expected to diagnose concussions but tools have been developed, such as the Concussion Recognition Tool 5, to help coaches and parents to identify potential concussions. This tool helps recognize visual cues and common symptoms associated with concussions as well as potential memory loss. Visual cues may include having “Bambi feet” when getting up after a big hit, decreased performance or athletes having a blank look in their eyes. Some common symptoms after a concussion are headache, nausea or feeling like in a fog. Please reference the Concussion Recognition Tool 5 for a more complete list. If athletes are found to have these signs and symptoms or do not pass balance testing they are to be removed from sport/activity and be assessed by a licensed health care practitioner. This would include practitioners such as physicians, physiotherapists, athletic therapists and chiropractors. The Concussion Recognition Tool 5 also identifies red flags when athletes may need to be medically transported to a hospital for more urgent care. I have also added a Concussion Info Sheet which I hand out to athletes who have a concussion. I encourage coaches and parents to use it.
When in doubt, sit them out! It is important that athletes recover from concussions before returning to sport/activity. It is not appropriate to return an athlete to sport simply because the athlete or parent is upset. Concussions can lead to permanent problems if not managed properly. Be confi dent explaining to the athletes and parents why you suspect they have a concussion and that the protocol is “when in doubt, sit them out” until they can be appropriately diagnosed by a licensed health care practitioner.
After a concussion, athletes may initially require reduced physical activity such as limiting playing with friends as well as reduced mental activity such as decreased TV and computer time and reduced school hours. The degree of rest will depend whether these tasks increase their symptoms and the opinion of a licensed health care practitioner. It is estimated that 6-10% of concussions show delayed symptoms within 24-48 hours after a head injury, therefore it is important to monitor for onset or changes in symptoms throughout this time. Most concussions recover over 7-10 days but some take longer. Typically, youth take longer to recover from concussions than adults. Athletes should follow up with a licensed health care practitioner throughout their recovery and should not return to sport without medical clearance. Not all concussions occur during sports, however, the same principles apply.
Written by: Trevor Adamus of Martensville Collective Health & Wellness (Physiotherapist)