Via Christi Sports Medicine

Presented by:

Travis Francis, MS LAT ATC

Manager – Sports Medicine

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Concussions

A concussion is the most common form of head injury suffered by athletes. It is a form of traumatic brain injury that occurs when the brain is violently jarred back and forth or rotated inside the skull as a result of a blow to the head or body. This can "stun" the brain cells or even result in their death.

You do not need to lose consciousness to suffer a concussion.

Concussions, cont…

Any athlete in motion is at risk for a concussion.

This may occur in any sport, to boys and girls alike.

Symptoms may appear immediately or develop over several days.

They may last a few days to several months and interfere with schoolwork and social life.

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Concussions, cont…

Common Features:

1. Caused by direct blow with impulsive force transmission.

2. Rapid onset of short lived impairment.

3. Functional disturbance rather than a structural injury.

4. Graded clinical symptoms; resolution follows sequential course.

5. No neurological imaging abnormalities. (MRI, CT, etc..)

Concussion: Quick Facts

Quick Facts• Always remove athlete immediately after suspecting a

concussion. Do NOT allow return to play the same day with a concussion.

• Athletes do NOT have to be knocked out to have a concussion. 90% of concussions occur without a loss of consciousness.

• CT scans don’t diagnose concussions. Everyone with a concussion has a normal CT scan.

• It is OK to let someone fall asleep after being hit in the head. With careful monitoring, rest and sleep will be helpful.

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Concussion: Quick Facts cont…

• “Warm Up for Return” is a graded process that requires a minimum of five days.

• 9 out of 10 athletes will be back to normal within two weeks. They may miss a few games.

• Kansas law requires a physician’s signature (MD/DO) to "Return to Play."

• Athletes who return to full contact too early risk Second Impact Syndrome, a rare but devastating brain injury that may result in death.

• Concussions can affect driving, school work, sleep, emotions, relationships and self worth.

• The “game plan” is not just about returning an athlete to their sport, it is about returning the person back to their life.

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Concussion: Quick Facts cont….

Adult vs. Adolescent Brain• Adolescent brain more likely to have:

Diffuse Injury Prolonged Brain Swelling Slower recovery Neurological deficits following re-injury

• Adult brain is supported by mature skull development and mature muscle development

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Concussion: Quick Facts cont….

Male versus FemaleFemales are:

More likely to report sleep disturbances and headaches

More likely to have post-concussive syndrome at one, three and six months post-injury

2011 Study Girls twice as likely to sustain concussion

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ConcussionSigns and Symptoms

Signs Observed Reported By Others:• Appears dazed or stunned • Is confused about assignment • Forgets plays • Is unsure of game, score or

opponent • Moves clumsily or has slurred

speech • Answers questions slowly • Loses consciousness • Shows behavior or personality

changes • Cannot recall events prior to hit • Cannot recall events after hit

Signs Reported by Athlete:• Headache • Nausea or vomiting • Balance problems or dizziness • Double or fuzzy vision • Sensitivity to light or noise • Feeling sluggish or drowsy • Feeling foggy or groggy • Concentration or memory

problems • Confusion

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Concussion: Management

Once a concussion is diagnosed OR perceived:• Remove from activity IMMEDIATELY• Assess physical, emotional and cognitive

symptoms (see Score Card #1)• Determine if advanced medical attention is

warranted: LOC, symptoms worsening, drainage from ears or nose, fracture….

• Assess memory, balance, and concentration: (Score Card #2)

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Concussion: Management

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Concussion: Management

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Concussion: Management

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Concussion: Management

• Refer to physician for further evaluation and treatment; all student-athletes must be evaluated AND cleared by a physician to practice medicine and/or surgery (MD or DO)

• Rest!!• Physical • Cognitive

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Concussion: When to call EMS or see a physician immediately?

Symptoms that need immediate referral:• LOC – Loss Of Consciousness• Vomiting• Headache that worsens over time• Slurred speech or other changes in speech• Pupils are unequal or dilated • Blood or other discharge from ears or nose• Seizure• Any signs of amnesia either pre or post injury

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Concussion: Return to ‘Learn’ and Return to ‘Play’

Return to Learn•Assess symptoms that affect learning (concentration, light sensitivity, headache, etc..)•If trouble with basic functions, take a few days off of school•Limit activities that rely on ‘heavy’ brain function (texting, watching TV, playing video games, etc..)•Allow time for rest throughout the day; utilize PE and recess times •NO TESTING!!

Return to Play•Don’t begin until fully returned to school•Day 1: Increase heart rate; stationary bike (5-10 minutes)•Day 2: light activities that may include: (15-20 minutes)

• Jogging: do 2 or 3 laps around the gym with 1 to 2 minute rest periods

•Day 3: increase activity duration, moderate intensity; no contact opportunities; may lift weights, sprint, any conditioning

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Concussion:Return to ‘Play’ cont..

Return to Play

•Day 4:• Full activity with no restrictions• Follow up testing with ‘Score

Card’

•Day 5:• Released to full activity both in

school and other activities

When to STOP RTP

•At any time during the progression, if symptoms worsen.•If you stop progression, take next day off and take one step back on progression to resume.•If you have to stop progression multiple times; refer to physician

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THANKS!!

QUESTIONS??

Kansas Sports Concussion Partnership• www.kansasconcussion.org

Center for Disease Control• www.cdc.gov/Concussion

Safe Kids Worldwide• www.safekids.org

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