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Concussion Management

CONCUSSION MANAGEMENT

What is a concussion? 

A concussion is a type of traumatic brain injury-or TBI-caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. The sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. the severity of a concussion depends on many factors and is not known until symptoms resolve and brain function is back to normal. 

Why should I report my symptoms? 

  • Your brain is the most vital organ in your body
  • practicing or playing while still experiencing symptoms can prolong the time it takes to recover and delay return to play 
  • unlike other injuries, there may be significant consequences to 'playing through' a concussion. 
  • repetitive brain injury, when not managed promptly, may cause permanent damage to your brain. 
  • while your brain is still healing, you are much likely to have another concussion. repeat concussion can increase the time it takes to recover and the likelihood of long-term problems. 

What to look out for? 

Quite often the signs of concussion do not appear immediately after trauma, but hours later. The extent of the injury may not be readily observable for hours after the initial trauma. The signs and symptoms listed below may occur several hours after the initial injury.

After an initial injury, be especially observant for the following signs and symptoms; 

After an initial injury, be especially observant for the following signs and symptoms; 

  •  Headache or "pressure" in head
  • Feeling sluggish,hazy, foggy, or groggy
  • Confusion
  • Nausea or vomiting
  • Amnesia/difficulty remembering
  • Sensitivity to noise
  • Balance problems
  • Sensitivity to light
  • Irritability
  • Feeling more emotional
  • Dizziness
  • Sleep disturbances
  • Difficulty concentrating
  • Double or blurry vision

Dangerous signs and symptoms of a concussion: 

  • one pupil larger than the other
  • Drowsiness or inability to wake up
  • A headache that gets worse and does not go away
  • Slurred speech, weakness, numbness or decreased coordination
  • Repeated vomiting or nausea or decreased coordination
  • Unusual behavior, increased confusion, restlessness or agitation
  • Loss of consciousness (passed out/knocked out)

Concussion symptoms differ with each person and with each injury, and may not be noticeable for hours or days. Different symptoms can occur and may not show up for several hours. During recovery, exercising or activities that involve a lot of concentration (studying, working on the computer/iPad, or playing video games) may cause concussion symptoms to reappear or get worse. 

All concussion are serious. Don't hide it, report it. Take time to recover. Its better to miss one game than the whole season. 

Concussion Managment Guidelines

The recognition and treatment of athletes who have suffered a concussion has become a national priority. An increasing number of studies have revealed that concussions, not properly treated, can result in permanent mental difficulties. Other studies suggest that concussions may lead to the development of early dementia. This led to mandates by the National Federation of High Schools (NFHS), NCAA, and the NFL. 

As outlined in Indiana State Law IC-20-34-7 “A high school athlete who is suspected of sustaining a concussion or head injury in a practice or game, shall be removed from play at the time of injury and may not return to play until the student athlete has received a written clearance from a licensed health care provider trained in the evaluation and management of concussions and head injuries, and not less than twenty-four (24) hours have passed since the student athlete was removed from play.”

In compliance with the Indiana Department of Education’s Concussion and Head Injuries Position, CGCSC has developed the following guidelines for their schools.

***Even if a student athlete has a completed physical on file, they will NOT be eligible to practice or condition until their signed Concussion/Sudden Cardiac Arrest Acknowledgement forms are also on file in the athletic office or athletic training room.
 

Neurocognitive Testing

Neurocognitive testing such as the ImPACT (Immediate Post Concussion Assessment and Cognitive Testing) is a computerized test that documents the athlete’s cognitive and speed skills. The test has been validated as an accurate measure of brain function recovery following a sports concussion (www.impacttest.com).

CGCSC has partnered with IU Health and Indiana Sports Concussion Network (www.indianasportsconcussionnetwork.com) to receive baseline ImPACT testing for CGCSC middle and high school athletes. The computerized baseline test is conducted at school and administered by the certified athletic trainer. These baseline tests can be used by the ImPACT trained physician to assist in the management and treatment of an athlete who has suffered a concussion.

Athletes should have a baseline test prior to the season. In the event that the athlete sustains a concussion, a repeat test can be performed by a physician and compared to the baseline test. This can help show the degree of injury and help measure when recovery has occurred.

Who gets ImPACT baseline testing?

Baseline testing for athletes begins in 7th grade with retest every 2 years (9th and 11th), as athletic participation continues.  Other students to include in baseline testing include all transfer students, first year players and any other athletes that have not been previously tested.   

  • Fall – Football, Soccer, Volleyball, Cheer
  • Winter – Basketball, Wrestling, Diving, Cheer
  • Spring – Baseball, Softball, Track (Hurdlers & Pole Vaulters)
  • Non-Athletes: Sound System, Surround Sound, Color Guard

ImPACT Testing Procedure

  • Pre-Test set up is approximately 20 minutes, testing takes approximately 20 minutes. Total time investment = 40 minutes
  • Upon completion of baseline tests, the Athletic Trainer will receive a list of students completing the baseline testing. The Athletic Trainer will retest anyone who did not pass the initial test.
  • ATC maintains results of ImPACT testing. Parents can contact the ATC if they need baseline data sent to their MD.

Return to Play Following a Concussion

Recovery from a concussion requires limitation of physical activity, which includes practice, drills, games, and physical education classes. In significantly symptomatic athletes, mental activity should also be limited to allow the brain to heal. These activities may include limiting assignments, allowing greater time to complete quizzes and tests or assignments and less homework. Also limited should be activities such as watching TV, texting, playing video games and surfing the Internet. The athlete may also have to stay home from school.

Before the concussed athlete can return to action, the most current standard of care for the sports concussion includes the following:

  • The athlete must be symptom-free at rest with a normal neurological exam
  • A neurocognitive test such as the ImPACT test must have returned to baseline, and
  • The athlete must be symptom-free with increased (physical and mental) activity and pass an activity progression protocol.

Taking shortcuts or seeking “favorable” opinions on return to action decisions remains unacceptable when utilizing this most current standard of care for sports concussions.

Current CGCSC Guidelines dictate that an athlete who has sustained a concussion may not return to activity until he or she has received written clearance from an ImPACT trained physician. CGCSC athletic trainers will assist the family in finding an ImPACT  trained physician within their insurance network.

The CGCSC administration, coaches, and athletic training staff are striving to keep your child’s health and safety at the forefront of the student athletic experience. If you have any questions regarding concussion management, please feel free to contact your schools’ athletic director.

General Concussion Information

Following a concussion, these general instructions can be followed:

It is OK to:

  • Take acetaminophen (Tylenol)
  • Rest (no physical activity)
  • Use ice pack on head and neck as needed for comfort
  • Eat a light diet
  • Return to school
  • Go to sleep 

There is NO need to:

  • Check eyes with a flashlight
  • Wake up every hour
  • Test reflexes
  • Stay in bed 

Do NOT:

  • Drive while symptomatic
  • Exercise or lift weights
  • Take Ibuprofen/Aspirin or other Non-Steroidal Anti-Inflammatory
  • medications
  • Eat spicy food
  • Watch TV, text, and play video games

Additional Resources: