Concussion Management 

Managing a Determined or Suspected Concussion of Your Athlete

For many of you parents "Concussion" of your youth or teenager brings a tremendous amount of anxiety and unknown.  Who can help us, how long is the recovery, what can we expect along the way and can my athlete play in the "Big Game" next week.

The Wisconsin Concussion Law Act 172-Statute 118.293 is a piece of legislation recently passed that requires by law all youth athletic organizations to educate coaches, athletes and parents on the risks of concussions and head injuries.  The law requires immediate removal of an individual from a youth athletic activity if symptoms indicate a possible concussion has been sustained.  A person who has been removed from a youth athletic activity because of a determined concussion or suspected concussion or head injury may not participate again until he or she is evaluated by a health care provider and received written clearance from the health care provider to return to activity.  For more information on this law visit:  http://docs.legis.wisconsin.gov/2011/related/acts/172.  For the high school athlete the initial determination or suspicion typically comes from the certified athletic trainer (ATC) who supports the team.  For the non contact sports who don't always  have a ATC or other health care provider on the sidelines this responisbility falls then on the coaches and parents.

Middle school athletes and club organizations are not immune to concussion and often either in contact and non contact sports they have no medical provider assisgned to the sideline.  This leaves the responsibility for determining or suspecting a concussion to the coaches and parents.  My recommendation is for all parents and coaches of any sport to become better educated and aware of concussion.  The WIAA website and WIsportsconcussion.org offer easy access to basic information.

ImPACT testing is a neuro-cognitive tool that compares pre-injury baseline scores with the injured and recovering brains post score.  It has become part of the standard in the assessment of the concussed athlete.  ImPACT is typically administered through the schools in larger group formats.  The costs for group testing is commonly donated or absorbed by the school or booster organizations.  Private single athlete ImPACT testing is also avialable at a small cost less than $30.00 to the family.  The private session is administered in a controlled single tester environment to ensure an accurate baseline score of your athlete.  Many health care systems, including Optimum Therapies, LLC in association with the OakLeaf Concussion Clinic offer private ImPACT testing.

Once a determined concussion or suspected concussion occurs the post concussion ImPACT Test should be repeated optimally within 72 hours / 3 days.  This will also coincide with a medical evaluation by a physician trained and experienced in head injuries.  In the days following your medical consultation you will be directed in how to monitor and care for yor head injured athlete.  Once your athlete is symptom free from their individual complaints they begin a regimented return to exertion/activity protocol.  This is a five state process that after each stage requires a 24 hr. monitoring of returning symptoms.  If no symptom occur between each stage progression to the next more physical stage results.  I recommend a trained health care provider monitor and administer stages two and three with your athlete.  If no symptoms are provoked and your health care provider identifies no concerns in your movement, balance, coordination or brain function you progress to stage four indicating a return to practice before final return to play in stage five.

There has been a tremendous amount of research and gains made in understanding the brain as an organ and as an injured organ that needs to heal and recover.  Delayed recovery, multiple concussions will have an impact on your athlete's  recovery and their abilities to maintain there shcool responsibilities.  Managing the determined or suspected concussion athlete whether youth or high school age needs to be a group effort.

For more information or education you can visit our website and blog at:  www.optimumtherapies.com and http://www.oakleafmedical.com/clinci/oakleaf-concussion-clinic.