Causes of Concussion



Concussion Protocol for Kennett High School Athletics2020-2021Concussions are a part of all sports and can be defined as a “traumatic brain injury that can result in a variety of symptoms such as headaches, confusion, altered levels on consciousness and others.” The severity of concussions can vary from each incident causing some recovery periods to be much longer than others. This packet will discuss the causes and symptoms of concussions, as well as the Kennett High School concussion evaluation and return to play pathway. For any questions or comments regarding the packet please contact the Head Athletic Trainer: Causes of ConcussionA concussion can result from a bump, strike or jolt to your head, neck or body and causes an impulsive force to your brain temporarily changing the way it functions. The NovaCare Rehabilitation team understands that concussion symptoms and recovery time are unique for every person. That's why we do a comprehensive exam and develop an individualized care plan to help get you back to the activities you enjoy.If an athlete has sustained a concussion, immediate rest is the most important first step in recovery. Referral to an MD will determine if and when you can return to activity, school, work or athletics.Most concussions resolve independently with many individuals reporting no symptoms after 7-10 days. If symptoms have not resolved, it is important to know that physical therapy can help with balance, stability, focus, gait and mood. Treatment plans will focus on reducing symptoms and determining the root cause of those symptoms.Our Kennett Sports Medicine Team of experienced athletic trainers and licensed physical therapists work closely with you, your referring physicians, and coaches on the path of recovery.Signs and Symptoms of ConcussionSymptoms of a concussion can include:Balance issues Blurred vision Difficulty concentratingDizzinessDouble visionDrowsiness HeadachesIrritability or mood swingsSensitivity to lightSensitivity to noiseEvaluation and DiagnosisDuring almost all sporting events the ATC present will be the individual to conduct initial concussion screening for injured athletes. It should be noted that if an athlete sustains a concussion, they will be restricted from play immediately – regardless of severity. No same day return to play for an athlete exhibiting signs and symptoms of concussion. (See Appendix 3: National Athletic Trainers’ Association Guidelines on Concussion). If a concussion is suspected, the athlete must be seen by a physician specialized in treating concussions.An ATC is able to use different tools to assess for a concussion. These tools include but are not limited too:ImPACT TestingScat5Balance Error Scoring System (B.E.S.S)Vestibular Ocular-Motor Screening (VOMS) All of these tools are typically compared to baseline measures before an athlete has begun a sports season. A comparison or measure is used to assess the function of the brain to better examine for potential injury.Return to Play ProtocolDay 1 (Initial Injury)Initial Assessment by ATMD referral (mandatory if concussion suspected) and school education planIf concussion confirmed, AT and parents should contact school nurse for academic planEducation of red flags and acute management is provided to athlete and parents24-48 hours of cognitive restDay 3-4*if athlete has history of concussion refer to PT by day 3 for specialized careATC or PT trained in concussions performs further testingIf all tests passed, athlete begins RTP progression stages (see below)If Fail BCTT, and pass VOMS, SCAT5 and/or cognitive testInitiate sub-symptom exertion program, then refer to PT for full examination if symptoms continue for more than 7 days.If Pass BCTT, but fail VOMS, SCAT5 and/or cognitive test or fail all testsRefer to PT for full exam Stage 1Daily activities do not provoke symptoms, Return to academic activitiesStage 2Light aerobic exercise, walking or stationary bike for 20-30 minutesStage 3Sport specific exercise, running drills with no head impact activities, increase movementStage 4Non-contact practice drills, sprints, agility, passing drills, moderate resistance trainingStage 5Full contact practice, participate in normal training activities to restore confidence and assess functional skills by staffStage 6Full Return to play, game clearanceImportant: If any symptoms worsen or arise during exercise the athlete should regress to the previous day’s activities before moving forward. If symptoms are present for over 7 days, PT referral is encouraged to aid healing process and prevent future complications.Prolonged SymptomsAs stated above prolonged concussion symptoms require referral to physical therapists with specialized concussion training. Specialized treatment can help to reduce these prolonged symptoms and help to prevent long term concussion complications. Common persistent post-concussion symptoms include but are not limited to:HeadachesDizzinessFatigueIrritabilityAnxietyInsomniaLoss/decrease of concentration and memoryRinging in the earsBlurry visionNoise and light sensitivityRarely, decreases in taste and smellIn the event the athlete requires Physical Therapy for persisting symptoms we encourage you to see one of our concussion specialists located at a clinic near you. Please see the list below:NovaCare Chester County Physical Therapy Concussion SpecialistsOxford610.932.3619Christine DoughertyThorndale610.383.7700Cynthia LewisExton610.594.9333Alissa BelgeMalvern484.321.8660Elizabeth ThayneWest Chester610.692.7208Rita Padhiar, Greg GurtizenGlen Mills610.459.2731Chris SlabekDevon610.688.7776Mark Bersheim ................
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