A concussion, or mild traumatic brain injury, is a disturbance of brain function that can be sustained by any direct blow or blunt force trauma to the head and/or neck area. The force sustained causes a violent shaking of the brain inside the skull. A concussion is sometimes termed a “closed” injury meaning you cannot see the effects (swelling, bleeding, bruising, etc.) with the human eye. The only way to determine the severity of the injury and how the healing process is maturing is to monitor how the athlete is responding to his/her symptoms. This is an injury that can be very serious and when treating concussions, it is important to take the conservative route and error on the side of caution as to not develop any consequences.
- appears dazed or stunned
- forgets plays
- is unsure of game, score or opponent
- responds slowly
- loss of consciousness (temporarily)
- shows behavior or personality change
- forgets events prior to hit (retrograde amnesia)
- forgets events post hit (anterograde amnesia)
Signs reported by Athlete
- balance problems
- blurry vision
- feeling sluggish
- trouble concentrating
- change in sleep pattern
- sensitivity to light/noise
Most athletes who experience a concussion do recover over time. Some athletes may experience chronic or long-term effects related to their injury. Suffering a second blow to the head while still recovering from the initial concussion could have catastrophic consequences such as second impact syndrome. Athletes should not return to competition until symptoms have ceased.
Second Impact Syndrome
Over the past decade, 30-40 deaths have occurred to athletes who had sustained concussions and been allowed to return to play too early. Second impact syndrome is the result of a second concussion occurring while the athlete is still symptomatic from the first injury. The force that causes the second concussion may be very minimal or less severe than that of the first concussion.
West Genesee High School Return to Play Concussion Protocol
The information below is to be used as mere guidelines that are to be implemented in the time following a concussive event. This information is not to be considered as all-inclusive or all-encompassing.
When an athlete shows signs or symptoms of a concussion or is suspected to have sustained a brain injury after an evaluation by a medical professional at the time of incident:
- The athlete will not be allowed to return to play in the current game or practice.
- The athlete will not be left alone; regular monitoring for deterioration is essential over the time from initial injury up to 24 hours following the injury.
- Following the initial injury, the athlete must follow-up with their primary care physician (PCP) or ER within the first 24-48 hours. If necessary, the athlete will be advised to be treated by a concussion specialist.
- Return to play criteria will follow this below process once released from a physician.
It is the Athletic department’s job to ensure that your athlete returns back to participation in utmost health. In treating concussions, especially those that are more severe, it is important to error on the side of caution and treat the concussion conservatively. Proper concussion management protocol is rest until all symptoms subside (asymptomatic) and then a gradual program of exertion before returning to sport. The protocol involves six steps to exert the athlete, with each step covered over a 24-hour period. The six steps involve the following:
- No activity until asymptomatic. (time frame of 5-7 days)
- Light aerobic exercise such as walking, jogging, stationary bike. No resistance exercise.
- Sport-specific exercise such as running, agility drills, etc. Progressive addition of resistance training may begin.
- Non-contact training/skill drills.
- Full contact training in practice setting (if contact/collision sport)
- Return to competition.
If by chance any concussion symptoms recur, the athlete will stop the exercising immediately and discontinue for the next 24 hours. The following day, the athlete will be re-evaluated and return to the last step of the concussion protocol that was completed. The athlete will continue to be monitored for symptoms and if for any reason, symptoms keep returning, the athlete will discontinue exercise and report back to the physician to ensure there are no underlying problems.