Gone are the days of returning to the game the same day you suffered a concussion. Well it is supposed to be. Even with all the media attention and front line education on concussions; coaches, parents, officials, athletes and trainers are still missing the message. After a concussion has been diagnosed it is extremely important to have the athlete rest. Not only physical rest but cognitive as well. No matter the age of the athlete it is important to offer them this rest.
I has amazed me over the years that parents, athletes and coaches have tried to circumvent the return to play protocols because the concussion occurred in another sport. It is the parents role to inform teachers and other coaches of their child's concussion. Concussed athletes may need to take time off work or school, to give the brain the rest it needs. Student athletes need to be given the chance to fully recover before returning to full mental and physical activities. Having athletes refrain from attending school while still suffering symptoms will aid in their recovery. It may be required for the student athlete to remain home from school until symptom free as the level of concentration at school is too much. Gradually introduce them back into school and homework. Consultation with their teachers is important, ask for extra time to complete assignments and tests. The other major part of cognitive rest is to take away screen time. Put down the phones, turn off the computer, TV and video games. That scream you just heard was every young athlete having a minor heart attack due to this. The bright lights, sound and concentration needed for these activities do not help the brain heal.
Right after injury it is imperative that you do not give the athlete any pain medication. Advil, Tylenol, Aspirin and Ibuprofen will only mask the signs and symptoms of the concussion.
Your qualified health care provider will complete a concussion test and compare it to the athletes baseline evaluation. Only when an athlete is sign and symptom free do they progress onto step two of the return to play process. A minimum of 24 hours is required between each step where the athlete must remain symptom free.
Step 1 - Rest until 24 hour symptom free.
Step 2 - Light aerobic exercise such as biking or jogging for 20-30 minutes.
Step 3 - Sport specific exercises such as skating in hockey, running drills in soccer or football.
Step 4 - Non-contact training drills such as passing drills.
Step 5 - Full contact training drills upon medical clearance
Step 6 - Return to normal game play.
An athlete should remain at step 5 until both the athlete, parent and coach feels that the athlete is able to keep up with the play both physically and mentally.
Key points to remember are:
- Return to learn before return to sport
- No difference in management between elite and non-elite athletes.
- Younger athletes may require longer to recover.
- Rushing any athlete back to sport to quickly can cause serious damage both to the brain and other areas of the body.
- Following proper concussion management may help to decrease the long term effects of concussions.
Robin Tharle-Oluk is a Certified Athletic Therapist at Elite Injury Management. Robin graduate from the University of Alberta with a degree in Physical Education and from Mount Royal College with an Advanced Certificate in Athletic Therapy. She has worked with local hockey and lacrosse as a Head Therapist and has worked with athletes in a variety of sports including soccer, figure skating, gymnastics and dance.