(the following is a sample of some initial information we have gathered based on one possible source of medical prevention and treatment services. The results of the survey will help us determine how we next proceed. If you have not yet answered the survey, please click Here to complete it on line. Thanks for your participation).
It is estimated that approximately 10-15% of athletes involved in contact sports will suffer a concussion injury each year. This means that on a team of 15-20 people at least 1 to 2 people per season will likely suffer a concussion injury. Because of the complex nature of concussion injuries as well as the associated risk of serious complications, the problem faced by many sports-based practitioners is making the appropriate diagnosis and also knowing when the athlete has fully recovered. Many research studies, done on both animals and humans, have shown that suffering a second concussion before you have fully recovered from the first leads to more serious and potentially permanent, or even fatal, brain injuries. Research also suggests that children and adolescents are not only more at risk of suffering these injuries, but they also tend to have prolonged recovery periods because the brain is still in development. Due to widespread lack of knowledge within the general medical community surrounding these injuries as well as the lack of access to specialist practitioners; concussions are not being properly managed in amateur athletes, who are, coincidentally, most at risk.
Since 2001 there have been recommendations from a worldwide group of concussion experts known as the ‘Concussion in Sport’ group, which have called for widespread & comprehensive baseline testing (done prior to each season), as well as a strict, step-wise, monitored return-to-play criteria. However, even with the ease of access to this information, this type of proper concussion management is only being done in high-level sports with access to full-time team medical staff such as NHL, NFL, OHL, Universities, etc.
What the sports world needs is a program that brings the level of care seen in professional sports organizations to the athletes most at risk; the amateur athlete.
Step 1: Baseline Testing
The first, and most important step, is pre-season, comprehensive, baseline testing. Because of the complexity of the human brain, we have to establish an athlete’s function before they get injured so that after an injury, we can then use this information to both determine whether or not they have suffered a concussion as well as determine when they have fully recovered and are safe to return to play.
Without having a proper baseline test, it becomes very difficult to determine whether all of the athlete’s systems have returned to their full functioning capacity because we have no way of knowing what their capacity was before they got injured. Due to the risk of potential long-term damage from returning too early, baseline testing is a necessity for proper concussion management (baseline testing should be repeated annually).
Step 2: Education
The best programs would also provide free education sessions for the parents, coaches, teachers and trainers so that these injuries will be assessed and managed properly from the moment they happen. Educational sessions would include information on what a concussion is, how to quickly assess it, what to do if you are suspecting a concussion, as well as some things to look for that indicate an emergency.
Step 3: Management
Should an injury be sustained athletes should have preferential access within 24 hours following their injury. The athlete should have a full concussion assessment and be provided with a step-wise management plan according to top-level research. From there, the athlete would be closely monitored and, with ongoing communication with the team’s coaches and training staff and the athlete’s family physician, progressed through the appropriate stages of recovery and rehabilitation.
Once the athlete has recovered symptomatically and is able to meet all of their baseline standards on repeat testing, the athlete would be put through a few final tests of physical ability (designed by an authority in their sport), before being cleared to play.
Step 4: Post-concussion syndrome rehabilitation
90% of concussion injuries recover within 2 weeks however, for a yet unknown reason, the other 10% go on to have a more prolonged recovery. For these patients they would be referred to a network team of more advanced sports medicine physicians, neuropsychologists, chiropractors, and physiotherapists to help with rehabilitation of ongoing neurological impairments.
A program like the above would quickly become the most comprehensive concussion management program for amateur athletes available in the GTA.
Baseline Testing Specifics
Multiple tests are done prior to each season to measure:
- Cognitive Function
- Reaction Time
- Motor strength
- Visual Tracking/Processing Speed
- Online Neurocognitive Test1
This in-depth testing takes approximately ½ hour per athlete however when tested in team format, the process can test about 20 athletes per hour.