Concussions are the current hot topic for research in athletics today. Guidelines are constantly changing and being updated. Northeast Rehab's concussion protocol is updated yearly to reflect what the latest research and guidelines recommend. Below is important information to understand not only for athletes, but also parents/guardians.

If your son/daughter gets a blow to the head and they have one or more symptoms of a concussion lasting 10 minutes or longer, they will not return to athletics that day. This is not only our policy but the guideline recommended by the state. They will be evaluated by the Athletic Trainer and take the ImPACT test to determine the severity of the injury.

What is an ImPACT Test?

The impact test is an online neurocognitive examination given to athletes to ensure concussions are managed as safely as possible. It tests each individual's ability to process information, their reaction time and their memory. Every athlete will take this test prior to the start of their participation in athletics. This provides us with a baseline score. While the ImPACT test can be utilized without a baseline on file, it is much more accurate if one is on record. An athlete CAN NOT FAIL the baseline. We simply want to see how the athlete performs when they are healthy. In the event a concussion may have been sustained, this gives us a good reference point to compare the post-injury test too. This post injury test will be taken as soon as possible after the injury.
 
***Studies have shown that even when an athlete no longer has concussion symptoms, their brain and cognitive function can still be impaired. Utilizing this ImPACT test allows us to make sure the athlete is absolutely ready to return to sport. It is an incredibly useful tool.

Returning to Sports after a Concussion

After an athlete sustains a concussion, there are certain criteria that must be met before he/she can return to sport. An athlete with a concussion will check in daily with the Athletic Trainer to track his/her symptoms on a sheet. This gives us a qualitative way to see how their symptoms are progressing. Once the athlete has been symptom free for 2 DAYS and is BACK TO BASELINE LEVELS on their ImPACT test, they can start the return to play.

What is the Return to Play (RTP) progression and why do we do it?

The RTP is a process that implements 5 days of supervised exercise. Athletes that are recovering from a concussion can not just be thrown back into play. This process makes sure that they can handle the demands of sport in a safe environment before being allowed to play unsupervised. Here is a summary of the RTP.
 
**Remember, this is not started until the athlete has been symptom free for 2 days and is within normal levels on their ImPACT test.

• STEP 1- Light activity (15-20 minutes on a stationary bike)
• STEP 2- 15 minute warm up on a bike. Another ~10 minutes of dynamic warmups (butt kicks, high knees etc)
• STEP 3-  Dynamic warm up. Sport specific drills and activity. ~30 minutes of activity
• STEP 4- Non-contact practice. This means they can condition with their team but can not do any activities that may result in another blow to the head (drills with an active defense for example)
• STEP 5- Regular practice

 
After each step the athlete will again record their symptoms on the symptom sheet. If any of this activity caused symptoms to return, all activity is stopped and the athlete will wait 24 hours and then repeat the previous step. So if symptoms returned on step 2, step one will be performed again the next day.

Referrals to a Neurologist

When an athlete that has sustained a concussion does not improve, has an unusually high symptom count or has a concerning history of prior concussions, it may be necessary to send them to a specialist. This will be talked about with the parents/guardians and the athletic trainer. In these situations, it is highly recommended the directions of the Athletic Trainer are followed. Your family doctor isn't the best person to see in situations like this and more often than not, your doctor will tell you this as well. They understand the complexity of these situations. They need to be handled delicately under the supervision of the right professionals.