In my over twenty five years working with sports from high school football and hockey, university and club rugby, provincial, national and academy soccer I have been a first responder and treated many concussions. Wow! Things have changed!
Back in the day if an athletes symptoms were gone with in twenty minutes he / she would be able to go and play. If the symptoms lasted longer than twenty minutes they were out for the game. That was the information I had.
Not only that we graded concussions based on if they were knocked out or not. This no longer exists as the scientific evidence does not support it.
Two years ago the number of concussions with the work I do in soccer more than doubled than the previous year and two players had set backs when they returned to play after I put them through my return to play protocol. I had to ask myself why were there setbacks and what was I missing.
I thought I was up to date and current with following SCAT3 and Child SCAT3 assessment and return to play protocol as set out by the British Journal of Sport Medicine.
I thought that was enough but as I have later learned it was not. After doing more research and taking courses put out by Anne Hartley, Shift Concussion and on going work in in the clinic and on the field I learned that I was missing a few things in my initial assessment. I know for some of you reading this is probably nothing new; however a good refresher keeps us honest.
So here are some things I have learned through courses and treating individuals with concussions:
- It takes ten days for nerve cells to regain normal shape after being stretched. This I consider to be a vulnerable time.
- Blood flow to the brain in some people is still restricted /minimized eight days after the initial blow.
- Cranial Sacral Therapy helps for stress and anxiety.
- Parents and children do not communicate well. For example – Parent “ my child seems to be to be fine – I do not see anything wrong with him /her, I want them back on the ice tonight” Me “ he/she –seems fine and as I mentioned to you they told me wrote down that they had a headache, felt dizzy and had some blurred vision. They are still having symptoms…”
- Parents believe that ImPACT testing will tell them whether or not their child has a concussion.
- A concussion lasts only ten days. For ongoing symptoms after ten days you must find out the source.
- Post concussive symptoms may arise from any of the following three things: inner ear issues, vison problems, muscle tightness in the neck and shoulders.
- Concussions can be minimized through improving neck strength by reducing angular velocity (mainly females), peripheral vision training and reaction time training.
- Many repeat concussions occur because the first one was poorly managed or not managed at all.
- We are getting closer to a blood test for concussion MTBI diagnosis. It is still a clinical diagnosis by a physician.
- The biggest thing that I have discovered is that resting is not a complete solution to managing a concussion and parents of student athletes need to be educated about concussions.
On a daily basis I continue to gain more academic knowledge and integrate this clinically. There is no one be all solution to managing and treating post-concussion symptoms. It is a symptom driven, individualized program with a willing participant to follow instructions so that they may to return sport, work, play and school.