Concussion Return to Play

   Concussion treatment and rehab has become a very popular thing in the last five to seven years. There are many companies and individual practitioners who put on certification and concussion courses.

   I have taken or have attended over ten concussion courses and symposiums. I have treated my fair share of concussions in the clinic and have been at the field implementing return to play protocol.

   There is a lot research that is and has been done for treatment and for return to function / sport. That being said I think it is important to make a few things clear.  This comes from my experience from the clinic, the field and my own research of several articles. As with any injury, safety is first and foremost the most important thing in returning an individual to play or to sport.

   You cannot prevent a concussion.  What you can do is take the steps to minimize any type of injury from happening in the first place.

Injury prevention for any individual is ongoing. Teams need to be providing guidance in the off season for home programs that incorporate resistance training, hand eye coordination, fitness etc.

Clinical Clearance

   An individual who has had a concussion needs to first be cleared from the clinic.  This would include negative test results for Vor Cancelation, horizontal and vertical gaze, horizontal and vertical saccades and many more. Any hint of lingering symptoms such as a “slight” headache or “mild” dizziness needs to be resolved.

   Therapists use different techniques in the clinic for treatment. I use a combination of therapies such as Micro-current with Dolphin MPS, Matrix Repatterning and Craniosacral Therapy. There is no one magic bullet!

   There is also an emotional and nutritional component to treatment too. If necessary an individual may be referred out to the appropriate professional. It is important to note that any type of treatment cannot prevent a concussion from happening again.  Treatment provides an opportunity for the individual to participate in active exercises to minimize the chances of a concussion occurring again.

Concussion Return to Play Protocol

   Once an individual is cleared from the clinic – symptom free from all testing – the next step is to follow the return to play guideline.  This is from Parachute   https://parachute.ca/wp-content/uploads/2019/06/Return-to-Sport-Strategy.pdf .  Briefly these are the steps.

Stage 1: Symptom-limiting activities
Stage 2: Light aerobic activity
Stage 3: Individual sport-specific exercise with no contact
Stage 4: Begin training drills with no contact
Stage 5: Full contact practice following clearance by a doctor.
Stage 6: Return to Sport – Full game play or competition.

   Each individual team or practitioner. Will have their own version of this.

   Furthermore individuals in school should be back full time in class without any symptoms before attempting the return to play protocol. School before sport!

   Clinically cleared is not the same as being and functionally cleared for sport.  For example an individual may be able to perform clinical tests without any symptoms and then as soon as they participate in interval training or go for a jog their symptoms return.

  Are they able to process and carry certain plays on the field, are they able dribble a ball, handle the puck or catch a football without recreating their symptoms?

   Just being able to pass tests in a clinic does not equate to being ready to get back into action.

   Prevention is proactive.  Regardless of the type treatment an individual receives, the mind to muscle body connection needs to be retrained in order to minimize the chance of re-injury. This is true for any injury including concussions.

   Would you ask someone who just got out of leg cast to run intervals or go for a jog?

   Finally, you cannot prevent an injury or concussion from re-occurring. What you can do is take the steps to minimize the opportunity for it to occur.