Management of Concussions By: Michael Cox Technology and Assessment
Dec 29, 2015
Management of ConcussionsBy: Michael Cox
Technology and Assessment
Management of ConcussionsBy: Michael Cox
Technology and Assessment
What is a Concussion?What is a Concussion?
•Concussions are injuries that transiently impair the way your brain normally functions•They can be caused by a direct blow to your head or by a force that causes your brain to shake within your skull•Not all concussions include loss of consciousness
•Concussions are injuries that transiently impair the way your brain normally functions•They can be caused by a direct blow to your head or by a force that causes your brain to shake within your skull•Not all concussions include loss of consciousness
What to Do if There is a Suspected Concussion
What to Do if There is a Suspected Concussion
If there is an athletic trainer at the location where the injury took place, call him/her for immediate evaluation
Contact your primary physician If they are not available
Contact emergency services
If there is an athletic trainer at the location where the injury took place, call him/her for immediate evaluation
Contact your primary physician If they are not available
Contact emergency services
Concussion SymptomsConcussion Symptoms Headache Dizziness Nausea Ringing in the ears Blurred vision Dazed or confusion Amnesia Balance and coordination problems Aniscoria (pupil size)
Headache Dizziness Nausea Ringing in the ears Blurred vision Dazed or confusion Amnesia Balance and coordination problems Aniscoria (pupil size)
Evaluating A ConcussionEvaluating A Concussion Determine their consciousness and what symptoms the athlete is
experiencing Signs and Symptoms
Memory Testing Determine what they remember before the injury (antrograde
amnesia) and what they remember after the injury (retrograde amnesia)
SAC test Balance Testing
Have athlete balance on both feet with their eyes closed Then perform same test with one foot in front of the other and
vies versa Neurological Testing
Test dermatome (sensitivity to touch) and myotome (strength test) to specific nerve roots
Determine their consciousness and what symptoms the athlete is experiencing Signs and Symptoms
Memory Testing Determine what they remember before the injury (antrograde
amnesia) and what they remember after the injury (retrograde amnesia)
SAC test Balance Testing
Have athlete balance on both feet with their eyes closed Then perform same test with one foot in front of the other and
vies versa Neurological Testing
Test dermatome (sensitivity to touch) and myotome (strength test) to specific nerve roots
Cranial Nerve TestingCranial Nerve Testing
Olfactory- Sense of smell Optic- vision, reading a text at close proximity and distant proximity Oculomotor- PEARL, pupil dilation Trochlear- Eye trackign up and down Trigeminal- Facial sensations Abducens- Lateral eye tracking Facial- facial movements Vestibulocochlear- Balance and hearing Glossopharyngeal- Swallowing reflex Vagus- Gauge reflex Accessory- Shoulder shrug Hypoglossal- Tongue lag
Olfactory- Sense of smell Optic- vision, reading a text at close proximity and distant proximity Oculomotor- PEARL, pupil dilation Trochlear- Eye trackign up and down Trigeminal- Facial sensations Abducens- Lateral eye tracking Facial- facial movements Vestibulocochlear- Balance and hearing Glossopharyngeal- Swallowing reflex Vagus- Gauge reflex Accessory- Shoulder shrug Hypoglossal- Tongue lag
Determining the Severity of a Concussion
Determining the Severity of a Concussion
• Grade 1• No loss of consciousness• Memory loss lasting < 30 minutes• Symptoms lasting < 24 hours
• Grade 2• Loss of consciousness lasting < 1 minute• Memory loss lasting 30 minutes to 24 hours, OR• Symptoms lasting > 24 hours but < 7 days
• Grade 3• Loss of consciousness lasting > 1 minute OR• Memory loss lasting > 24 hours OR• Symptoms lasting > 7 days
• Grade 1• No loss of consciousness• Memory loss lasting < 30 minutes• Symptoms lasting < 24 hours
• Grade 2• Loss of consciousness lasting < 1 minute• Memory loss lasting 30 minutes to 24 hours, OR• Symptoms lasting > 24 hours but < 7 days
• Grade 3• Loss of consciousness lasting > 1 minute OR• Memory loss lasting > 24 hours OR• Symptoms lasting > 7 days
Post-concussion SymptomsPost-concussion Symptoms
Photophobia (sensitivity to light) Seeing stars Difficulty concentrating Irritability Depression Anxiety Fatigue Headache Trouble sleeping
Photophobia (sensitivity to light) Seeing stars Difficulty concentrating Irritability Depression Anxiety Fatigue Headache Trouble sleeping
RehabilitationRehabilitation
Once an athlete has been diagnosed with a concussion they are not aloud to start rehabilitation until they are symptom free
Once symptom free, a 7 day progressive rehab program can begin focusing on cardiovascular exertion, strengthening, and sport-specific activites
If at any time an athlete develops symptoms as a result of their rehab, they are to stop activity until symptoms are gone and start over
Once an athlete has been diagnosed with a concussion they are not aloud to start rehabilitation until they are symptom free
Once symptom free, a 7 day progressive rehab program can begin focusing on cardiovascular exertion, strengthening, and sport-specific activites
If at any time an athlete develops symptoms as a result of their rehab, they are to stop activity until symptoms are gone and start over
DAY 1DAY 1
10 minute elliptical/bike session Moderate intensity
Impact test- cognitive functioning
SAC test- memory
No participation during practice/game
Goal: Increase heart rate
10 minute elliptical/bike session Moderate intensity
Impact test- cognitive functioning
SAC test- memory
No participation during practice/game
Goal: Increase heart rate
20-25 minute elliptical/bike session Higher intensity
No participation during practice/game
Goal: Increase heart rate
20-25 minute elliptical/bike session Higher intensity
No participation during practice/game
Goal: Increase heart rate
DAY 2DAY 2
20-25 minute elliptical/bike session Begin full-body lifting
Leg extension/curls Chest press Bicep curls Triceps pull-downs Seated rows
No participation in practice/game
Goal: Get person moving
20-25 minute elliptical/bike session Begin full-body lifting
Leg extension/curls Chest press Bicep curls Triceps pull-downs Seated rows
No participation in practice/game
Goal: Get person moving
DAY 3DAY 3
Warm-up on elliptical/bike 10-15 minutes
Full-body workout Sprinting
10-15 sprints ranging from short to long distances
No participation in practice/games
Goal: increase athletes heart rate close to max
Warm-up on elliptical/bike 10-15 minutes
Full-body workout Sprinting
10-15 sprints ranging from short to long distances
No participation in practice/games
Goal: increase athletes heart rate close to max
DAY 4DAY 4
Warm-up on elliptical/bike 10-15 minutes Sport specific activities
i.e- shooting, throwing, hitting, kicking Minimal participation in practice No participation in game
Goal: get them back to sport-specific training
Warm-up on elliptical/bike 10-15 minutes Sport specific activities
i.e- shooting, throwing, hitting, kicking Minimal participation in practice No participation in game
Goal: get them back to sport-specific training
DAY 5DAY 5
Return to practice with no contact
Goal: Return to all sports activity restraining from contact
Return to practice with no contact
Goal: Return to all sports activity restraining from contact
DAY 6DAY 6
Full return to participation including contact Able to play in games
Goal: Contact drills being aware of any symptoms that may return
Full return to participation including contact Able to play in games
Goal: Contact drills being aware of any symptoms that may return
DAY 7DAY 7
Returning from a Concussion to Soon
Returning from a Concussion to Soon
Returning from a concussion before someone is ready can not only lead to an increase in symptoms, but it can cause further damage
Secondary Impact Syndrome This occurs when an athlete sustains a secondary head injury while
still experiencing symptoms from the first concussion The secondary injury can be very minor It will cause rapid swelling and disruption of the brain possibly
leading to respiratory failure and possibly death
Returning from a concussion before someone is ready can not only lead to an increase in symptoms, but it can cause further damage
Secondary Impact Syndrome This occurs when an athlete sustains a secondary head injury while
still experiencing symptoms from the first concussion The secondary injury can be very minor It will cause rapid swelling and disruption of the brain possibly
leading to respiratory failure and possibly death
What to Avoid What to Avoid Athletes who sustain a concussion should avoid certain behaviors until
instructed otherwise. Such behaviors include: Drinking coffee or other stimulants
Consuming alcohol
Consuming foods in excess that will upset the stomach
Weight lifting or exercise
Taking medications that contain ibuprofen such as advil or Aleve because they are blood thinners and can cause further problems
Athletes who sustain a concussion should avoid certain behaviors until instructed otherwise. Such behaviors include: Drinking coffee or other stimulants
Consuming alcohol
Consuming foods in excess that will upset the stomach
Weight lifting or exercise
Taking medications that contain ibuprofen such as advil or Aleve because they are blood thinners and can cause further problems
Some Ways to Help Treat a Concussion
Some Ways to Help Treat a Concussion
• There is no cure or specific medication for a concussion but there are some ways to help treat the symptoms:• REST- the most important thing a person can do is rest the body
and get a good nights sleep• Taking tylenol (acetaminophen)
for minor headaches• Avoid strenuous activity• Try not to watch TV or use the
computer to much• If doing homework or reading is bothersome, stop doing it
• There is no cure or specific medication for a concussion but there are some ways to help treat the symptoms:• REST- the most important thing a person can do is rest the body
and get a good nights sleep• Taking tylenol (acetaminophen)
for minor headaches• Avoid strenuous activity• Try not to watch TV or use the
computer to much• If doing homework or reading is bothersome, stop doing it
Summary Summary If an athlete sustains any type of headache or “not feeling right” after
being hit in the head, it is very important to have a certified health professional evaluate the injury
Do not lie about symptoms
Most important thing to do is
rest the body and refrain from
strenuous activity
A doctor must clear the athlete
before returning to activity
If an athlete sustains any type of headache or “not feeling right” after being hit in the head, it is very important to have a certified health professional evaluate the injury
Do not lie about symptoms
Most important thing to do is
rest the body and refrain from
strenuous activity
A doctor must clear the athlete
before returning to activity