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Concussion protocol

What is a concussion?

A concussion is a neurological disorder which alters brain function as a result of direct or indirect forces exerted to the head. It results in a variety of non-specific signs and symptoms which may include headache, nausea, dizziness, confusion, change in personality, just to name a few.

What causes concussions?

The common misconception is that an athlete has to lose consciousness to have a concussion. This is definitely not the case. Because the brain is suspended in a pool of fluid called the Cerebrospinal fluid (CSF) and not fixed inside the skull it is extremely mobile. Typically the CSF acts as a cushion to protect the human brain from the bony surfaces of the brain. But with enough indirect or direct force exerted to the head the CSF isn’t sufficient enough of a cushion anymore and the brain comes into contact with the skull.  When the brain comes into contact with the skull that is when athletes experience signs and symptoms of a concussion.

A good example of this is the video below

brain

NOTE: There should be at least 24 hours (or longer) for each stage and if symptoms recur the athlete should rest until they resolve once again and then resume the program at the previously asymptomatic stage. Resistance training should only be added in the later stages.

 If the athlete is symptomatic for more than 10 days, then consultation by a medical practitioner who is expert in the management of concussion is recommended.

Common symptoms of a concussion

Headache Sensitivity to light Fatigue or low energy Nervous or anxious
“pressure in head” sensitivity to noise Confusion numbness and tingling of arms and legs  (DO NOT MOVE)
Neck Pain Feeling slowed down Drowsiness  
Dizziness “don’t feel right” More emotional  
Nausea and/or Vomitting Feeling slowed down Drowsiness  
Blurred vision Difficulty concentrating Irritability  
Balance issues Difficulty remembering Sadness  

Red Flag Symptoms

If your athlete shows any of the following Red Flag Symptoms call 911 immediately.

– Neck pain

-Increased confusion or irritability          -Deteriorating consciousness

-Loss of consciousness                          -Severe or increasing headache

-Unusual behaviour change                   -Double vision

-unequal pupils (eyes)                           -Repeated vomiting

-Seizure or convulsion                          -Weakness in arms/legs            – Tingling or burning in arms/legs

What is the danger of returning from concussion too soon?

All concussions must be taken extremely seriously as improper care will lead to prolonged symptoms and further complications.  If a concussion is suspected athletes are NOT to return to sports or activity that same day.  Premature return to play following a concussion may result in a deadly condition called second impact syndrome.  Second impact syndrome leads to severe brain swelling and possible brain herniation. The second incident may be as subtle as the head whipping forward following a jump or merely bumping into another player but this is enough for a catastrophic episode which often results in death.

FCT Concussion protocol

  1. An athlete showing any signs and symptoms of a concussion (listed above and/or on the SCAT 3) will be removed from training or match that day. The athlete will not return to the game or practice that day.

                -In the event the athlete loses consciousness => ACTIVATE 911.  Athlete is not to be                      moved unless absolutely necessary

                -Associated skull fracture/neck injuries as a result => ACTIVATE 911.

  2. If an  Athletic Therapist is on site a full SCAT 3 form will be filled out to establish severity of symptoms. This will then be given to the athlete or the parent to take to a physician for a follow-up.
  3. Following the concussion the athlete should visit a sports medicine physician familiar with concussion protocols for a follow-up.  Athletes will then start a gradual supervised return to play program with the Athletic Therapist once all initial symptoms are gone.

The Return to play protocol is as follows:

Rehabilitation Stage Functional Exercise at each stage of rehabilitation Objective of each stage
No activity physical and cognitive test Recovery
Light Aerobic exercise walking,swimming or stationary cycling keeping intensity, 70% maximum predicted heart rate. No resistance training Increase Heart Rate
Sport-specific exercise Running drills in soccer./futsal No head impact activities Add movement

Non-contact training drills

Progression to more complex training drills (such as passing, shooting, and dribbling) Exercise, coordination and cognitive load
Full contact practice Following medical clearance participate in normal training activities Restore confidence and assess functional skills by medical and coaching staff
Return to Play Normal game play