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Articles by our Physical Therapists

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13. WHEN IN DOUBT - SIT THEM OUT

WHEN IN DOUBT – SIT THEM OUT

For those of us who have been involved in or “around” sports, we often hear of an athlete who “gets their bell rung” or “got dinged” following trauma to the head, whether from another athlete, the ground or some object.  In reality what these athletes may be experiencing is a sports related concussion requiring appropriate medical intervention.

So what exactly is a concussion?  In basic terms a concussion is a mild Traumatic Brain Injury (TBI) that can occur from an impact to the head.  Although most common in football, soccer and basketball, a concussion can occur in any sport, physical activity or accident involving a blow to the head. 

In 2009 the Oregon Legislature enacted Max’s Law to require implementation of concussion management guidelines to protect athletes and help ensure their safe return to athletics and academics.  The first component of managing a suspected concussion is to RECOGNIZE if a concussion has occurred. 

Symptoms reported by the athlete may include:

  • headache
  • nausea
  • blurred or double vision
  • dizziness
  • feeling groggy
  • problems with concentration or memory

Symptoms observed may include:

  • confusion
  • long-term or short-term amnesia
  • delayed responses to questions
  • personality or behavioral changes
  • poor recall
  • loss of consciousness (LOC).   

LOC does not have to be present for a concussion to have occurred! 

If a concussion is suspected the athlete should be REMOVED from participation in that event or training for the remainder of the day.

The athlete should then be REFERRED for proper medical treatment.  In the presence of LOC or deteriorating signs and symptoms this could involve immediate referral to the ER. 

RETURN to participation is allowed only after medial release from an appropriately trained medical professional, usually the athlete’s primary care provider.  This should follow a stepwise progression involving gradual return to physical activity as well as mental and cognitive activity as follows:

  1. Complete rest until symptoms have resolved
  2. Light mental activity and low impact physical activity after asymptomatic for 24 hrs.
  3. Non-contact / sport specific activity if remaining symptom free following step 2
  4. Return to sport specific drills
  5. Return to full contact participation with medical clearance

The athlete must remain symptom free prior to and following progression to the next level of activity. 

Keep your kids healthy!  If you suspect, or have questions regarding a possible concussion situation please contact your health care provider.

Written by Rob Bachman, PT

Published September 2011

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