The Centers for Disease Control (CDC) estimates that there are approximately 300,000 cases of mild traumatic brain injury (MTBI) or concussions annually in the United States as the result of participation in sports. The Sports Concussion Institute estimates that 10 percent of athletes in contact sports suffer a concussion during a season. A 2006 report estimated that there were 92,000 cases of concussions in American high School sports annually, and that these rates seem to be increasing. Also of concern is the risk of repeated concussions and second impact syndrome to our young athletes. These two problems can have long lasting, and even terminal effects, on the individual. In order to have a standard method of managing concussions to Timber Creek athletes, the following guidelines are intended to serve as a written protocol for concussion management.
Concussion or Mild Traumatic Brain Injury (MTBI) -A concussion or MTBI is the common result of a blow to the head or body which causes the brain to move rapidly within the skull. This injury causes brain function to change which results in an altered mental state (either temporary or prolonged). Physiologic and/or anatomic disruptions of connections between some nerve cells in the brain occur. Concussions can have serious and long-term health effects, even from a mild bump on the head. Symptoms include, but are not limited to, brief loss of consciousness, headache, amnesia, nausea, dizziness, confusion, blurred vision, ringing in the ears, loss of balance, moodiness, poor concentration or mentally slow, lethargy, photo-sensitivity, sensitivity to noise, and a change in sleeping patterns. These symptoms may be temporary or long lasting.
Second Impact Syndrome – Second impact syndrome (SIS) refers to catastrophic events which may occur when a second concussion occurs while the athlete is still symptomatic and healing from a previous concussion. The second injury may occur within days or weeks following the first injury. Loss of consciousness is not required. The second impact is more likely to cause brain swelling with other widespread damage to the brain. This can be fatal. Most often SIS occurs when an athlete returns to activity without being symptom free from the previous concussion.
Pre-season Baseline Testing
All Timber Creek student athletes that participate in a collision or a contact sport MUST complete the following:
- Online Concussion Course required by FHSAA/OCPS policy
- Concussion Baseline Test using Concussion Vital Signs
Evaluation for Concussion/MTBI
At the time of injury, administration by the TCHS Sports Medicine Staff of one or more of the following tests will be performed to assess the student athlete:
- Sports Concussion Assessment Tool 2 (SCAT2)
- Graded Symptom Checklist (GSC)
- Sideline Functional & Visual Assessments
- On-field Cognitive Testing
*The athlete cannot return to a game or practice if he/she exhibits any signs and/or symptoms of a concussion or if a coach, athletic trainer, parent or other health care provider suspects a concussion.
Once the athlete has exhibited signs and/or symptoms of a concussion, has been removed from the field of play and has been evaluated on the sideline; they will follow up with an online post-concussion test using concussion vital signs within 24 hours of the injury. *If signs/symptoms worsen within a short amount of time, they will be referred to the Emergency Room for further testing.
If the athlete scores poorly (poorly = does not score within 5% of their baseline score) on the online post-concussion test, the student athlete MUST be evaluated by a physician (preferably a concussion clinic) in order to start the return to play protocol.
School modifications will be made by the treating physician.
Return to Play Protocol
- No activity for at least 24 hours after injury and athlete is asymptomatic
- Written clearance from the treating physician to begin Return to Play Protocol, 4-Day Process (see AT-18 Form)
- Day 1 – Light aerobic exercise with no resistance training
- Day 2 – Sport specific activity
- Day 3 – Non-contact training drills with resistance training
- Day 4 – Full contact training drills
- Written Clearance from treating physician to Return to Play
- Return to play as long as athlete continues to be asymptomatic
- Please note – Athlete progression continues as long as athlete is asymptomatic at current level. If the athlete experiences any post concussion symptoms with any step above, athlete will wait 24 hours and continue at the previous step.
- All headgear must be NOCSAE certified.
- Make sure the headgear fits the individual.
- For all sports that require headgear, a coach or appropriate designate should check headgear before use to make sure air bladders work and are appropriately filled. Padding should be checked to make sure they are in proper working condition.
- Make sure helmets are secured properly at all times.
- Mouth guards should fit and be used at all times. They also need to be checked throughout the season to maintain their integrity and proper function.
- National Athletic Trainers Association