Return to Play after Injury
Sport-related concussion (SRC) has received increasing attention from the media, researchers, and athletes over the past few years. With the increased awareness surrounding concussions in sport, there has also been an increased amount of diagnosed concussions. This has left many athletes in need of attentive and comprehensive concussion care to return to their sport in a safe and timely manner.
This resource will provide guidance on what to do at each stage during your concussion recovery, from recognition to return to sport.
What to do if you suspect an athlete has suffered a concussion?
The first step is recognition.
If you are a coach/parent and suspect that an athlete has suffered a concussion, the first thing to do is remove them from the playing field. Once you have removed the player from the field, it will allow you to conduct a more accurate sideline assessment. Follow the instructions on the SCAT5 (Sport Concussion Assessment Tool – 5th Edition) to conduct a sideline assessment. A conservative approach is best to ensure that the athlete does not suffer an additional injury even if they report feeling “OK”.
Rowan’s Law makes it mandatory for sport organizations to establish a removal from sport and return to sport protocol. A phrase to remember is: or “Hit. Stop. Sit.”
Red Flags
Red flags” may mean the person has a more serious injury. Treat red flags as an emergency and call 911.
Red flags include:
- Neck pain or tenderness
- Double vision
- Weakness or tingling in arms or legs
- Severe or increasing headache
- Seizure or convulsion
- Loss of consciousness (knocked out)
- Vomiting more than once
- Increasingly restless, agitated or aggressive
- Getting more and more confused
I suspect that I have suffered a concussion. What now?
At this point, it is wise to make an appointment with your doctor to get a preliminary assessment and potentially diagnosed with a concussion. For most people, it is recommended to initially rest for the next 24-48 hours (Schneider, Leddy, Guskiewicz et al., 2017).
Rest includes no screen time (TV, Phone), no exercise, no homework, or any activity that would increase cognitive or physical load. Some activities you CAN do include slow and short walks, meditate, listen to podcasts or audiobooks, and play with a pet. To read more about what a concussion is, click here.
My doctor has diagnosed me with a concussion. What do I do now?
Once it has been determined that you have suffered a concussion, it is important to seek out a rehabilitation clinic that specializes in concussion and brain injury management such as the Surrey Neuroplasticity Clinic. A full concussion assessment to evaluate, emotional, cognitive and physical functioning will be conducted to help guide proper treatment.
After an initial 24-48 hours of rest, you may begin introducing some very light activity such as longer walks, light chores, homework, and screen time for short durations (Schneider et al., 2017). It is important to ensure that none of these activities result in increased symptoms and make you feel worse.. It is also important to not get stuck in the “rest” phase, as this has not been proven to be beneficial in individuals who have suffered an SRC (Schneider et al., 2017).
What does sport-related concussion treatment look like at the Surrey Neuroplasticity Clinic?
Our concussion rehabilitation begins with a short consultation to review your injury history, as well as any other important medical history. After this information is collected, you will complete a series of assessments that evaluate your static and dynamic balance, physical activity tolerance, cognitive functioning and/or other areas of functioning based on your clinical presentation such as vestibular function. Once we have interpreted your results, our interdisciplinary team will collaborate to develop a comprehensive treatment plan based on your symptoms and goals.
The typical prognosis for concussion recovery is 1-4 weeks (McCrory et al., 2017), but in some instances, symptoms may take longer to resolve. As such, the frequency of sessions will vary from client to client.
Once it is determined that you have safely progressed to a point where a return-to-play decision can be made, you will undergo a final series of assessments using objective performance measures to help ensure you are not only clinically symptom free but physiologically recovered before getting cleared by your physician for a return to play.
At the Surrey Neuroplasticity Clinic, we see brain health as a continuous process. In athletes, brain health does not begin or end with the sports season. Our Brain and Body Performance Optimization program allows for year-round monitoring to ensure you are at your best.
Some assessments offered at the Surrey Neuroplasticity Clinic
- Buffalo Concussion Treadmill Test
- Sensory Organization Test
- NeuroCatch Brain Function Assessment
- Cambridge Brain Science
- King-Devick Test (in association with the Mayo Clinic) – Oculomotor/Visual performance test
- Balance Testing (Clinical Test of Sensory Integration in Balance)
- Neurological and Cervical screening
- Vestibular Assessment using ICS Impulse Goggles
- Gapski-Goodman Test (aka Chicago Blackhawks Test) – Physical Exertion Test
- Functional Gait Assessment
Additional Resources
- Return-to-Sport Strategy after a Concussion
- Strategy for Return to School after a Concussion
- SCAT5 (Sport Concussion Assessment Tool – 5th Edition)
- C-SCAT5 (Child Sport Concussion Assessment Tool)
References
McCrory P, Meeuwisse W, Dvorak J, et al. (2017) Consensus statement on concussion in sport – the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838-847.
Schneider KJ, Leddy JJ, Guskiewicz KM, et al. (2017) Rest and treatment/rehabilitation following sport-related concussion: a systematic review. British Journal of Sports Medicine, 51, 930-934.