Concussion in sport is an important topic. Professional athletes steal the headlines when it comes to all things sports, including injuries, but education and protection for the common recreational or child athlete is of greater importance to the future of sport and wellbeing. In the United States, close to 175,000 children are treated every year in emergency departments for head injuries that happen during sports.
One definition of concussion is “a complex pathophysiological process affecting the brain, induced by biomechanical forces” that “results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously”. Concussion can result from a direct blow to the head, neck or face, or to the spine if there is a force transmitted to the head after contact.
Signs and symptoms of a concussion are vast and vary between cases. Onset and duration are also unpredictable. Symptoms can develop within minutes to hours, sometimes days after an injury. Every injury is different, so while most concussions last between 7 and 10 days, other injuries can result in months of symptoms.
Physical signs and symptoms can include headache, nausea/vomiting, dizziness, visual disturbances, and loss of balance. Less obvious behavioural changes can include irritability, increased crying, sadness, and anxiety. Cognitive impairment examples are slowed reaction times, difficulty concentrating or remembering, and feeling in a fog. Another category of symptoms are sleep disturbances such as drowsiness, trouble falling asleep, and sleeping more or less than usual.
The SCAT3 is the most recent standardized tool for evaluating for concussion in injured athletes who 13 years and older. The SCAT3 is designed for use by medical professionals. Aside from diagnosing a concussion, this tool can be used as preseason baseline testing.*
*Please feel free to contact our North Vancouver chiropractors about having your team or individual
players evaluated for baseline testing.
The SCAT3 advises that any injured athlete not be left alone and he/she be monitored by a parent or other responsible adult for signs listed above (e.g. change in behavior, vomiting, dizziness, worsening headache, double vision or excessive drowsiness). Immediate hospitalization is recommended if these signs and symptoms are present.
The SCAT3 states: in the event an athlete, after a direct or indirect blow to the head, displays any obvious potential signs of concussion (LOC, balance or motor in-coordination, disorientation or confusion, loss of memory, blank vacant look, visible facial injury in combination with any of the other signs), the "athlete should stop participation, be evaluated by a medical professional, and should not be permitted to return to sport the same day."
When in doubt, the athlete should be removed from play and kept out until cleared by a medical professional.
Some other points of interest include:
- the need for cognitive rest (not taxing brain with activities such as video games, watching television, texting, homework etc.) and avoiding strenuous activity for at least 24 hours
- not consuming alcohol or taking sleeping pills
- not using aspirin or anti-inflammatory medication (acetaminophen (Tylenol) only for headache)
- not driving until medically cleared, and
- returning to sports only after following a stepwise, symptom-limited progressive exercise program and obtaining medical clearance.
Returning to Play After a Concussion
Return to play Guidelines:
Stage 1 – No activity. Symptoms limited to physical and cognitive rest. Objective: Recovery.
Stage 2 – Light aerobic exercise. Activity including walking, swimming, or stationary bicycle, keeping intensity less than 70% of maximum predicted heart rate; no resistance training. Objective: Increase heart rate.
Stage 3 – Sport specific exercise. Skating drills in ice hockey, running drills in soccer and football. No head impact activities. Objective: Add movement.
Stage 4 – Non-contact training drills. Progression to more complex training drills in practice, including stick handling and passing in hockey, and catching drills in football. Objective: Exercise, coordination and use of brain.
Stage 5 – Full contact practice. Following medical clearance, participate in normal training activities. Objective: Restore confidence to allow coaches to assess functional skills.
Stage 6 – Return to play. Normal game play.
How Chiropractic Care Can Help
Recovery from a concussion takes time and effort. While there is a natural history for recovery, treatment through proprioceptive rehabilitation and neurological stimulation can speed up the process. Within the chiropractic community, a field of study is emerging with advanced treatments in this realm. Pittsburgh Penguin superstar Sidney Crosby, after months of little to no relief, underwent intensive neurological chiropractic care in order to return to play. While his case was extreme and most chiropractors don't have access to such treatment methods, there are treatment modalities and rehabilitation exercises that can be done in office.
Ensuring a full recovery is critical to helping prevent future injury and long term damage. Chiropractic is a great adjunct to this recovery. For more information, contact Dr. Lucas Tisshaw and see how he can help.