The Best Advice For Handling Concussions
Top tips from athletic trainers dealing with concussions daily
Posted Nov 23, 2016
A concussion-caliber collision starts a process inside the brain to manage the effects. While the neural synapses scramble to recalibrate, there is a lot on the line. To avoid an altered future fraught with headaches, memory loss and mood dysregulation from the potential injury not healing correctly, I asked athletic trainers from the front lines to help answer:
What is your single best piece of advice for handling a concussion?
It may seem like a basic question, but I’m finding there is still a lack of understanding and misunderstandings about the mild traumatic brain injury. So I asked athletic trainers dealing with concussion risk virtually every day. Athletic trainers also maintain continuing education regarding concussions, and comply to some of the highest standards of care established by the National Athletic Trainers Association (NATA) and the American College of Sports Medicine (ACSM), among others.
Here are a few tips gathered from the field, through a LinkedIn query. I’ve added my own Top 5 Tips for Handling Concussions as well:
- Take your time!
“Due to the constant pressure from coaches, administrators, fans, family, and even fellow teammates, avoid rushing into making decisions about return to play before the athlete is truly symptomatic. An extra day out saves that athletes brain, career, and maybe their life long term.” — Traci Tauferner LAT, CSCS, PES, Tactical athletic trainer for Ascension/Ministry health care
- Take them seriously!
“They need to be taken seriously especially at a junior level and assessed properly at all times. No short cuts can afford to be taken.” — Gareth Florida-James, Clinical Lead Physiotherapist at Head2toe Physio in Redhill, United Kingdom
- It’s personal!
“It's not about any one thing, it's about the student-athlete and the way they received the blow to the head, how tired they are, the amount of food and water they had during the day. Are they on any medications for learning problems? There are a lot of small conditions that add up to the simple or complex concussion. Finding the combination of conditions that amounted to the tipping point to put a student-athlete into a concussed injury is the trick. Being around the student/athletes daily is a big start. I guess that might be the one big thing, make sure every school has a certified athletic trainer in the building working with the student-athletes on a daily basis.” — Wayne Harmon ATC, Olathe Medical Center, Olathe North High School
- It’s technical!
“In working with high school athletes, my most important factors in concussion evaluation are P.E.A.R.L. (Pupils Equal and Reactive to Light), occular tracking, retro/anterograde amnesia, cognitive responses to questions (basic math), awareness level, and balance and head pain. I'm more concerned about the long term issues a student athlete may have with their brain. It is difficult with some of the parents…but I tell the students that, yes, their sport is important but your brain is more important...It's one injury that could last a lifetime.” — Kristen A. Milazzo ATC/L, Head Athletic Trainer, Lakeland Regional High School, Wanaque, NJ
- Rest and take responsibility!
Adding my own single best piece of advice, concussions do not discriminate. Concussions occur at epidemic levels, so everyone must have a basic level of knowledge of the injury. It’s not OK for onlookers to see a massive clash on the field, notice unusual reactions by the athlete and do nothing. The sports culture needs to shift from “it’s just a ding” to “it means everything” to take concussions seriously.
Here are my Top 5 Tips for Handling Concussions:
- Don’t move an unconscious person. Call 9-1-1 if the person does not wake up in 30 seconds. An unconscious athlete should always be assumed to have a cervical spinal injury. Moving them before proper stabilization of the cervical spine can risk quadriplegia or even death. This includes removing the helmet. When awake, ask the person if they feel injured, and can get to their feet.
- Don’t decide too early. Although evaluations should begin immediately, it’s important to note that many concussion symptoms are not experienced for 24 hours. In the meantime, any trouble with responding to questions, standing, walking qualify as effects of possible concussion. Every team should have a “sideline assessment” using a smartphone that can help provide medical personnel other necessary information.
- “When in doubt, sit them out.” Error on the side of caution because there’s really no need to return to play.
- Rest. The best thing to do to heal from a concussion is rest. However, to expedite recovery., I prefer the term “relative rest,” which includes gradual reintroduction of cognitive and physical activities. Sleep is very good for the brain, so monitor that closely.
- Comply with state laws. Today, every state requires that clearance to return to play be given by a qualified medical professional. It’s always helpful to provide your doctor all the facts from your evaluation from the “crash” seen on the field. Details about the way the injury occurred, the person’s responses, and resulting actions all play a factor in the final decision.
# # #
About the Author
Harry Kerasidis, M.D. is the founder and medical director for the sports concussion management platform XLNTbrain, LLC, based in Maryland. He is also the founder of Chesapeake Neurology Associates in Prince Frederick, Maryland and serves as the Medical Director for the Center for Neuroscience, Sleep Disorders Center and Stroke Center at Calvert Memorial Hospital. His new book, “Concussionology: Redefining Sports Concussion Management For All Levels” is available now online.