Understanding Concussions in High School Sports A Comprehensive Guide for Coaches, Athletes, and Parents

By Jay Cherok, PT, DPT, Cert. MSKUS

In the fast-paced environment of high school sports, being aware of concussion management can make all the difference in keeping our young athletes healthy. Coaches and parents play a crucial role in understanding concussions to protect our young athletes. So, what is a concussion, and how does it impact the brain and nervous system? Let's break it down.

What is a Concussion?

A concussion is a type of traumatic brain injury (TBI) caused by an impact to the head or a sudden jolt that makes the brain move quickly inside and impact the skull. This movement can damage brain cells, creating a chemical reaction that disrupts normal brain function. Since our nervous system depends on clear communication between neurons, any impairment can affect cognitive abilities, physical skills, and emotional well-being.

For instance, a player receiving a hit to the head or hitting the ground during a sport may experience a concussion, possibly leading to short-term memory loss or coordination issues to name a few of the issues that may arise.

Signs and Symptoms of a Concussion

Identifying the signs and symptoms of a concussion is crucial for timely care. It is best to have the athlete examined by a medical professional trained in concussion management, but that is not always available to us. Here are some of the most common indicators to assist you in evaluating the possibility that your athlete has a concussion, although not all inclusive:

1. Physical Symptoms:

   1. Headaches

   2. Nausea or vomiting

   3. Balance problems

   4. Sensitivity to light or noise

   5. Fatigue

2. Cognitive Symptoms:

   1. Confusion or feeling “foggy”

   2. Difficulty concentrating

   3. Memory issues

   4. Slowed reaction times

3. Emotional Symptoms:

   1. Increased irritability

   2. Anxiety

   3. Mood swings

      
      

It's essential to remember that symptoms may not appear right away. They can develop over hours or even days following the injury. For example, an athlete may play a full game and only start feeling dizzy the next morning. If you suspect a concussion has occurred, it is best to treat the athlete as if it has, hold them from the game or practice until further evaluation by a trained professional can be completed. A second impact injury when suffering from a concussion increases the effects of the injury and multiplies the damage that can occur.

Healing Time and Return-to-Sport Guidelines

Recovery from a concussion can vary widely, with some athletes needing just a few days while others may require several weeks. Research shows that most high school athletes can safely return to sports after a minimum of 7 to 14 days if they have no symptoms. However, careful monitoring for delayed symptoms is crucial.

A general recommended step-by-step return-to-sport protocol includes:

1. Rest and recovery: Ensure physical and cognitive rest until symptoms are controlled.

2. Asymptomatic Aerobic exercise: Start with gentle activities like walking or stationary cycling at an intensity that does not provoke the concussion symptoms, utilize a Physical Therapist to guide the rehab process and ensure that your player is healing properly and effectively.

3. Sport-specific exercises: Begin movements specific to the sport without any head impact and minimize risk for impact during this period.

4. Non-contact training drills: Move to more intense practice while avoiding physical contact.

5. Full-contact practice: After clearance from a medical professional, athletes can engage fully in practices.

6. Return to competition: Full participation in games is allowed when symptom-free during the previous steps and release from the medical professional.

   
   

Progressing through these steps carefully helps ensure a safe return to sports.

Myths About Concussions

Misunderstandings about concussions can have serious consequences. Here are a few common myths:

• You must lose consciousness to have a concussion. Myth!

- Fact: Many concussions occur without loss of consciousness. Reports indicate that only about 10% of concussions lead to loss of consciousness.

• All concussions lead to the same symptoms. Myth!

- Fact: Symptoms can differ greatly among individuals. For example, while some may experience intense headaches, others might feel a sense of confusion.

• It is safe to return to play as soon as symptoms pass. Myth!

- Fact: Returning too soon can lead to more severe injuries. According to studies, athletes who resume play before fully recovering face a greater risk of long-term cognitive issues. Seek the care and advice of a trained professional in concussion rehab strategies.

Preseason Concussion Screening Tools

Preseason concussion screening plays a vital role in protecting athletes. These tools help identify those at risk and create a baseline for post-injury comparison as well as more accuracy in diagnosis:

• Neurological assessments: Tests to evaluate balance, coordination, and cognitive function.

• ImPACT tests: Computerized assessments that measure key areas such as memory, attention, and reaction times.

• SCAT5 (Sport Concussion Assessment Tool): A comprehensive tool used by medical professionals to assess suspected concussions.

  
  

By using these tools, coaches and healthcare providers can make more informed choices about an athlete's health and readiness to compete.

Current Rehabilitation Approaches

Rehabilitation practices for concussions continue to improve, and are guided by the latest research. Here at Summit PT, we utilize the most effective approaches which typically involve:

1. Cognitive rest: Initially limiting activities that require focus, like reading, studying, or excessive screen time.

   
   

2. Gradual physical activity: Engaging in light aerobic exercises can enhance blood circulation and speed recovery. For example, stationary biking can be beneficial.

   
   

3. Vestibular rehabilitation: This type of physical therapy aims to restore balance and spatial awareness through targeted exercises.

   
   

4. Cognitive rehabilitation: Customized programs help manage cognitive symptoms and improve tasks that require concentration.

   
   

5. Therapeutic interventions: These can include managing headaches or anxiety through counseling or specific medications and or modalities.

   
   

Working with healthcare professionals experienced in concussion management is essential for developing an effective recovery plan. It is advised to work with one of our trained professionals at Summit to help your athlete with this.

Making Safer Choices for Young Athletes

Understanding and addressing concussions in high school sports is crucial. Coaches, athletes, and parents must work together to ensure a safe environment for young athletes. With ongoing education and adherence to safety guidelines, we can minimize risks and help our youth compete safely. It's all about prioritizing the health and well-being of these young athletes and giving them the greatest chance to succeed both on and off the field.

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