Monday Medical: Team up to manage concussions

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Group concussion testing will be available at 5:45 p.m. Tuesday at Strawberry Park Middle School. Pre-registration is required by calling SportsMed at 970-871-2370.

The school year is about to start in Routt County. For many students, this means playing fall sports. Participating in sports activities brings with it a risk for sustaining a concussion. About 10 percent of all student athletes in contact sports suffer a concussion during their season.

What is a concussion? It is a common injury defined as a direct or indirect force on the head that produces a disturbance in the normal metabolic function of the brain causing multiple symptoms: physical, cognitive, emotional and sleep-related dysfunctions. Symptoms of a concussion can include dizziness, headache, nausea, vomiting, irritability, vision problems, difficulty concentrating and more.

No longer is a concussion considered “just a bump on the head.” A concussion is a traumatic brain injury. A TBI can be rated mild to severe, but even a mild concussion can have significant side effects.

Recovery may take days, weeks or even months. Proper management of the injury is the first step in avoiding long-term complications.

“It's impossible to tell how long the recovery process will be just by watching the injury occur,” said Jennifer Kerr, a physical therapist with SportsMed's concussion program at Yampa Valley Medical Center. “Oftentimes, a relatively mild appearing hit to the head may have a significant recovery process. The reverse may also be true where someone who sustained a seemingly forceful hit recovers very quickly. Every concussion is different.”

Furthermore, the developing brain in the child or teen is very different from the adult brain. Concussion symptoms may show up later — hours or days after the initial injury — and last longer. If the child is not evaluated and given time to rest and recover, there could be long-term problems.

A key element to managing concussions is to endorse a team approach among coaches, athletes/students, families, school personnel and health care professionals. Everyone plays an important role.

More than 80 percent of concussions resolve very successfully if managed well within the first three weeks post-injury. Research shows that this is the average recovery time for a child or adolescent and is a little longer than the average recovery time for an adult.

After the child has been evaluated and determined to have a concussion, the immediate focus is to reduce the potential for further injury or stress to the brain. For the athlete, this means immediate removal from the sport with gradual return. This also means a reduction from mental activity. Academic (school) and physical accommodations also should be made, especially during the first week after injury.

“The emphasis is on a collaborative approach. The family, school personnel and coaches all have a role in assisting the medical team,” Kerr said. “Communication is essential throughout the process.”

Neurocognitive or neuropsychological testing has been proven to have significant clinical value in concussion management, especially with teenagers and especially when baseline scores are available. We are fortunate to have this testing available in our community. This testing can help determine whether an athlete/student safely can return to sports and the classroom. One such testing system is called ImPACT™ (Immediate Post-Concussion and Cognitive Testing). This testing is available at YVMC SportsMed clinics in Steamboat Springs, Hayden and Walden, and at Soroco High School and Steamboat Springs High School Athletic Department.

Once the baseline test has been completed the data is kept for two years. If the athlete/student suffers a concussion, then trained personnel can compare a post-accident test with the baseline test in order to properly assess and manage the concussion.

The best practice for concussion management is the team approach where a consensus is reached among the members of the family, school and medical teams. For more information about concussion management, visit the following websites: www.yvmc.org/sportsmed, www.youthsportsmed.com and www.cdc.gov/concussion.

Lisa A. Bankard is director of Wellness and Community Education at Yampa Valley Medical Center. She can be reached at lisa.bankard@yvmc.org or 970-871-2500.

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