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Concussion Management

Concussions require prompt diagnosis and treatment. They also happen to be one of the top sports-related injuries. That’s why Elite Sports Medicine has developed a comprehensive, sports-related concussion program for adolescent and young adult athletes.

Services Include:

  • Concussion management, including school and sport recommendations
  • Baseline and post-injury neurocognitive testing
  • Physical therapy
  • Vestibular therapy
  • Speech therapy
  • Co-management, in which Connecticut Children’s medical experts team up with pediatric primary care providers to execute efficient treatment

“Know the Signs: Concussion Anthem” – An exclusive track from Elite Sports Medicine Division

Who Should Be Seen?

We gladly treat athletes ages 10 to 30 and provide concussion management for a safe return back to the playing field and the classroom.

What to Expect During a Visit

Initial Evaluation – 50 Minutes

  • Detailed history
  • Neurocognitive testing: ImPACT
  • Physical examination
  • Vestibo-ocular evaluation
  • Individual treatment plan

Management of Sport-Related Concussion

  • Recognize that a concussion has occurred. Be attentive and ask questions about how an athlete feels after they take a hit and blow. If they report signs or symptoms after a hit that were not present prior to the hit, a concussion has occurred.
  • Remove the athlete immediately from practice or competition. It is very dangerous to allow an athlete with symptoms to sustain another hit or blow.
  • Refer the athlete for medical care. It is critical that proper medical attention be given to an athlete with a concussion immediately to ensure the correct treatment is executed.
  • Rest, both physical and cognitive, is the only treatment for concussions. Again, a concussion is a functional injury. For the brain to heal properly, any exertion that causes symptoms must be avoided.
  • Athletes should be able to tolerate all cognitive activities prior to returning to the athletic field. Evaluation of cognitive function includes ability to handle full school days without symptoms, athlete is receiving normal grades on tests and quizzes, work is completed in reasonable amount of time and neurocognitive testing is normal or back to baseline. Following normal cognitive function, a graded return back to physical activity is required.

Return to Exertion:

  • Non-pounding aerobic activity
  • Pounding aerobic activity
  • Sport-related skills and drills or conditioning
  • Full participation in practice
  • Return to competition

More Information

What is a Concussion?

A concussion is a functional injury to the brain resulting from a traumatic hit to the head, face, neck or a blow to the body that delivers an impulsive force to the head (i.e. whiplash).

A concussion injury occurs at the cellular level. After a hit occurs, calcium, which is located outside of the cell, floods into the cell, triggering an increased need for glucose from the brain. Glucose is required for energy production, which, in turn, is needed to allow healing to take place.

In contrast, Potassium leaks out of the cell, resulting in a surge of events that ultimately end in vaso-constriction, meaning a decrease in the normal amount of blood that is delivered to the brain.

This neuro-metabolic cascade that is occurring within the cells of the brain is simply an energy crisis: the brain is demanding glucose to heal from the injury and the body is not supplying the blood that carries the glucose.

Myths about Concussions

Loss of consciousness must occur for an athlete to have a concussion.

False: Loss of consciousness is relatively uncommon and reported to occur in only 5-11% of adolescent sport-related concussions. The most commonly reported signs and symptoms are:

  • Headache
  • Feeling slowed down
  • “Fogginess”
  • Difficulty concentrating
  • Nausea
  • Sensitivity to light
  • Fatigue
  • Sensitivity to noise
  • Dizziness
  • Balance problems

MRI and CT scan are negative and therefore the athlete does not have a concussion.

False: A concussion is a functional injury, not a structural injury. MRI and CT scan will detect if a skull fracture or bleed has occurred, but they currently are not sensitive enough to detect the cellular dysfunction.

Adolescent and adult recovery times from a concussion are the same.

False: The brain continues to develop roughly up to the age of 22. During this developmental time, the brain is less resilient to the forces of a concussion. The typical time frame for recovery from a concussion is 7 to 10 days, but it is common for adolescents to take longer.

If I wear a “concussion” helmet, headband or mouthguard, I will be protected from sustaining a concussion.

False:  Unfortunately there is no helmet, headband or any other type of protective equipment that can eliminate the chance of a concussion. The best prevention is to wear properly fitted equipment, avoid dangerous playing styles and immediately report if a concussion has occurred.

Call 860.284.0220 to schedule an appointment or learn more about our educational programs for coaches, athletes, parents and allied health professionals.

Learn more about our Sports-Related Concussion Program. Download brochure >

Providers may access the ImPACT testing client login, the most widely used and scientifically validated computerized evaluation system for post-concussion assessment.

 

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