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Question:

Dear SIRC Librarian:

I am looking for information on how to identify if my athlete has a concussion and when they can start playing again. Do you have any suggestions on where to look?

Thanks,

Brian,
Community Sport Coach

Answer:

Dear Brian:

Thank you for emailing SIRC with you question regarding concussion. There is a variety of materials available to you on this topic. I have provided a few examples what you will find in the references below as well as some links to additional resources.

If you would like more documents on this topic or have any questions or concerns please contact us again.

Sincerely,

Your Sport Librarian

Symptoms
Table 1. Symptoms Rated in the Post-Concussion Symptom Scale*

Headache Nausea Emesis Balance problems Dizziness Fatigue Trouble falling asleep Sleeping more than usual Sleeping less than usual Drowsiness Irritability

Sensitivity to light Sensitivity to noise Increased sadness Nervousness Feeling more emotional Numbness or tingling Feeling slowed down Sensaiion of being "in a fog' Difficulty with concentration Difiiculty with memory Visual problems

*Each item is graded from 0 (asymptomatic) to 6 (severely symptomatic).

Majerske, C., Mihalik, J., Ren, D., Collins, M., Reddy, C., Lovell, M., et al. (2008, May). Concussion in Sports: Postconcussive Activity Levels, Symptoms, and Neurocognitive Performance. Journal of Athletic Training, 43(3), 265-274.

Return to Play (RTP)

Same-day RTP

• Use added caution in allowing the adolescent athlete to RTP.
• The athlete must be asymptomatic at rest and with exertion to RTP.
• RTP in the adolescent should not be considered unless asymptomatic, with initial symptoms being minimal (not involving memory function) and of short duration. Other risk factors such as younger age and previous concussion history must be considered.
• The safest course of action is to keep the athlete out of play.

Post-game

• All symptoms must resolve completely before considering RTP.
• Consider a variety of other factors when making RTP decision, including age of athlete, sport, concussion history (number, severity, proximity), duration and severity of symptoms, mismatch in force and injury, and learning disabilities.
• Younger athletes warrant a longer period of rest.
• For the athlete to RTP, they must remain asymptomatic with limited cardiovascular exertion, unlimited cardiovascular activities, sport-specific activities without risk for contact, practice activities with limited risk for contact, full practice activities with unlimited risk for contact, and then full play.
• NP testing may be considered, if available and understanding limitations, to help guide RTP decision.

FROM CDC: National Center for Injury Prevention and Control HEADS UP - CONCUSSION IN HIGH SCHOOL SPORTS. (2006). Sports medicine standards and malpractice reporter ( Canton, Ohio), 18(4), 55.

References

Broglio, Steven P., Macciocchi, Stephen N., and Ferrara, Michael S. (2007). Neurocognitive Performance of Concussed Athletes When Symptom Free. Journal of athletic training ( Dallas, Tex.), 42(4), 504-508.

Cantu, R. (2009, January). When to Disqualify an Athlete After a Concussion. Current Sports Medicine Reports, 8(1), 6-7.

Elbin, Robert J., Kontos, Anthony P., and Couassin, Tracey (2009). HEADS UP! A Soccer Coach's Guide to Concussion. Soccer journal ( Mission, Kan.), 54(2), 38;40;60.

Herring, Stanley A., Bergfeld, John A., Bernhardt, David T., Boyajian-O'Neill, Lori, Gregory, Andrew, Indelicato, Peter A., Jaffe, Rebecca, Joy, Susan M., Kibler, W. Ben, Lowe, Walter, and Putukian, Margot (2009). SELECTED ISSUES FOR THE ADOLESCENT ATHLETE AND THE TEAM PHYSICIAN: A CONSENSUS STATEMENT. Sports medicine update ( Rosemount, IL), (), 2-17.

Lovell, M., & Fazio, V. (2008, January). Concussion Management in the Child and Adolescent Athlete. Current Sports Medicine Reports, 7(1), 12-15.

O'Donoghue, E., Onate, J., Van Lunen, B., & Peterson, C. (2009, May). Assessment of High School Coaches' Knowledge of Sport-Related Concussions. Athletic Training & Sports Health Care: The Journal for the Practicing Clinician, 1(3), 120-132.

Reddy, C., & Collins, M. (2009, January). Sports Concussion: Management and Predictors of Outcome. Current Sports Medicine Reports, 8(1), 10-15.

Additional Links:

Canadian Academy of Sports Medicine

Position Statement: Head Injuries and Concussions in Soccer

Discussion Paper: Head Injuries and Concussions in Soccer

American College of Sports Medicine

Concussion (Mild Traumatic Brain Injury) and the Team Physician: A Consensus Statement*

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