The medical community is often asked, “Have concussions become more common lately?” The answer is both yes and no.
recent years, concussion awareness has increased dramatically, largely
due to Sidney Crosby's absence from NHL hockey (for most of 2011 and
part of 2012), as well as the deaths of some well-known athletes, who
previously experienced head injuries.
A “bigger, faster,
stronger” trend has become commonplace across many sports and hence the
risks of all injuries to athletes have increased.
We have noted a
significant increase in the diagnosis and management of head injuries
at TSC since early 2011. As a result, we have assembled a team of
physicians and therapists to manage concussion using a standardized
protocol derived from the latest concussion consensus.
At TSC, we use the SCAT3 assessment tool (click here for PDF)
to assess athletes and follow a graded protocol for full return to
play. We encourage anyone at risk to obtain a pre-season ImPACT test as
this makes our return to play decisions more accurate.
coach, trainer or parent, if you suspect an athlete of having suffered a
head injury, he/she should be removed from play immediately. If
symptoms persist, the athlete should be prohibited from participation in
any sport and assessed by a physician. We recommend no physical or
cognitive activity until all symptoms disappear. This may involve
keeping the player out of school. Return to play should be a gradual
process after all symptoms have disappeared and should never be rushed.
The experience of a first concussion puts the individual at slightly
higher risk of a second concussion - particularly if they return too
One’s ability to return to a sport, post-concussion, varies
on an individual basis and should be carefully scrutinized one-on-one
by a medical professional. At TSC, we assess each athlete individually.
Our athletic therapist will initiate the process with a thorough
questionnaire and complete cognitive and balance testing using the SCAT3
protocols. One of our concussion-trained sport physicians will review
the athlete’s status and make ongoing recommendations. Once symptoms
have cleared we will recommend a graded return to play schedule. When
this is achieved, without setback, our physician will provide the player
with a full return to play document. This process will usually takes 2
to 4 weeks.
We encourage ImPACT testing (www.ImPACTtest.com)
as it provides our dedicated team of health care providers with
additional decision-making tools. It is a computer-based neuropsychological test developed by the
University of Pittsburgh Medical Center over the past 20 years to assess
brain function, particularly as it relates to head injury. It uses
several different parameters, and is particularly useful if a pre-injury test is available.
This testing process has also proven
to be very effective in educating coaches, trainers, parents and kids.
Ask your league or association if they can arrange for your team to be
tested. ImPACT tests are inexpensive and effective. Our professional
TSC staff is experienced in performing both team testing in the computer
labs at U of T Mississauga or individually at our clinic at UTM. Please
call if you are interested in participating and remember – pre-season is the best time to get tested.
More information can be found at www.thinkfirst.ca
or call us at TSC and our professional staff will be happy to answer
your questions. In addition, our sports physicians are available to
visit you to speak to your team or group.
The problem of
concussions is not going to disappear from sports any time soon, so we
ask that you to pay special attention to head injuries. “If in doubt,
keep them out” and consult an expert.
Dr. Christopher Woollam, MD,
Diploma Sport Medicine