Concussion Management - What you need to know

The medical community is often asked, “Have concussions become more common lately?” The answer is both yes and no.

In 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.

As a 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 soon.

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

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