The Sport-Related Concussion Program at St. Elizabeth Healthcare

A sport-related concussion is a disturbance of brain function caused by a direct or indirect force. Most concussions occur from a direct hit to the head, but sometimes a hard hit to the body can transfer forces to the brain and cause a concussion. Fortunately, most concussions in young athletes resolve quickly with adequate time for full physical and cognitive recovery. 

The sports medicine physicians at St. Elizabeth are specially trained in the diagnosis and management of sport-related concussions. St. Elizabeth Sports Medicine had 745 concussion-related visits in 2017. A comprehensive plan was developed for each athlete treated to help facilitate a safe return to activity.

What are the signs and symptoms of a sport-related concussion?

Ninety percent of concussions do not involve loss of consciousness. The most common signs and symptoms of a concussion include:

• Headache  
• Blank stare
• Nausea 
• Dizziness  
• Balance problems  
• Blurry vision
• Difficulty concentrating
• Mental confusion
• Sensitivity to light and noise  

How do you diagnose concussion?

The experts at St. Elizabeth Healthcare utilize a comprehensive history and physical examination to diagnose sport-related concussions. Standard imaging techniques, such as X-ray, CT-scan, or MRI, cannot diagnose a concussion. Exciting new research is looking at advanced imaging techniques and special laboratory tests that may someday help in the diagnosis and management of concussions.

Our comprehensive evaluation includes the following:

• Symptom rating scale
• Past concussion history
• Neck examination
• Vestibular ocular motor-screening (assessing response to various eye movements)
• Balance testing
• ImPACT™ testing

ImPACT™ testing is an efficient (30 minute) computerized neurocognitive test that is utilized in some athletes to help us gain insight into the following cognitive functions:

• Memory
• Attention
• Processing speed
• Reaction time

Neurocognitive testing is done in conjunction with our comprehensive history and physical to help with our management and return to play decisions. ImPACT™ testing is typically given after the athlete is symptom free and it is most accurate when compared to a baseline exam taken before the concussion occurs.

What are the potential consequences of a concussion?

For most athletes, signs and symptoms improve rapidly during the first two weeks after their injury. Current research indicates that athletes may be exposed to additional risk by returning to play while there is ongoing brain dysfunction. These risks will most typically involve worsening and prolongation of symptoms. Serious complications involving brain swelling are very rare.

We still have many unanswered questions regarding the cause and effect relationship between repeated concussions and long-term cognitive disability. Multiple concussions appear to be a risk factor for cognitive impairment and mental health problems in some individuals.

What is the typical treatment for a sport-related concussion?

If a concussion is suspected, the athlete should be removed from the game or practice and restricted from returning to play that same day. The athlete will not be permitted to return unless written clearance from a physician is provided.

The hallmark of treatment is rest and adequate time for full physical and cognitive recovery. All concussed athletes are encouraged to get plenty of sleep, stay well hydrated, and maintain a well-balanced diet. Many student athletes will report worsening symptoms with cognitive/academic stimulation. These students will benefit from temporary academic accommodations. Most athletes will require only brief use of over the counter analgesics for their post-concussion headache. 

For the small percentage of athletes that have a more prolonged course, other treatment options may include:

• Medication
• Physical therapy  
• Vestibular (balance) therapy
• Psychological rehabilitation

How do you know when it is safe for an athlete to return to play? 

The student athlete will be cleared by the physician to begin a graduated stepwise return to activity when he or she:

• Is symptom free.
• Has a normal physical exam.
• Passes all appropriate testing.

The athlete will typically begin with light aerobic exercise and progress to sport-specific exercise, non-contact training drills, full contact practice and finally return to competitio n.

Our Doctors

In addition to our concussion program, St. Elizabeth Sports Medicine is dedicated to providing comprehensive musculoskeletal care to active individuals and athletes.

Our Sports Medicine team combines the expertise of Dr. Michael J. Miller, Dr. Tyler Browning and Dr. James Hahn with outstanding physical therapy and athletic training services to ensure you get the care you need to live a healthy, active life.