Sports-Related Concussion (SRC)
Concussions
Concussions have become a hot topic with critical importance at every level of sport. Out of recognition of the importance and significance of this issue to NAIA student-athletes, the association is working diligently, through multiple entities, to ensure the health and safety of our student-athletes. The US Centers for Disease Control (CDC) estimate that 1.6 – 3.8 million concussions occur annually through sports and recreational activities in the US. That staggering statistic may not be accurate as the result of a number of concussions never being reported to health care providers.
Concussion Resources
- Berlin Consensus Statement on Concussion in Sport – 2017
- NATA: Concussion - Positon Statements, Resources, and Initiatives
- NCAA: Concussion - Educational Resources, Best Practices, Data and Research
Understanding Concussions
Defining Concussions
The term concussion is synonymous with the term Mild Traumatic Brain Injury (mTBI) and is used interchangeably.
According to the 5th International Conference on Concussion in Sport consensus statement, a sports related concussion (SRC) is defined as a traumatic brain injury induced by biomechanical forces. The common characteristics of a concussive head injury include:
- Causation by either a direct blow to the head, neck, face, or anywhere else that may transmit a force to the head.
- SRC result is a rapid onset with short-lived disruption of neurological function that typically resolves spontaneously.
- The neuropathological changes are usually manifest in functional disturbances rather than structural injury.
- SRC can result in a wide range of signs and symptoms. Recovery from a SRC is frequently sequential and in some cases may be prolonged.
Post-Concussion Syndrome
Post-concussion syndrome refers to the lingering symptoms following a concussion or a mild traumatic brain injury (mTBI). It’s also known as post-concussive syndrome. This condition is typically diagnosed when a person who has recently suffered a head injury continues to feel certain symptoms following a concussion. These include dizziness, fatigue, and headaches.
Post-concussion syndrome can begin to occur within days of the head injury. It can sometimes take weeks for the symptoms to appear.
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Second Impact Syndrome
Second-impact syndrome is a rare and dangerous result of second concussion that happens when the brain is still healing from a previous concussion. Second-impact syndrome causes dangerous brain swelling and bleeding that can cause death or permanent disability. It can occur even days to weeks after a first concussion is diagnosed. It is a very rare diagnosis but may be preventable by removing concussed athletes from practice or play until their symptoms have gone away and the athlete is cleared by a health-care professional. Adolescent athletes seem to be the most at risk to develop second-impact syndrome.
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Return-to-Play
Return-to-Play (RTP) is an individualized, gradual, progressive approach to safely making decisions for the concussed student-athlete to RTP. This graduated approach begins when the patient is symptom free and has a normal neurological exam. Activities increase daily until full return as long as there is no reoccurrence of symptoms thought the process. If symptoms reoccur, then the activity should be stopped and the patient returned to the previous phase of activity once symptoms have resolved. Final determination on RTP must be made by a licensed healthcare professional trained in the evaluation and management of concussions.
Click here for a sample of a graduated RTP protocol.
Return-to-Learn
Return-to-learn (RTL) is a relatively new concept in concussion care. It is a parallel approach similar to the Return-to-Play protocol yet, RTL is designed to address the needs of the concussed patient as they increase cognitive activity (brain energy). This individualized process should include controlled cognitive activity until the symptoms of the concussion resolve. Then a gradual return to activities and the classroom should be considered. It is important to approach RTL through a multifaceted integrated approach involving the SA’s healthcare team and appropriate institutional academic support.
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