Post-Concussion Management

What should athletes do once they have sustained a concussion?

Tell someone! Tell a coach, parent, teacher, trainer, therapist. The first step is recognizing that you may have sustained a concussion. Remove yourself from all sporting activities, school, or work until a trained medical professional can assess your condition. Until then, complete REST is the best thing that you can do. If symptoms are severe or worsening, either go to the hospital or get a medical evaluation as early as possible. Going to the hospital will help rule out other more severe conditions. It is important that the athlete be monitored for a couple of hours after the injury. If the condition worsens, make sure someone takes you to the hospital. Do not drive yourself.

Once cleared from the hospital, schedule an appointment to see a Sports Physician or EPA Concussion Management Physiotherapist. Rest your body and brain. Until your appointment follow the Post-Concussion Rest Instructions.

Visit one of the Eramosa Physiotherapy clinics for your initial assessment. If you have previously undergone baseline testing, these objective measures will be available for the therapist and will help guide return-to-play decisions. If you have never completed a baseline test, a full comprehensive assessment will still be performed by your physiotherapist. Objective findings can be compared back to public “normative values”. There is more detail on this page for what to expect during your initial assessment.

Follow the management recommendations and participate in active treatment with your physiotherapist. Various treatments will include: concussion education, school/work/activity modifications, manual therapy (neck), vestibular-ocular motor therapy, progressive exercise, and other recovery strategies. At EPA, we also maintain ongoing communication between family physicians and specialists.

Return to normal school, work, and sport activity.

What is involved in the assessment and treatment of a concussion? 

Initial Assessment

ImPACT Neurocognitive Testing: Developed by clinical experts who pioneered thefield, ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the most-widely used and most scientifically validated computerized concussion evaluation system.  ImPACT provides trained clinicians with neurocognitive assessment tools and services that have been medically accepted as state-of-the-art best practices — as part of determining safe return to play decisions. The program measures multiple aspects of cognitive functioning in athletes, including attention span, working memory, sustained and selective attention time, response variability, non-verbal problem solving, and reaction time. For a video, see Concussion Baseline Testing.

Just like the baseline testing, in addition to neurocognitive performance testing, a comprehensive initial assessment includes other aspects of physical performance that may be affected with a concussion.

Part 1 involves a subjective assessment where the athlete is asked a variety of questions to determine the severity of symptoms and give the therapist an idea of general medical and injury history. At EPA, we utilize the use of the SCAT3 (Sport Concussion Assessment Tool) to maintain consistency and standardize this portion of the assessment.

Part 2 involves a full physical assessment which includes strength, range of motion, and co-ordination testing, neurological screening, and a comprehensive neck examination. Other orthopaedic physical testing may be performed if secondary injuries were sustained.

Part 3 involves a comprehensive Vestibular-Ocular Motor Screening (VOMS). This is another component administered by a physiotherapist which tests the function/connection between the vestibular system (inner ear) and ocular function (vision).