Concussion and Return to

PlayEducation tool for Ontario

Rugby U20 Women’s Team 2011

What is a concussion?

• A traumatic injury to the brain as a result of a violent blow, shaking, or spinning. A brain concussion can cause immediate and usually temporary impairment of brain function such as of thinking, vision, equilibrium and consciousness.

• Most concussion (80-90%) resolve in a short period (7-10) days

Sign and Symptoms of a Concussed Athlete

1. Loss of consciousness

2. Seizure or Convulsion

3. Amnesia

4. Headache

5. Pressure in head

6. Neck Pain

7. Nausea and vomiting

8. Dizziness

9. Blurred Vision

10. Balance problems

11. Sensitivity to light and/or noise

Reference: www.athletictherapy.org/en/pdf/SCAT2.pdf

Sign and Symptoms of a Concussed Athlete (continued)

12. Feeling Slowed down13. Feeling like “in a fog”14. “Don’t feel right”15. Difficulty concentrating16. Difficulty remembering17. Fatigue or low energy18. Confusion19. More emotional20. Irritability21. Sadness22. Nervous or anxious

Clinical Journal of Sport Medicine: May 2009 - Volume 19 - Issue 3 - pp 185-200 @ http://journals.lww.com/cjsportsmed/Fulltext/2009/05000/Consensus_Statement_on_Concussion_in_Sport_3rd.1.aspx

Graduated Return to Play Protocol

• Stepwise Process• Athlete should continue to proceed to the next level if

symptom free at the current level.• Generally Each step should take 24h hours• Take approximately one week to proceed through the full

rehab protocol after being symptom free at rest• If any post-concussion symptoms occur while in the

stepwise program, then the athlete should drop back to previous asymptomatic level and try and progress again after a further 24-hour period of rest

Rehabilitation Stage 1: No Activity

• Complete physical and cognitive rest• Scholastic work, video games, text messaging may

make symptoms worse and possibly delay recovery• This helps the brain recover from the trauma

Rehabilitation Stage 2: Light aerobic Exercise

• Walking, swimming or stationary bike• < 70% maximum heart rate• Goal is to increase your heart rate

Rehabilitation Stage 3: Sport Specific Exercises

• Running drills• No head impact activities• Goal is to add movement

Rehabilitation Stage 4: Non-Contact training drills

• Progression to more complex training drills• Passing drills• May start progressive resistance training• Goal is to increase exercise, coordination and cognitive

load

Rehabilitation Stage 5: Full Contact Practice

• Following medical Clearance, participate in normal training activities

• Restore confidence• Assessment of functional skills by coaching staff

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Rehabilitation Stage 6: Return to Play

• Normal Game Play

If an athlete is suspected of having a concussion

1. Athlete will be REMOVED FROM PLAY for that day

2. Medically assessed by trainer

3. Monitored for deterioration (i.e., should not be left alone)

4. Should not drive a motor vehicle

5. Required to see family physician or sports medicine physician.