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Concussion Management for Athletes

MSMC is proud to announce our Concussion Management Program that includes baseline and post-injury Impact® Testing. Our physicians utilize state of the art assessment tools and extensive concussion management experience to give athletes, families and coaches clear guidance in navigating potential concussions.

What is a concussion?

A concussion is a disturbance in brain activity and/or function caused by either a direct blow or by transmitted forces from a blow elsewhere on the body. It is a functional injury, in that there are no abnormalities seen on traditional imaging modalities (MRI, CT). The Centers for Disease Control (CDC) estimate as many as 3.8 million concussions happen each year in the United States are sports-and-recreation event–related. Most concussions will resolve on their own, but require early identification, careful evaluation and specialized management.

If an athlete returns to play before the brain heals from the original concussion, any additional bump or blow can cause more damage. Our physicians at Montgomery Sports Medicine Center have the specialized training and expertise needed to evaluate potential concussions and develop a treatment plan to safely help an athlete return to play.

What are the symptoms?

There are a variety of symptoms of concussion, but none are specific just to concussion.  There does not need to be loss of consciousness. Symptoms may include, but are not limited to, those listed below.

  • Headache/Head Pressure
  • Cognitive Fog
  • Difficulty Concentrating
  • Fatigue
  • Sensitivity to Light and/or Sound
  • Dizziness
  • Lightheadedness
  • Feeling Slowed Down
  • Irritability
  • Anxiety
  • Visual or Sleep Disturbances
  • Depression
  • Slowed Reaction Times
  • Nausea
  • Balance Problems
  • Neck Pain/Stiffness
  • Ringing in the Ears
  • Short-term Memory Loss
  • Mood Changes

How is a concussion diagnosed?

In a sports injury, a concussion can be diagnosed on the sideline or at a later time. On the sideline, a neck injury should always be ruled out. The athlete should then be assessed for symptoms of concussion. Tools of assessment on-site include the modified Maddocks score and the SCAT3 (sport concussion assessment tool). A key mantra with concussion is “if in doubt, sit them out”.

Here at Montgomery Sports Medicine Center the SCAT3, balance testing and Impact testing (Immediate Post-Concussion Assessment and Cognitive Testing) are often used in conjunction with an in-depth clinical analysis when evaluating a patient for concussion. The Impact test is a short computerized neuropsychological test that can be very useful in diagnosing concussions as long as a baseline test has been done prior to the injury. Imaging, such as MRI or CT, is rarely indicated.

How long do concussions last for?

The majority of patients with concussions (80-90%) recover in 7-10 days. Children and adolescents may take longer.

How do you treat concussions?

There is no easy “cure” for concussion.  The mainstay of treatment is rest, both mental and physical.  Mental rest includes limiting screen time (computer, TV, video games, phone) and reading.  It may also include taking time off of school or work, or modifying the day (taking breaks, wearing sunglasses to reduce light sensitivity).

Physical rest means completely stopping physical activity until there are no symptoms.  The athlete should then follow a graduated return to play protocol.

A common protocol is:

  1. Complete rest
  2. Light aerobic exercise
  3. Sport-specific activities
  4. Non-contact training
  5. Contact training
  6. Return to games

Treatment may also include physical therapy or osteopathic manipulative therapy which can be conducted in-office.  We may also provide referrals for ear/vision/balance issues, neck pain, neck muscle spasms, headaches.

Through our state-of-the-art assessment tools and extensive concussion management experience, Montgomery Sports Medicine provides an essential medical perspective and can give athletes, families and coaches clear guidance in navigating potential head injuries.

Immediate Post-Concussion Assessment and Cognitive Testing

ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing) is a 20-minute computerized neurocognitive test that has been scientifically validated to measure the effects of concussion. After a child or athlete receives a baseline test, his or her data is stored on a secure, HIPAA compliant server. If a concussion is suspected , a follow up test is administered to see if the results have changed from the baseline. This comparison helps MSMC physicians to identify and manage concussion.

The ImPACT® Baseline Test should be the first step in the season of ANY athlete participating in contact or collision sports, or anyone who is otherwise at risk for sustaining a concussion.

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