The start of fall sports season brings the opportunity to review youth
safety and concussions. One in 10 high school athletes in high-impact
sports will experience at least one concussion. While not every concussion
can be prevented, we can all take important steps to help manage concussions
when they do occur, and limit their long-term impact on the athlete.
Mariecken Fowler, Neurologist with Winchester Neurological Consultants,
Inc., has 14 years of experience treating concussions and is a Credentialed
ImPACT Consultant through the University of Pittsburgh. As the head of
the Concussion Care Clinic, she works with a multidisciplinary team to
manage concussions in Winchester, Virginia. She represents Valley Health
and works with local schools and Athletic trainers to establish a consistent
protocol for managing concussions.
Watch: Dr. Fowler discusses Concussions in the Handley Athletic Bowl.
The first step in concussion management is RECOGNITION. This is usually
done by the Athletic Trainers and coaches on the sidelines. However, coaches
and trainers cannot see every person on the field every moment of the
game. Vigilance is key in recognizing the signs of concussion in our children,
friends, and teammates.
Concussion symptoms to look for include:
- A dazed look
- Complaints of headache, nausea, and dizziness
- Obvious confusion
- Memory loss
If your friend or child plays a contact sport, be on the lookout for these
symptoms and notify the Athletic Trainers or their coach if they are present.
If red flags such as loss of consciousness, vomiting, or weakness occur
the athlete should be brought to the ER for evaluation.
Once a concussion is identified on the field or after a game, the student
should be held out of physical activity, including practices and gym,
until cleared by a medical professional trained in concussion management.
Additionally, video games, computer, and phone use should be minimized
Most athletes within the Valley Health service area who play high school
sports will be given a baseline ImPACT test by their athletic trainer.
This computerized test is a type of brain game that evaluates an athlete’s
memory and reaction time. Most athletes who play high school sports will
be tested at the beginning of their first sports season by their Athletic
Trainer, and again every 2 years for a baseline. If an athlete is diagnosed
with a concussion, they will be retested by their trainer to make sure
they are back to their normal level of functioning before returning to
activity. If symptoms continue for more than 7 days or the ImPACT test
does not return to normal, the athlete will need to see a neurologist
or another trained medical professional for clearance.
If symptoms continue for more than 7 days or the ImPACT test does not return
to normal the athlete needs to a medical professional for clearance. When
the symptoms of a concussion have resolved for at least 3 days and the
student's ImPACT test is back to normal they will need to follow Return
to Play protocol. This involves 5 days of progressively increasing physical
exertion, with the 5th day being full contact. If any symptoms return
during this progression, the student athlete must rest for 24 hours prior
to trying any further exertion. During the time of recovery, academic
accommodations may be made in school, and often the student may miss a
few days of school immediately after the injury.
It behooves the students and the team to allow the athlete time to recover,
as re-entry into sports too early could result in significant long term
consequences. Luckily, 80-90% of our young athletes recover from concussions
within a few weeks and are able to get their lives back to normal but
it is incumbent on all of us to allow the athlete the proper time to recover.
Working together, we can optimize recorvery and ensure our students experience
a safe return to sports!