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Concussion Awareness

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
  • Vomiting
  • Fatigue
  • Irritability

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 or avoided.

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 recovery and ensure our students experience a safe return to sports!