Concussion management presents one of the more complex problems for the athletic trainer in everyday practice. Concussions can be difficult to identify and manage properly unless an athletic trainer and athletic department have the necessary resources.
In 2004 the National Athletic Trainers’ Association (NATA) published comprehensive guidelines for the management of sports concussion injuries. This paper* contains 36 specific recommendations in the areas of:
“The Certified Athletic Trainer (ATC) should play an active role in educating athletes, coaches and parents about the signs and symptoms associated with concussion, as well as potential risks of playing while still symptomatic.” (#4, p.281)
“Baseline testing on concussion assessment measures is recommended to establish the individual athlete’s “normal” pre-injury performance and to provide the most reliable benchmark against which to measure post injury recovery.” (#12, p.281)
“The use of objective concussion assessment tools will help ATCs more accurately identify deficits caused by injury and post injury recovery and protect players from the potential risks associated with prematurely returning to competition and sustaining a repeat concussion.” (#13, p.281)
“A team approach to the assessment of concussion should be taken and include a variety of medical a specialists...a neuropsychologist should be identified as part of the sports medicine team for assisting athletes who require more extensive neuropsychological testing and for interpreting the results of neuropsychological tests.” (#20, p. 282)
“Athletic trainers working with younger (pediatric) athletes should be aware that recovery may take longer than in older athletes.” (#26, p.282)
“Because damage to the maturing brain of a young athlete can be catastrophic (ie, almost all reported cases of second-impact syndrome are in young athletes), athletes under age 18 years should be managed more conservatively, using stricter RTP guidelines than those used to manage concussions in more mature athletes.” (#28, p.282)
*Guskiewicz, K. et al. National Athletic Trainers’ Association Position Statement: Management of Sports-Related Concussion, Journal of Athletic Training. 2004; 39(3):280-297.
For the Athletic Trainer and Team Physician, working with a neuropsychologist who specializes in sports concussion management offers several advantages:
Knowledge of educating others about the effects of brain injury and the consequences of repeat concussions and more severe brain trauma.
Expertise in interpreting neuropsychological tests of memory, speed, reaction time and impulse control that are central to understanding recovery from concussion.
Experience in understanding and working with the wide variety of learning issues that students have, especially during recovery from concussion.
The opportunity for more in-depth evaluation of student athletes who may be slower to recover.