As of July 1st, Indiana law requires student-athletes who sustain neck or head injuries to be cleared by a healthcare provider before returning to play or practice. Trust your student-athlete to the professionals at UAP Clinic and Union Hospital Sports Medicine. They have the training and experience to help manage sports-related concussions and evaluate if your student-athlete can safely return to practice and play.
Union Hospital Sports Medicine athletic trainers serve Terre Haute North Vigo High School, Rockville High School, Riverton Parke High School, South Vermillion High School, and West Vigo High School. Our Sports Medicine athletic trainers also assist the Rose- Hulman athletic training staff when necessary. Our Certified Athletic Trainers serve as extensions of the UAP Clinic Sports Medicine Physicians and evaluate injured athletes in conjunction with the team physician to determine a proper course of treatment.
At risk athletes will take a baseline neurocognitive test. Baseline tests should be repeated every two years in the high school athlete. Following a concussion, a post-concussion test will be administered 24-72 hours after the concussion. Depending on post-concussion results, it may need to be repeated when the athlete is asymptomatic until post-concussion results improve to within baseline values. Test values will be reviewed and compared by either Dr. Andrew McDonald (sports medicine physician, UAP Clinic), Dr. Thurman Alvey (sports medicine physician, Union Hospital) or Dr. Ken Victor (neuropsychologist, Union Hospital). Student athletes that belong to schools not associated with the UAP Clinic and Union Hospital Sports Medicine program can request an ImPACT baseline test by scheduling an appointment with Dr. McDonald, Dr. Alvey, or Dr. Victor.
Indiana law requires student-athletes who sustain neck or head injuries to be cleared by a healthcare provider before returning to play or practice.
Trust your student-athlete to the professionals at UAP Clinic and Union Hospital Sports Medicine. They have the training and experience to help manage sports-related concussions and evaluate if your student-athlete can safely return to practice and play.
Definition of Concussion
A concussion is a disturbance in brain function that occurs either following a blow to the head or as a result of a violent shaking of the head. It is a form of mild traumatic brain injury.
Signs and Symptoms of Concussion
Signs of a concussion may include the player appearing dazed or stunned, confused about plays or score, moving clumsily, answering questions slowly, behavior changes, forgetting events prior to or after a collision, or loss of consciousness.
Symptoms of a concussion may include headache, nausea, balance problems or dizziness, double or fuzzy vision, sensitivity to light or noise, feeling sluggish or “foggy”; change in sleep pattern, concentration or memory problems.
Symptoms of a concussion may last days or even weeks.
A diagnosis of concussion must be made by the school’s certified athletic trainer or team physician. The athlete and his/her parents will be notified of the diagnosis of concussion.
Athletes and coaches are expected to report signs or symptoms of a concussion that were not witnessed by the medical staff.
- Symptoms of the concussion progressively resolve over seven to ten days.
- Modifying Factors requiring Medical Clearance
- Symptoms of the concussion persist either at rest or with exertion beyond ten days.
- A concussion is associated with loss of consciousness greater than one minute, post-traumatic convulsions, or prolonged cognitive impairment greater than twenty-four hours.
- A concussion should also be considered complex if it is the second concussion of the season or if the athlete has had three or more lifetime concussions.
Guidelines for Emergency Department Transport
Any athlete who has prolonged loss of consciousness, post-traumatic convulsions, complaints of associated neck or back pain, or has a focal neurologic examination will be treated as a cervical spine injury: activation of emergency medical response system (EMS), provided cervical spine stabilization, transported via ambulance with cervical collar and spine board immobilization.
Any athlete who exhibits brief loss of consciousness, multiple episodes of vomiting, abnormal mental status changes greater than 1 hour, deteriorating cognitive function, or increasing agitation will be referred to the emergency department. EMS will be activated if a parent/guardian is not readily available.
Return to Play Guidelines
Any athlete who has suffered a concussion will not be allowed to return to play in the same game or practice.
All athletes diagnosed with a concussion must be evaluated (as required by law as of July 1, 2011). If the athlete does not have a personal physician or cannot be seen by their physician, they will have access to a Union Sports Medicine physician for further evaluation.
The certified athletic trainer will discuss the each head injury, including mechanism of injury, concussion history and examination findings, and results of neurocognitive testing with the school’s team physician to coordinate return to play guidelines.
Ongoing Management of Concussion
Daily re-examination by certified athletic trainer.
An ImPACT test (computerized neurocognitive test) will be performed within 24-72 hours of the concussion and compared to preseason baseline tests when available.
Symptomatic athletes should avoid all physical and mental exertion to allow the brain injury to heal as quickly as possible.
Athletes who exhibit any of the modifying factors discussed earlier will be required to have medical clearance prior to beginning any return to activity from their family physician or team physician who has performed a post-concussion evaluation.
The athlete may begin a graduated return to activity when completely asymptomatic at rest (example: day 1-light activity, day 2-sport-specific vigorous activity).
The athlete may progress through a graduated return to activity when completely asymptomatic with exertion and post-concussion ImPACT test is within baseline values (example: day 3-noncontact training drills after medical clearance, day 4-contact training drills, day 5-game play).
The athlete will be required to complete a return to play progression prior to any competition regardless of medical clearance from a health care provider.
Complications of a Concussion
Complications of a concussion are concussion symptoms that last from several weeks to over a month after the injury and are known as post-concussive syndrome. Complications are more likely to occur in the setting or multiple, previous concussions, but may occur after the first concussion.
If persistent symptoms occur, schedule an appointment with your primary care physician or UAP Clinic and Union Hospital Sports Medicine Physician (located at our Bone and Joint Center) at 812-238-7677.