Memorial Regional Health: Treating concussions before they happen again — schools, trainers, physicians and other providers work together in Moffat County when a child or teen suffers a concussion
- Headache/feeling of pressure in the head
- Ringing in the ears
- Disrupted vision
- Temporary loss of consciousness
- Slurred speech
Editor’s note: The following article is sponsored by Memorial Regional Health.
Since 2012, students and coaches in Colorado have been more proactive about recognizing and treating concussions, thanks to the Jake Snakenberg Youth Sports Concussion Act.
The legislation “requires that coaches receive education about concussion, that a student athlete is removed from the field of play if a concussion is suspected, and that the student be signed off by a health care professional before returning to play,” according to the Colorado Brain Injury Collaborative, a group of stakeholders that spent more than a year working on the bill. This is significant, because a second concussion could result in serious injury or even death if proper treatment and recovery haven’t occurred following a first concussion.
About the same time the state legislation was created, Frani Jenkins came to Craig to work as a certified athletic trainer and physician assistant, bringing a wealth of sports medicine experience and knowledge about concussion injuries. She helped create a local collaboration between physicians, athletic trainers, physical therapists, and the school district now known as the Craig-Concussion Action Team, or C-CAT, which also collaborates with and includes members from the Moffat County School District’s Traumatic Brain Injury Team.
Concussions are so dangerous because they involve both physical and neurocognitive symptoms. The C-CAT stays current on national and international research to ensure local concussion treatment protocols incorporate the latest evidence-based research, Jenkins said.
“It’s a need that every community has, not just here,” she said.
A concussion is a form of traumatic brain injury in which the brain suddenly moves back and forth, causing a disruption in function, according to the National Injury Prevention Foundation. It’s often caused by trauma to the head, but it could also be caused by violent shaking to the head or upper body.
More than 62,000 concussions occur every year in high school contact sports, according to the American Association of Neurological Surgeons. “Estimates show that between 4 percent and 20 percent of college and high school football players will sustain a brain injury over the course of one season,” according to the American Association of Neurological Surgeons. “The risk of concussion in football is three to six times higher in players who have had a previous concussion.”
People with concussions often can’t remember what happened immediately before or after the injury and may act confused. A concussion can affect memory, judgment, reflexes, speech, balance, and muscle coordination, according to the American Association of Neurological Surgeons.
Research shows the brain is still developing into a person’s mid-20s. Children who have had one concussion are more likely to have a second, and second concussions occurring close to the first can have devastating consequences.
Marshall Kraker, one of Moffat County School District’s certified athletic trainers who also works as an athletic trainer with Memorial Regional Health Sports Medicine and as an athletic trainer in concussion rehabilitation with Memorial Regional Health Physical Therapy, said the C-CAT tries to educate students and parents about all these dangers.
“One concussion might not completely debilitate a kid, but multiple ones throughout school can have detrimental effects,” Kraker said.
Parents of concussed children sometimes don’t fully understand the dangers of the injury. Jenkins said she often hears parents claim they hit their heads many times as a child and turned out fine — that their child just got his or her “bell rung.”
“One of the things we run into is the length of time it can take for a kid to return to full activity, full sports, and full academics,” she said. “One requirement is you have to be back in class with no academic accommodations before going back to athletics.”
This recovery can take 3 to 4 weeks, minimum, she added.
The C-CAT involves school athletic trainers, physical therapists, the school nurse, and other medical providers, so identification and treatment of concussions are always done thoroughly and collaboratively. Memorial Regional Health asks parents to sign a medical release form when a child comes in for evaluation for a concussion so the health care providers can communicate with the school nurse, teachers, physical therapists, and athletic trainers about the injury.
That communication allows these folks to better monitor children and teens after their injuries. At school, for example, students are monitored to see if they’re having any learning or classroom struggles. This might necessitate shorter days at school, rest breaks, limited computer time, extended periods of time to return schoolwork, and shortened work assignments.
One of the many tools used in treatment plans is baseline testing, in which student athletes are given a computerized test that assesses balance and brain function, including learning and memory skills, ability to pay attention or concentrate, and how quickly the student can solve problems. The results, according to the Centers for Disease Control and Prevention, are compared with results from a similar exam after a student gets a concussion.
Kraker said the testing can be useful, but he likes to incorporate other methods, as well.
Perhaps the most important concussion treatment and management tool in Craig is this collaborative effort toward care, he said. It’s something for which the school district and the C-CAT are incredibly proud.
“We’re pretty ahead of the game to have a functional team with quite a few individuals that provide a communal approach to concussion management,” Kraker said. “If you don’t have this group planning, how can you expect to be successful?”