What does a concussion clinic do?

[plansrme]

In case you were under the impression that baseball is not a contact sport, let me disabuse you of that notion.  My 12 yo's head collided with another kid's knee yesterday.  The other kid is built like a brick and is fine; my kid could barely recognize me five minutes later and had no short-term memory for over three hours afterwards (for example, he did not believe me when I told him school is out for the summer, and he asked us literally 50 times what happened and why he was at the hospital).  We drove straight from the field to the children's hospital's ER where they offered a CT scan or observation, and we chose observation.  His symptoms mostly cleared up between hours 3 and 4.  We have the concussion protocol for athletes that was developed by the guy who runs the concussion clinic and will follow that.  So, assuming he doesn't get any worse, is there any point in calling the clinic when it opens again on Tuesday?  

 

And without going into all kinds of boring detail, can I just say that we're calling this one a win for Dr. Mom?  Speaking of dads and coaches who know nothing about concussion protocols, I am pretty sure I've read something that says that if a kid sees stars or blacks out even for a second, that he is not to go back into the game that day, period, end of discussion.  Where is that?

[Caroline]

I don't know what they do at the concussion clinic, but I agree with not going back into the game. We had a kid at our soccer tournament get a concussion yesterday. He is not allowed back in the tournament. Tournament rules.

[Ali in OR]

Here's an excerpt from our soccer club's page on concussion. Yes, it is a big deal, and it happens several times a year to various players on dd's team (usually head to ground contact after getting tripped up by another player). Typically players are out of practice for a week.

 

Independent of anyone’s opinion, the State of Oregon has been very clear about how concussions are to be handled by passing two laws (Max’s Law (OAR 581-022-0421) and Jenna’s Law (ORS 417.875) to protect youth athletes.   Basically these laws state that if an athlete is suspected of having a concussion they must be removed from all activity immediately and cannot return that day and must be cleared by a “Health Care Professional†(MD, PA, DO or NP or Psychologist licensed by the Oregon Board of Psychologist Examiners) prior to returning to activity.  

How Do These Laws Affect our Club?

1. If an athlete is removed from activity (by a coach or referee) because of suspected concussion (ANY concussion sign or symptom no matter how brief) the athlete must meet the following 2 conditions to return to activity:
   • The athlete no longer exhibits signs, symptoms or behaviors consistent with a concussion (see below for a list); and
   • The athlete receives a medical release form from a health care professional. (As defined above).
2. The league is requiring referees to note in their game reports to note any athlete who was removed from the game for “suspected†concussion.  This report then triggers the league needing a copy of the attached form to document the athlete has received a medical release from a health care professional.

At times we have encountered parents saying their son or daughter is “fine†and should be able to return to play.  We would like to remind all of us that not long ago we grossly underestimated the potential long term effects of concussion, not to mention the potential life threatening effects of getting a second concussion before the first one is resolved.

 

[SounderChick]

Their are grades/degrees of concussions even a grade 1 concussion which doesn't involve any kind of blacking out should include 1 week of no contact activities from when symptoms stop.  The reason to go to the clinic would likely be to determine what grade concussion and how long they should be held out.  I am not a Dr or anything just an old jock that had an unfortunate number of concussions.

[rmtzc2009]

My friends daughter had a bad concussion that required them to visit a concussion clinic. They used computer testing to determine what was causing the headaches following the concussion.

 

In her case, they found, when she shifted her eyes from looking down to straight ahead, she experienced headaches. (She could do it some, but not a lot without developing a headache). My friend loved that place and really credits her daughter's recovery to the help they provided.

[MysteryJen]

Ds3 had a grade 1 concussion in a rugby game. He was required to be out 2 weeks and could only return when medically cleared and we signed an additional waiver. It took him nearly the full two weeks to be totally back to normal. Especially in the pool, doing flip turns.

A concussion clinic is a great resource and helps to keep everyone from rushing back to full activity.

[Junie]

Ds15 had a concussion a few years ago.  He's a baseball catcher; so, yes, I know that baseball can be a full contact sport.

 

This is the chart that we used for determining recovery time:

 

http://www.concussiontreatment.com/images/SCI_RTS_Illustration.pdf

 

 

I hope your son has a good recovery.

[Guest]

In case you were under the impression that baseball is not a contact sport, let me disabuse you of that notion. My 12 yo's head collided with another kid's knee yesterday. The other kid is built like a brick and is fine; my kid could barely recognize me five minutes later and had no short-term memory for over three hours afterwards (for example, he did not believe me when I told him school is out for the summer, and he asked us literally 50 times what happened and why he was at the hospital). We drove straight from the field to the children's hospital's ER where they offered a CT scan or observation, and we chose observation. His symptoms mostly cleared up between hours 3 and 4. We have the concussion protocol for athletes that was developed by the guy who runs the concussion clinic and will follow that. So, assuming he doesn't get any worse, is there any point in calling the clinic when it opens again on Tuesday?

 

And without going into all kinds of boring detail, can I just say that we're calling this one a win for Dr. Mom? Speaking of dads and coaches who know nothing about concussion protocols, I am pretty sure I've read something that says that if a kid sees stars or blacks out even for a second, that he is not to go back into the game that day, period, end of discussion. Where is that?

When my DD got a concussion at school in soccer, she had to be cleared by the neurologist before playing again. This is why (at least, where I live) all sports are establishing a baseline of neurological function before play, because if they are concussed, they have to meet a standard afterwards that is satisfactory compared with the baseline.

[Alice]

Concussion is an area of medicine that is rapidly evolving. The protocols that were recommended (and are still recommended) in some places 1-3 years ago, are not recommended now as we've learned more about concussion and recovery. That's one reason to go to the Concussion Clinic, they should know the most up to date research and help you navigate what to do if he ends up having any degree of longer-term symptoms. 

 

Most kids with concussion will recover quickly. I see a lot of kids now with mild concussion, that would have never come in to the office 10 years ago. Kids who have a headache and feel dizzy after getting hit in the head with a ball at recess. Yes, it's concussion. Most of them quickly recover. Some kids go on to have a more prolonged recovery phase. It's not always predictable who will take longer to recover based on severity of injury. We can see kids who lose consciousness and have what seems to be a very severe injury go on to be symptom free fairly quickly. We can have other kids who have what seems to be a very mild injury continue to struggle with the ability to focus or with headaches for fatigue for months and months. 

 

One reason to see the concussion clinic now is that if your son is an athlete and likely to continue in sports, it's good to have neuropsych testing done so that he can be followed if he has recurrent concussions or if there is any question of full recovery. 

[PinkTulip]

With my son's recent concussion, we were told no physical activity (soccer) for one week after all symptoms went away. So once the headache stopped, he had to wait 7 more days.

[TechWife]

Go to the concussion clinic. Your son needs to be followed by a medical professional. Brain damage is nothing to fool around with.