Concussion Protocol

finfan365

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Can anyone clear up the rules for OHSAA's concussion protocol? Last week, my DD was determined by the opposing school's trainer that she had a concussion. We spent the weekend relaxing, and followed up with our school's trainer on Monday, to see about steps to return to play. We were told we needed to first see our physician, then she could begin the 6 day gradual return to play.

Physician stated she could not be cleared by him, until at least 7 days without a headache, then begin the 6 day process. If this is the case, a single concussion, even minor as in this case, would effectively remove play for 2 weeks minimum. Is the doctor correct? The trainer states she only needs to be free of headache for 24 hours, then she can begin the 6 day process. If the trainer is correct, can we just go to another physician to have them signoff so she can begin the return to play procedure? I wouldn't think returning to the same doctor stating "no, our trainer says ..." would be beneficial either.

Also, why is the school's trainer recognized as having the ability to diagnose a concussion, but not have the ability to test and allow for return. There seems to be no real procedure a doctor will do besides ask if she has had headaches, or any recurring symptoms? I would think the trainer would be able to determine this as well.
 

Freeze Mizer

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Having lived this with my DD I can tell you that there is no such thing as a “minor” concussion.
The rules governing players, coaches, sports programs are very distinct and are based on science.
There are steps to the return process. It could take days, weeks or months. It depends upon the injured individual. The main thing is that this process CANNOT be rushed. Also remember, that when the steps are followed, if there is any setback/headache, etc, that the process goes back to step 1 and begins again.
Trying to circumvent the process by going to another doctor is never a good idea. Hopefully, you have access to a neurologist instead of a family doctor. Those folks specialize in this kind of injury. They do specialized testing to determine where the athlete is in their process.
I realize that this is tough to deal with. Unlike a broken bone or torn ligament, there are no visible signs of injury. You can’t do an x-ray to see a concussion and how it is healing. Remember, this is a brain, your daughters brain, that you are dealing with. It takes a long time to heal. There is also an increased risk of greater injury if rushed back.
Please be patient and trust the medical professionals. And educate yourself. Be thankful that there is a strict policy in place to protect our kids.
To everyone else who reads this: GET YOUR PLAYERS BASE-LINE TESTED. This can actually assist in a more-efficient diagnosis and treatment. .( I’m kicking myself for not doing this with my DD- she ended up missing 10 weeks of school after getting hit by a volleyball serve. As a freshman. She is a senior now and still has issues- occasional migraines, etc).
A brain injury is nothing to mess with.
 
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I agree with freeze mizer. My son got a concussion playing football and missed several weeks. It doesn’t start until day 1 of no headaches and then once a head ache occcurs it starts back at step one. We took my son to family dr. They referred him to a specialist and they gave him a break down of how many days each step lasted and what needed to be done in order to pass that step. It took a couple weeks. His 1st game back he got a 2nd concussion and was done for the season and now no long plays (parents decision). now this is football but I’m sure the steps are the same. There is no specific test or diagnosis to determine a concussion. They just do some basic neuro tests. Be thankful that it’s not serious and let her rest and recover. 2 weeks is nothing compared to the damage she can suffer long term.
 

finfan365

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Don't misunderstand. I'm not trying to circumvent any process, just trying to understand the correct process. We've received conflicting statements as to what that procedure is.
Trainers - Trained to know what a concussion is and the process for return, state the rule is 24 hours, begin the process of return
Doctor - states the rule is 7 days, then begin the process for return.
 
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Well for us, he couldn’t go back to practice until he was cleared by a dr. Dr wouldn’t clear him until he passed the concussion protocol. Which are the steps. As for the trainers they train and know what to look for. They can’t and shouldn’t clear anyone to play. Especially after dealing with a head injury. They don’t have the education or knowledge to clear them.
 

Heavy Hitter

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You need to get a second opinion. Trainers evaluate the athletes and if they determine there is any chance a concussion has occurred they are going to hold out the athlete and they should. The next thing is to take your daughter to the doctor and have her evaluated her by the doctor to determine if she does a concussion. If it doctor determines she doesn't have a concussion then they fill out a form and she can return to play. If the doctor say she does have a concussion then she has to go through protocol. Always have the doctor determine if she has a concussion or not. Freeze Mizer is right all high school athletes should get base-lined tested.
 

VE_05

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As a coach, per ohsaa if we think that your child has received a concussion, we can not let them play until they have been to a dr and cleared by them.. plain and simple on that.

With today’s society on concussions we as coaches can’t just so they are good to go. All coaches have to do concussion training and if we see those signs then they come out of the game, and MUST be released from a dr at that point. Might be next day, or 6 days. Depends on how bad it is and what the dr says. And ALMOST all drs will say they had a concussion if they complain of a headache.
 

Xrayaries

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I played with concussions in HS. I remember getting woke up with smelling salts after a big hit. I was asked how many fingers I saw. I guessed two. Coach said get a drink your going in the next series. I was elbowed in the forehead playing basketball. I felt a little dizzy right afterwards, but continued to play. Right after the game it felt like I had a hangover headache. Playing baseball I took a knee to the same area where I was elbowed sliding into second base. I kept playing after they stopped the bleeding and verified my helmet would still fit over the lump on my head. I did not sleep for two days after that game because of a constant headache.

Today I suffer from migraines several times a month. Some last for up to 5 days. Be happy they take these precautions we did not have them when I played. I wish they did.
 

daboss

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You are looking to get her back on the field before the season is over. Why would you want her to play until a licensed doctor clears her and any or all parties agree she's okay? The heck with protocol. remember, a trainer is probably bound to school policy as well as OHSAA and NFHS. They'll need to go the distance whatever is the longest amount of time to error to caution. Take a deep breath and be glad they're doing this for the betterment of your daughter. Once everyone that needs to be are satisfied she'll have a great summer.

Might not be any physical signs but concussions are not to be taken lightly.
 

hammerhead20

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Do not go to your family Dr. for concussions. It is not their expertise. You need to go to a Dr. that specializes in Sports releated Concussions. They will put you on the proper path to recovery which could be 5 days or several weeks depending on the severity.
 

tjsmize3

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Finfan,

I am a primary care physician who runs both a family practice and urgent care. We get our fare share of these cases and needless to say I certainly don't agree that you need a specialist... just a competent physician. Most physicians comfortable in assessing athletes with a head injury are going to, of course, say your daughter has a concussion if there was a significant head injury that took place and ANY ONE (or more) of the symptoms on the list that Freeze Mizer linked to are present (as either reported by the athlete or the parents). I personally know of no 7-day rule and when your daughter has no symptoms we send a copy of the same progression Freeze Mizer linked to and ask that the HS trainer supervise and document completion. We have no requirement on our end they must start back at day 1 if there are any return of symptoms, but rather that they resume the level that they can tolerate symptom free (or rest) and move back through the progression until they have completed ALL levels symptom free. We ask for the trainer to document this. Once this has been completed and BOTH the parents and athlete report no symptoms on our checklist (much more than just HA) AND they pass a routine neurological exam, we will return to play. RARELY is any kind of specialized testing required.
Cases that we typically refer to our local head injury center include (but are not limited to) the following: Head injury w/ prolonged loss of consciousness, severe injury and/or concerning symptoms (especially amnesia or major cognitive changes), repeat concussions, concern for post-concussion syndrome. If your daughter has any of those it's a game changer and I would agree it's time to get her into a facility that specializes in care of head injuries.
I also have to say that it has not been my experience to see parents or athletes very patient with this process at all. It is really great to see how many people are on here pushing for "proper care" instead of giving advice on how to try to work around the system. Returning your daughter to play before she is ready is absolutely insane. If your personal physician's rules about 7 days seem onerous I'm sure it's more out of a concern for your daughters welfare and less a sign he doesn't know what he is doing. There are no unified hard and fast guidelines all physicians use when returning athletes to play so there is always going to some variability in the process. Talk to your physician about the 7 day hold if you are not happy about that. Good luck!!!
 
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