Athletic Trainers Treat and Manage Concussions

by Daniel Pokrifka, ATC/L
HeadFirst Concussion Care Program Administrator

Last month was Brain Injury Awareness Month, but did you know it was also Athletic Training Month? However, it’s important to be educated throughout the year about the roles that both play in sports. As a Certified Athletic Trainer (ATC), I’ve taken the past few weeks to reflect on the progress of care for mild traumatic brain injury (MTBI) and how it fits into the development of the athletic training profession.

Both have come a very long way in the time I’ve been involved with them. More importantly, though, is where each is headed in the future. Certainly, the two fields will remain integral to each other. When I was taking undergraduate courses, the instruction given regarding concussion care amounted to little more than a few PowerPoint slides in a single lecture in one class of my sophomore year.

At the time, the guidelines for returning an athlete to play were to wait just 10-15 minutes of being free of symptoms! I remember realizing the signs and symptoms of concussions and counting on both hands the number of concussions I must have sustained during my high school days that were never diagnosed or treated. For most of those injuries, the only thought going through my head was ‘get up before the other guy’ and ‘make sure you go back to the correct sideline!’

While an athlete’s mentality may not have changed much, thankfully medical understanding of MTBI and the care standards have increased dramatically. While we still have a long way to go, I am confident we have at least reached a precautionary stage that will turn the tide, and begin to pay dividends in the long term health quality of today’s athletes and athletes yet to come.

The other major change I have seen is in the field of athletic training. ATCs are recognized and valued in the medical community and general public at a much higher level than in previous years. Often in my career I’ve had to answer questions about what an athletic trainer is and does. Many times, I’ve explained that I’m not a strengthening and conditioning coach, nor a personal trainer, nor a fitness instructor. I’ve also had to explain to medical providers and staff my reasons for, and legality in, obtaining medical information for the continuing care of our patients.

These days, we see physicians volunteering the information to ATCs, and often seeking their opinion and input in the care of an athlete. Many providers, parents, and school administrators rely on Certified Athletic Trainers for creating, instituting, advising and enforcing care plans, policies and procedures, liability issues, and more. The benefits gained for the athlete with this partnership are huge.

ATC Word Cloud

I believe concussion care is headed the same way, and soon, we’ll see tremendous scientific breakthroughs in medical technology which will translate to safer healthy sports. As we gain a better understanding of MTBI and learn the most effective courses in preventing, diagnosing and treating these injuries, the role of an ATC will become more defined. Our role in concussion care will be as important as our role in treating, for example, sprained ankles and dehydration.

As a result, we’ll need to become keener in our decisions about when to treat a concussion and when to manage it. To parallel two common injuries to understanding the difference between treating and managing concussions, a sprained ankle requires an ATC to provide first aid, treatment, and rehabilitation to get the athlete back on the field. They understand the healing process and the necessary intervention.

A sprained anterior cruciate ligament (ACL), however, is a different matter. Although ATC understand all of the necessary interventions, they can’t provide all the treatment an athlete will need. The athletic trainer will refer the athlete to an orthopedic surgeon to order an MRI, conduct surgical intervention, and prescribe any necessary medications. In certain settings, the post-surgical rehabilitation may be better handled by a physical therapist.

While the ATC relies on these providers for the care of their athletes, it is still the ATC that manages the injury by directing the referrals, following up on the athlete’s compliance and resolving any issues that arise in the care plan.

As the seriousness of MTBI has been realized, so has the availability of well-trained medical personal with unique specialties to assist ATCs in the care of concussions. We now have a variety of referral sources to care for athletes including neurologists, neuropsychologists, vestibular therapists and ocular-motor therapists.   With these valuable referral sources, ATCs will always be the direct link and closest manager of the best care available for athletes.

HeadFirst Hosts ImPACT Symposium

HeadFirst Sports Injury and Concussion Care, a program of Righttime Medical Care, hosted its first ImPACT Workshop on Saturday, May 5, at the Severn School in Severna Park, Md. Jamie Pardini, Ph.D., neuropsychologist at the University of Pittsburgh Medical Center, discussed the ImPACT neurocognitive assessment program as a tool to diagnose concussions. Also presenting at the workshop were Milford H. Marchant, Jr., M.D., orthopaedic and sports medicine specialist at MedStar Harbor Hospital, and Christopher G. Vaughan, Psy.D., pediatric neuropsychologist at Children’s National Medical Center. More than 50 physicians, physical therapists, certified athletic trainers and other professionals attended the workshop to learn about helping students and their families navigate the road to recovery and make a safe return to play following a sports-related concussion.

For information about potential upcoming educational events, please email contact information to HeadFirst Program Director Amy Knappen.

HeadFirst Concussion Workshop

ImPACT workshop presenters Dr. Jamie Pardini (left), of the University of Pittsburgh Medical Center and Dr. Milford H. Marchant, Jr. (right), of MedStar Harbor Hospital, are joined by Dr. Robert G. Graw, Jr., CEO of Righttime Medical Care, at the first event sponsored by Righttime’s new program, HeadFirst Sports and Concussion Care.

HeadFirst Team Talks Concussion at Chesapeake Bayhawks Major League Lacrosse Game

Righttime Medical Care attended the Chesapeake Bayhawks first home game on Saturday, May 5, to focus on its new service, HeadFirst Sports Injury and Concussion Care. The Major League Lacrosse team (including from left, Michael Kimmel [#51]; Steven Brooks [#44]; Bayhawks owner Brendan Kelly; Mike Evans [#33]) plays their home games at the Navy Marine Corps Memorial Stadium in Annapolis, Md. The HeadFirst team (including Athletic Trainer Michelle Anderson, far right, of the Severn School in Severna Park, Md.) provides education, pre- and post-injury cognitive assessment testing and specialist referrals to help students and their families navigate the road to recovery and make a safe return to play following a sports-related concussion.

Righttime Medical Care’s Mobile Care Center, a 45-foot bus, was at Saturday’s game and will appear at each of the Bayhawks’ 2012 home games, delivering prizes and information to fans. For more photos, visit www.myheadfirst.com/pressroom.

© Righttime Medical Care

Keep Young Athletes Healthy

by Dan Mahoney, LAT, ATC, PES, Combine360 Certified Trainer

A growing epidemic of preventable youth sports injuries is decimating kids’ athletic hopes and dreams at an early age. Nearly half of all sports injuries that occur — more than 5 million annually — are due to overuse.

You might hear a story like this: An 11-year-old girl participates in soccer practices and games year round, plays on a travel club team, the local middle school team, and goes home at night and trains in her back yard. Then due to the stress on her still developing body, she suffers and injury to her knee that prevents her from playing the sport she loves. Her injury does not just affect her life now, but may keep her from learning the lifelong lessons that sports participation teaches. This is an all too common phenomenon that happens to youth athletes.

April is Youth Sports Safety Month, so the American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine and the STOP Sports Injuries campaign would like to share some simple tips to keep kids on the field and out of the examination room:

  1. Get a pre-season physical.
  2. Properly warm up and cool down before and after activity.
  3. Perfect practice makes perfect play. Get instruction on proper training and technique.
  4. Develop skills that are age appropriate.
  5. Increase training gradually.
  6. Don’t specialize in one sport.
  7. Don’t play year round ­– rest at the end of each season.Don’t play through pain – seek help if you are hurt.

Most overuse injuries are preventable, but if left untreated may require medical intervention and lost time from the playing field. Please listen to your body, and do not ignore the warning signs of injury. To learn more, visit STOP Sports Injuries, National Athletic Trainers Association, or The Centers for Disease Control and Prevention’s Youth Sports Injuries page.