This course highlights the impact of sports-related concussion on athletes, teaches how to recognize a suspected concussion, and provides protocols to manage a suspected concussion with steps to help players return to play safely after a concussion. Each state's requirements for concussion management are included as part of the course.
March 1997. New return-to-play guidelines. The guidelines from the American Academy of Neurology say that repetitive concussions can cause brain damage, and suggest that players be removed from the game if they lose consciousness or exhibit any concussion symptoms 15 minutes post-injury.
Though often cast as a recent phenomenon, the crisis in fact began more than a century ago, as concussions were identified among footballers in the game’s first decades. This early concussion crisis subsided—allowing the problem to proliferate—because work was done by football’s supporters to reshape public acceptance of risk.
In fact, a study of 17 medical schools published in the Canadian Journal of Neurological Sciences “found deficiencies in the concussion education curriculum provided in the majority of Canadian medical schools.”
2009NFL Guidelines Due to high numbers of traumatic brain injury among active and retired professional football players, the NFL established a concussion protocol in 2009, and it's since been updated several times.
California law mandates that all coaches must receive training on concussions. The training may be fulfilled through the free, online course available through the National Federation of State High School Associations (NFHS).
On April 29, 2010, the NCAA enacted its Concussion Policy and Legislation, which became effective in August 2010 (NCAA Bylaw: 3.2. 4.17) and stated that all member institutions must have a concussion management plan (CMP).
Two hours of concussion education training is required every two years and must be completed no later than September 1, 2012 and each subsequent two year period (2014, 2016 etc…)
State Legislation and Policy. Today, all 50 states have some form of legislation regarding sport-related concussion. Because such policies vary widely, physical education teachers and other school personnel should take the time to understand their state and local concussion policies in addition to their school policy.
A majority of people who have sustained a concussion will need to be sidelined for at least seven to 10 days, but in some cases, an individual could take several weeks to heal. CT scans and MRIs from concussion studies don't show structural changes, such as bleeding, in a concussion.
As part of its ongoing efforts to promote education on important safety issues and to prevent injuries, the NCAA has partnered with 11 other sports leagues, safety organizations and equipment manufacturers in a program designed to help reduce the occurrence of concussion in youth football.
The NCAA Provides Guidelines The first observation is a random one: the protocols differ in page length. For example, the University of Oregon's concussion protocol is four pages, while North Carolina State University's concussion protocol is 111 pages.
Any student-athlete with signs/symptoms/behaviors consistent with concussion: Must be removed from practice or competition for evaluation. Evaluation must be by an athletic trainer or team physician (or physician designee) with concussion experience.
Concussion in Sports is available for review for 3 months. The only “course expiration” that is considered by the NFHS is the First Aid component if you are applying for AIC or CIC certification (see below). Otherwise, you need to check with your school district and/or your state association.
WHAT IS A CONCUSSION PROTOCOL/POLICY? A concussion protocol is an organization's set of policies, tools, and assessments for caring for a concussion. It outlines how the concussion care team prepares for and responds to this injury.
There is no set number as to how many concussions humans can have before they suffer permanent damage. After all, some athletes experience symptoms for years after just one concussion, while others are seemingly okay after having more than one.
February 2010: The NCAA forms a Concussion Working Group that meets in Indianapolis. It discusses the policies of other leagues and considers putting forth legislative changes that would call for a uniform concussion policy.
April 2010: The NCAA holds its first concussion summit. It presents results of a survey of its athletic trainers that shows that only 66 percent of its schools performed baseline concussion testing and than less than 50 percent required a physician to see all athletes who suffered concussions. 39 percent did not establish guidelines on how long athletes should sit out before returning to play, and nearly half said they allow students to return to play in the same game in which he or she suffered a concussion. The summit’s original recommendations call for continuing education for players, coaches, and medical trainers as well as the monitoring of progress of such programs. None are adopted.
2004–2009: ISS data estimates that NCAA athletes suffered a total of 29,255 concussions in a six-year period. 16,277 occurred in football.
1998: The NCAA approves $50,000 in grants for concussion research because “much more research in this area was necessary.”
1933: The NCAA first acknowledges the dangers of concussions in its Medical Handbook for Schools and Colleges, which states that “the seriousness of [concussions] is often overlooked” and that concussions “should not be regarded lightly.” It lays out recommendations for immediate treatment, including rest, constant supervision, and x-rays of the brain as long as headaches persist. It also suggests hospital treatment for players with recurring symptoms until they are symptom-free for 48 hours and recommends that any player who experiences symptoms for longer than 48 hours “should not be permitted to compete for 21 days or longer, if at all.”
2004–2006: ISS data shows that in 2004, 14 percent of all game injuries in women’s soccer are concussions; they account for 6.3 percent in men’s soccer, 7 percent in field hockey, 22 percent in women’s ice hockey, and 18 percent in men’s ice hockey. In 2005–2006, 7 percent of all football injuries were concussions, and a team with 60 game participants experienced a concussion in one of every five games.
Advertisement. 2009: The National Football League adopts guidelines prohibiting players from returning to games or practices if they exhibit signs of concussions. The National Federation of State High School Associations requires officials to remove players suspected of suffering a concussion.
Concussion courses should provide an in-depth look at what a concussion is, the various ways someone can be impacted following the injury, and how to apply a practitioner’s skillset to assess, manage and treat all of the systems and domains from a holistic perspective. Without thorough training, practitioners may have difficulty offering care that can actually make a long-term difference for patients and their recovery.
Evidence-based, Comprehensive Training is Imperative. Because concussion is so complex and multi-dimensional, the continuing education and professional development must reflect this . For example, a training course for only vestibular therapy is not enough to teach a healthcare practitioner how to appropriately manage concussion patients.
The CCMI Practitioner Certification Course includes 12 online, in-depth modules; the latest concussion literature; how-to training videos; and much more! Check out a sample of the itinerary below:
This may come as a surprise to some, but various studies have shown that concussion and concussion injury management is not thoroughly covered in medical and healthcare curriculum s. These studies point to widespread gaps in knowledge, which could ultimately impact patient outcomes.
Although the media attention and volume of concussion-related research is exploding, we still have the problem of translating scientific discoveries and medical research into the hands of the treat ing clinicians, and ultima tely, for patient benefit .
That said, with the proper training, concussion management can be effective and efficient . Concussion care can be a large part of many therapists and healthcare practitioners practices; just make sure to get the proper training first!
Newspapers had been noting concussions in headlines for more than 20 years, as the cause of death or hospitalization. The shock with the statistics of the 1906 paper was not that concussions were happening, but that they were happening in nearly every game without such obvious evidence. According to the BMSJreport, a concussion could occur without even the player himself realizing it. “The injury was frequently noticed by a surgeon from the side lines before it was recognized by the players,” the authors explained. “A player might automatically run through a considerable series of plays before his fellows noticed that he was mentally irresponsible.”38Concussion was deemed something that could happen almost invisibly in the noise and action of a game. The concussion crisis had begun.
As early as the mid-16th century it had been defined as a blow resulting in escape of blood from ruptured tissue. By the early 19th century it was described as an “external violence” that caused “derangement of the organization of the brain.”32Though, as the authors of the BMSJreport noted, players were unlikely to acknowledge injury and tended to treat concussion as a joke, it was clear that “when a condition like this develops as the result of an injury, the central nervous system has received a very severe shaking up.” The doctors could not extrapolate from their small, one-season sample to make strong claims about the long-term consequences of concussion, and neurologists had not studied football injuries in particular, but those tasked with judging evidence for policy and practice took a stance. The American Medical Association reported that, although
The concussion crisis is commonly framed as a battle over evidence and a need for new technical solutions. Some high-profile reports accuse corporate interest groups of playing down data about brain injury in former players, and others claim public health interest groups are playing it up.7Corporation and player advocacy groups alike support epidemiological investigations of the link between concussion and a degenerative brain condition called chronic traumatic encephalopathy,8and both have partnered with prestigious medical institutions to study prevention, diagnosis, and treatment.9
The turn of the century was a time of heightened awareness to injury. The industrializing workplace was a space where accidents inspired worker’s compensation law, devastating factory fires alerted the public to a need for safety regulations, and the complexity of problems led to the formation of national councils to oversee them.
“The new rules,” wrote one, “which were expected to accomplish so much in reducing the record of injury to players, failed entirely of their purpose.”28The response to the failings of the first reforms was more reforms, while the game grew ever more entertaining.29
In the early 1970s air bladders were added to “energy-absorbing helmets” and four-point chin straps were required at the collegiate level after 1976. Over the next two decades scientific and media attention around concussions in professional football grew. By the mid-1990s concussions were making the news again.
As anxiety mounted over the death of a student from head injury in 1906,30the Harvard College team doctors released a damning and unambiguous report on “The Physical Aspect of American Football” in the Boston Medical and Surgical Journal (BMSJ), printed on page one.31Dismissing ongoing tinkering with reforms, the doctors came down “entirely against the game from its medical standpoint.” Their article, systematically documenting the nature and number of injuries sustained by the team over the 1905 season, highlighted one injury in particular that had been hiding in plain sight: concussion of the brain.
This paper summarizes a symposium on concussion held at Case Western Reserve University on June 23–24, 2015, and supported in part by the National Academies of Engineering and Medicine. 1 It reviews evidence for the seriousness of the problem of concussion (also called mild traumatic brain injury, mTBI) and considers relevant engineering, medical, and biological aspects; provides background, including relevant experimental results, on epidemiology, diagnosis, brain tissue injury mechanisms, histopathology, noninvasive imaging detection of brain injury, blood biomarkers, and progress toward prevention and treatment; and summarizes the short papers based on the presentations.
In 2000–2015 there were 270,000 concussions in the military, and from 2005 to 2011 the yearly incidence of mTBI doubled, to 24,000 cases (figure 1). Data indicate that 84 percent of IED-induced concussions occur within 10 meters of the blast, 93 percent within 30 m (cf. Perl paper, this symposium). Many who have been in close proximity to an IED-generated blast develop neurologic and behavioral systems referred to as postconcussive syndrome (PCS), which is closely related to PTSD.
(Mott subsequently countered his contention that brain injury was the cause of shell shock by arguing that the principal cause was psychiatric; Mott 1919.)
Infants and toddlers are in a special class for studies of biomechanical linkages to brain tissue injury because their brain tissues appear to have an unexpected elastic modulus, leading to a critical strain 3.6 times lower in infants relative to toddlers, as inferred from animal studies (Ibrahim et al. 2010).
Some 160 years later the same personality changes were found to accompany severe brain pathology in victims of multiple episodes of brain trauma. Four historical events brought the attention of the public, military, government, engineers, and physicians to the importance of understanding concussion and its effects.
The incidence of brain injury during military engagements has recently become a consequence of major importance because of the use of IEDs in the wars in Iraq and Afghanistan. These weapons produce a rapidly expanding high-pressure blast wave from which soldiers survive (thanks to protective armor) but not without brain injuries.
The symposium revealed areas of great need for research, of which the need for understanding the long-term consequences of concussion stood out as the most significant.
Pellman also tells Sports Illustrated that “concussions are part of the profession, an occupational risk.”. January 1994. Troy Aikman’s concussion. Dallas Cowboys quarterback Troy Aikman takes a knee to the head during the 1993 season NFC Championship game, landing him in the hospital that night.
The guidelines from the American Academy of Neurology say that repetitive concussions can cause brain damage, and suggest that players be removed from the game if they lose consciousness or exhibit any concussion symptoms 15 minutes post-injury.
Bennet Omalu decides to take a closer look at Webster’s brain, eventually discovering the first evidence of a brain disease that had never been previously identified in football players, Chronic Traumatic Encephalopathy, or CTE.
After years of struggling with cognitive problems, Mike Webster files a disability application with the NFL Retirement Board, claiming his NFL football career caused him to have dementia.
NFL Commissioner Paul Tagliabue describes concussions as a “pack journalism issue” during a panel on the future of sports:
Dr. Pellman tells The Chicago Tribune that the MTBI committee’s studies have found that brain injuries in football are relatively uncommon and minor. The paper reports:
Aikman later tells the Milwaukee Journal Sentinel that he can’t remember the game:
The SCAT5 is a standardized tool for evaluating concussions designed for use by physicians and licensed healthcare professionals. It was created by the International Concussion In Sports Group [...]
Welcome to the concussion in sport education package Information in this package is designed to assist you better manage your sporting patients both on the sideline and in your classroom. This [...]
Welcome to the Level 1 HeadSafe course in the acute management of head injury and concussion in sport. This training program is specifically designed for those sports trainers, coaches, players [...]
Welcome to the concussion in sport education package for doctors, which is the Level 2 HeadSafe course. To listen to associated Audio track, please select the PLAY arrow at the left hand end [...]
This course is divided into Lessons, each of which have Topics followed by an Assessment Quiz. You cannot move onto the next Lesson until you have completed all of the Topics in order, followed [...]
Welcome to the Level 1 HeadSafe course in the acute management of head injury and concussion in sport. This training program is specifically designed for those sports trainers, coaches, players [...]
The NFHS has teamed up with the Centers for Disease Control and Prevention (CDC) to educate coaches, officials, parents and students on the importance of proper concussion recognition and management in high school sports.
The NFHS Coach Certification Program is a national professional credential offered to individuals who are currently coaching or aspire to coach at the interscholastic level.
One in five high school athletes will experience a concussion. With proper care, most concussions can heal within 10 days; if not treated properly, however, a concussion may have lasting physical, emotional, and cognitive effects.
This fly-through showcases the brain’s blood vessels, nervous system, and cerebrospinal fluid cavities while emphasizing the complexity and fragility of the brain – as well as the importance of caring for it.
The Brain Fly-Through can be accessed through the video above, or on YouTube as a standard video and in virtual reality. This eight-minute CrashCourse Multi-Sport production was developed by award-winning nonprofit TeachAids in collaboration with USA Archery, USA Artistic Swimming, USA Baseball, USA Bobsled & Skeleton, USA Cycling, USA Diving, USA Fencing, USA Field Hockey, USA Football, USA Gymnastics, USA Hockey, US Lacrosse, US Ski & Snowboard, US Speedskating, USA Taekwondo, USA Triathlon, and USA Wrestling.