by: Jared Ferreira ATC, LAT

So maybe you didn’t read my prevention tips in time, but that’s ok! As I talked about last week, concussions are an injury that should not be taken lightly.

No matter what precautions you put in place, concussions are not entirely preventable, but if you are suffering from a concussion then your treatment plan is crucial, and always remember that treatments are different for every person. In fact, adolescents who have a history of concussions can take twice as long to recover than those who experience their first concussion, and they require different techniques to help them recovery properly.

By laying out the proper treatment plan, you can help prevent a longer recovery time. Here are some tips on recovery treatments and return to play protocols that are essential to follow in order to help players return to the field while staying safe.

      • Concussion emergencies: Any athlete that suffers from a loss or diminished level of consciousness, or neural damage, should immediately be transported to the hospital by emergency medical services. Also, if the athlete has a high number and/or severity of signs and symptoms of a concussion they should be brought to the hospital or seen by a concussion specialist as soon as possible.

 

      • Treatments: Treatment can be dependent on the severity of symptoms present, and a concussion history can also play a big factor. Recovery times for those with a history of concussion are often longer based on the number and severity of their past concussions, and the time elapsed since their most recent concussion(s). The priority in the beginning, regardless of severity, should be letting the brain rest and recover with time. Proper recovery from a severe concussion includes plenty of sleep, dark rooms, no/minimal use of electronic screens (TV, video games, cell phones, computers), no school/work, and minimal overall stimulus from other people or things around them. Rest alone can often be enough for symptoms to fully resolve without needing other treatments. Once the symptoms subside or have reduced substantially, they may return to work/school part time and resume more of their normal activities of daily living. They may continue to add more stimulation until they are able to complete all normal activities with little to no symptoms. Physical therapy treatments should be considered for those that don’t see a regular decrease in symptoms as time goes on. Athletic trainers and physical therapists are skilled in treating concussions and can help with treatment by testing the athlete’s balance, proprioception, coordination, and ocular responses, which are all controlled by the brain/nervous system.

 

      • Return to play protocol: An athletic trainer should oversee a five-day return to play protocol for all concussions, regardless of severity. In order for a concussed athlete to be eligible to start the protocol they must be symptom-free and cleared by a medical doctor; a concussion specialist is highly recommended. Once an athlete starts the protocol, they will be put through an exercise program that starts with just a small bout of aerobic exercise on the first day, then steadily increasing the intensity each consecutive day. If the athlete suffers from symptoms during or after each stage of exercise, they will be instructed to stop exercising for the next 24 hours. If the athlete’s symptoms persist, they will be sent back to day-one of the protocol until their symptoms do clear up. If the athlete’s symptoms subside within the 24 hours, they can return to the last stage of the protocol they attempted. As the protocol advances, the athletic trainer or physical therapist will institute sport-specific exercises in order to replicate their sport. This helps them determine if sport-specific activities will bring on symptoms. The final stage will be a full-length practice with some game simulation included. The athlete should still be monitored by their athletic trainer and coaches for signs and symptoms for the remainder of the sports season.

Each athlete recovers differently, so it is important to create an individualized plan of care for each athlete who may be suffering from a concussion. By practicing the prevention and assessment tools, and partnering those with these recovery techniques, you can help reduce the number of concussions your players may suffer from, and get them back on the field better and faster than before.


Jared Ferreira, ATC, LAT, has worked with Performance Physical Therapy since 2016 as an athletic trainer. Ferreira earned a bachelor’s degree in athletic training and sports medicine from Bridgewater State University. He has certifications in First Responder CPR, AED, and First Aid, and Bloodborne Pathogens, and has completed Heads Up to Clinicians Concussion Training.

Ferreira is comfortable rehabbing sports injuries, providing injury prevention, emergency care, and first aid. He is also well-versed in concussion testing, taping and bracing, biomechanical analysis, equipment fitting, strength and conditioning, and fitness training and testing. He’s worked as an athletic trainer with a number of sports teams, including the rugby and football teams at Johnson & Wales. Ferreira is both a NATA and RIATA member. He is currently working with Saint Raphael Academy in Pawtucket as an athletic trainer for their athletic department.