Concussion Management

by ERIC KOHN

We all cringe when we witness a big hit or a collision between athletes.

The possibility of a concussion is in our thoughts as we watch the players slowly get up and return back to their respective huddles. The recognition and management of concussions have been in the forefront over the past few years in all contact and collision sports. At all levels, there has been a collective effort to make sports safer and to help prevent head injuries from occurring.

Concussion research and training is one of the top themes in sports medicine. We have made great strides in the sports medicine field with concussion recognition, management, treatment and safely returning athletes back to their sport.

The first major improvement in concussion management has been the creation of a multi-disciplinary approach. The initial contact with the athlete is started with on-the-field clinical examination and cognitive assessment by the Athletic Trainer.

The Athletic Trainer will communicate with the coach and with the player’s parents to educate and inform the status of the athlete. The parents play the important role of monitoring the symptoms of the athlete over the first 24 hours.

Most Athletic Trainers will dispense a symptoms recognition card with the player’s parents at the time of injury to help them recognize changing symptoms. The athlete should then be evaluated by a medical professional trained in concussion assessment and taken through a thorough medical assessment and detailed neurological examination. At this time, the medical professional can compare the athlete’s current baseline testing to preseason neurological tests.

The Standardized Concussion Assessment Tool 3 (SCAT 3) is an afford- able tool to in helping the medical professional assess the initial symptoms as well as continuing symptoms. After no symptoms have been noted for 24 hours, and based on medical orders, the athlete may begin the process of returning back to play. The return is a gradual progression that can be monitored and lead by a Physical Therapist in the clinic setting.

Concussions protocols are at the forefront every time teams take the field these days. Athletic trainers, coaches, parents, and even teachers play roles in ensuring student-athletes are correctly diagnosed, treated, and return safely to competition.

The athlete is progressed from no activity to light aerobic and balance train- ing, then higher level aerobic and more functional movements, into sports specific movements, lastly non-contact training drills to full contact practice and finally full competition. Throughout the entire process the athlete is monitored closely by this multidisciplinary approach and is progressed based on individual response to each step. If there is a return of symptoms, the athlete is held back until the symptoms resolve and the progression starts again. It is not time specific but based only on the athlete’s response to each step.

Some of the advancements that have come from all of the concussion research is the improved equipment that is worn by athletes. Helmets and mouth guards have been made safer. Another is the use of baseline preseason testing which has created an objective measure to compare post injury cognitive testing. Some schools have initiated a return to learn program that is monitored by a school nurse and counselor that acclimates the athlete back into the classroom. Finally, the improvement in education and communication between sports medicine professionals, parents, and coaches has helped to keep our athletes safer.

With as much as we have learned through research there is much to understand about brain injuries no matter how big or small. We are still learning about the compound effect of multiple concussions. There is interesting research that demonstrates up to 6 months after a concussion an athlete is more susceptible to musculoskeletal injuries such as ACL tears or other knee injuries. We are learning that our brain and body connection is still effected even after all the outward symptoms and signs seem to have been cleared for months. We also have learned the importance of balance training and hand eye coordination in the full recovery of the athlete post-concussion.

Concussions still occur in sports but with a multidisciplinary approach our athletes are correctly diagnosed, treated, and returned back to the field in a safer manner.

Eric is a Board Certified Orthopedic Clinical Specialist, Doctor of Physical Therapy and Certified Strength and Conditioning Specialist. He practices at St Cloud Orthopedics in Central Minnesota and is an adjunct professor at The College of St. Benedict/St John’s University. He can be reached at ekohn@stcloudorthopedics.com

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Rankings

Class 3A

1. Dassel-Cokato (6-0)

2. Fairmont (6-0)

3. Dilworth-Glyndon-Felton (6-0)

4. Waseca (5-1)

5. Providence Academy (6-0)

6. Lake City (6-0)

7. Cannon Falls (5-1)

8. Litchfield (5-1)

9. Rockford (5-1)

10. Esko (6-0)

Class 3a

A new No. 1

For the second consecutive week the No. 1 team in Class 3A was defeated, leaving the door open for a new No. 1.

That new No. 1 would be Dassel-Cokato after last week’s top-ranked Litchfield fell to Watertown-Mayer 26-7 and Dassel-Cokato improved to 6-0 with a 49-14 win over Glencoe-Silver Lake.

Fairmont, with a 46-0 blanking of Worthington, jumps to the No. 2 spot. D-G-F stayed unbeaten with a 21-0 shutout over Hawley and Waseca beat southern rival New Ulm 38-7 to improve to 5-1.

Providence Academy continued their dominance with another lopsided win, this time 35-3 over Concordia Academy.

Lake City did the same by taking care of Zumbrota-Mazzeppa 40-7 to improve to 6-0.

The Bombers from Cannon Falls, who were No. 1 for four straight weeks before losing to Chatfield, are back on the winning track with a 54-12 trounc- ing of LaCrescent-Hokah.

Rockford and Esko also won their games. Esko has not allowed a single point in their last three contests.

Scores in Class 3A top 10: Watertown-Mayer 26, No. 1 Litchfield 7

No. 2 Dassel-Cokato 49, Glencoe-Silver Lake 14

No. 3 Fairmont 46, Worthington 0

No. 4 D-G-F 21, Hawley 0

No. 5 Waseca 38, New Ulm 7

No. 6 Providence Academy 35, Concordia Academy 3

No. 7 Lake City 40, Zumbrota-Mazzeppa 7

No. 8 Cannon Falls 54, LaCrescent-Hokah 12

Hermantown 28, No. 9 Aitkin 6

No. 10 Rockford 27, Montevideo 14

Rankings

Class 4A

1. Becker (6-0)

2. Stewartville (6-0)

3. Hutchinson (5-1)

4. Willmar (5-1)

5. Mound Westonka (6-0)

6. Kasson-Mantorville (4-2)

7. North Branch (6-0)

8. Holy Angels (5-1)

9. Zimmerman (5-1)

10. Faribault (4-2)

Class 4a

Stewartville beats

Kasson-Mantorville

In Battle Of Top 5 Teams

Eli Klavetter threw three touchdown passes for Stewartville as they held off No. 4 ranked Kasson-Mantorville for a 28-14 win last Friday.

Stewartville remains undefeated at 6-0 while Kasson-Mantorville fell to

4-2. Kasson-Mantorville thus fell out of the top 5 to No. 6, but is still a team that will have to be reckoned with come section playoff time.

Meanwhile top-ranked Becker beat Monticello 31-7 to keep a clean record heading into Week 7.

Former No. 1 Hutchinson stays at No. 3 with a 31-0 win over Big Lake.

One team to watch is Mound Westonka, who is quietly putting together an impressive season. They have outscored opponents 235-81 thus far and have a solid hybrid offense that can beat teams on the ground and through the air.

North Branch remained unbeaten with a 48-20 win over Duluth Denfeld and Holy Angels, behind the running of Emmett Johnson, are now 5-1 after a 49-25 win over St. Louis Park.

Zimmerman debuts at No. 9 at 5-1 with a 41-14 win over Little Falls and Faribault also makes a debut at 4-2 after bouncing Winona 40-0. Faribault’s two losses were close ones to both Stewartville and Kasson-Mantorville.

Scores:

No. 1 Becker 31, Monticello 7

No. 2 Stewartville 28, No. 4 Kasson-Mantorville 21 No. 3 Hutchinson 31, Big Lake 0 No. 5 Mound Westonka 40, St. Paul Highland Park 7

No. 6 Willmar 24, No. 7 Rocori 8

No. 8 North Branch 48, Duluth Denfeld 20

No. 9 Holy Angels 49, St. Louis Park 25 No. 10 Zimmerman 41, Little Falls 14

Friday Night Spotlight

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