GOVERNMENT OF ONTARIOCONCUSSIONAWARENESS RESOURCEE-BOOKLET: AGES 15 AND UP
Preventing injuries is important to keeping people active throughouttheir lives. Some injuries are easy to see and treat but what about aninjury inside the head? Brain injuries, such as concussions, don’t showon the outside and are not always obvious. Even when you can’t seethe injury, a person with a concussion still feels the effects and needsthe proper care to get better.This resource will help you learn more about concussions so you cankeep yourself and others active and safe – whether you’re an athlete,student, parent, coach, official or educator.Concussion Awareness Resource:Ages 15 and Up2
WHAT IS A CONCUSSION?A concussion is a brain injury. It can’t be seen on X-rays, CT scans or MRIs.It may affect the way a person thinks, feels and acts.Any blow to the head, face or neck may cause a concussion. Aconcussion may also be caused by a blow to the body if the force of theblow causes the brain to move around inside the skull. Examples includebeing hit in the head with a ball or falling hard onto the floor.A concussion is a serious injury. While the effects are typically short-term,a concussion can lead to long-lasting symptoms and even long-termeffects, such as memory problems or depression.Concussion Awareness Resource:Ages 15 and Up3
PREVENTING A CONCUSSIONFirst, educate yourself about concussions.You should also: Ensure you/your athletes useequipment that is in goodcondition; Ensure you/athletes you aresupervising wear sportsequipment that fits properly; Ensure you/your athletesrespect the rules of the sport; Commit to your sport organization/school’s Concussion Codeof Conduct and make sure yourathletes do too; and Promote a safe and comfortable environment for everyoneto report injuries. Make sureeveryone understands the risksof not speaking up.Concussion Awareness Resource:Ages 15 and Up4
RECOGNIZING A CONCUSSIONEveryone can help recognize a possible concussion if they know what tolook and listen for.A person with a concussion might have one or more of the signs orsymptoms listed below. They might show up right away or hours, evendays, later. Just one sign or symptom is enough to suspect a concussion.Most people with a concussion do not lose consciousness.Concussion Awareness Resource:Ages 15 and Up5
RECOGNIZING A CONCUSSIONCommon signs and symptoms of a concussion:PHYSICAL:EMOTIONAL: Headache Irritability (easily upset or angered) Pressure in the head Depression Dizziness Sadness Nausea or vomiting Nervous or anxious Blurred vision Sensitivity to light or soundCOGNITIVE (THINKING): Ringing in the ears Not thinking clearly Balance problems Slower thinking Tired or low energy Feeling confused Drowsiness Problems concentrating “Don’t feel right” Problems rememberingSLEEP-RELATED: Sleeping more or lessthan usual Having a hard time fallingasleepConcussion Awareness Resource:Ages 15 and Up6
RECOGNIZING A CONCUSSIONRED FLAGS:“Red flags” may mean you have a more serious injury. Treatred flags as an emergency and call 911. Neck pain or tenderness Double vision Weakness or tingling in arms or legs Severe or increasing headache Seizure or convulsion Loss of consciousness (knocked out) Vomiting more than once Increasingly restless, agitated or aggressive Getting more and more confusedConcussion Awareness Resource:Ages 15 and Up7
WHAT TO DO NEXT?If you suspect a concussion, remove yourself or the person you aresupervising from the activity right away. Continuing to participate putsyou or the person with a suspected concussion at risk of more severe,longer-lasting symptoms. Call the parent/guardian (for athletes under 18years of age) or emergency contact. Don’t leave anyone with a suspectedconcussion alone.Anyone who has been removed from sport with a suspected concussionshould see a physician or nurse practitioner as soon as possible. Thatperson should not return to unrestricted participation in training, practiceor competition until they have received medical clearance.Concussion Awareness Resource:Ages 15 and Up8
GETTING BETTERMost people with a concussiondo activities that may makeget better in one to four weeks.their symptoms worse. This maySome people take longer. Eachmean limiting activities suchconcussion is unique – don’tas exercising, screen time orcompare one person’s recoveryschoolwork.to another’s.Healing from a concussion isIt’s possible for a concussion toa process that takes patience.have long-term effects. PeopleRushing back to activities canmay experience symptoms,make symptoms worse andsuch as headaches, neck painrecovery longer.or vision problems, that last formonths, or even years. SomeAnyone who has a concussionmay have lasting changes in theirshould let others know. Thisbrain that lead to issues suchincludes parents, all sport teams/as memory loss, concentrationclubs, schools, coaches andproblems or depression. In rareeducators.cases, a person who suffersmultiple brain injuries withouthealing in between may developdangerous swelling in their brain,And remember, returning toschool comes before returning tounrestricted sport.a condition known as secondimpact syndrome, that can resultin severe disability or death.While a person is recoveringfrom a concussion, they shouldn’tConcussion Awareness Resource:Ages 15 and Up9
RETURNING TOSCHOOL AND SPORTAthletes and students who areactivity. Contact the school fordiagnosed by a physician ormore information.nurse practitioner as havinga concussion must proceedThe Return-to-Sport Protocolthrough their sport organization’sMost return-to-sport protocolsreturn-to-sport protocol and/or,suggest that athletes should restwhere applicable, their schoolfor 24 to 48 hours before startingboard’s return-to-school plan.any gradual return to sport.Athletes and students shouldwork with their healthcareprofessional and sportorganization/school to establishtheir individual plans to return toAn athlete must not resumeunrestricted participation intraining, practice or competitionuntil they have received medicalclearance.sport as well as return to school.The Return-to-School Plan(Learning and Physical Activity)Students in elementary andsecondary school will need tofollow their school board’s returnto-school plan, which supportsa student’s gradual return tolearning and return to physicalConcussion Awareness Resource:Ages 15 and Up10
RETURNING TOSCHOOL AND SPORTThe table below provides a list of steps and activities that are commonly found inmost return-to-sport protocols and return-to-school plans.Table: Common Steps in Graduated Return-to-Sport ProtocolsStepAimActivitiesGoal of Step1Symptom-limitingDaily activities that don’t makeGradual re-introduction of dailyactivitiessymptoms worse, such as movingschool and work activitiesaround the home and simple chores2Light aerobic activityLight activities that increase theIncrease heart rateheart rate just a little, such as walkingor a stationary bicycle for10 to 15 minutes3Sport-specific exerciseIndividual physical activity such asAdd movementrunning or skatingNo contact or head impact activities4Non-contact training,Harder training drillspractice, drillsExercise, co-ordinationand increased thinkingAdd resistance training(if appropriate)56Unrestricted practiceReturn to sportUnrestricted practice - with contactRestore confidence and assesswhere applicablefunctional skillsUnrestricted game playor competitionMedical clearance is always required prior to the athlete’s return tounrestricted practice, training or competition.Check with your sport club and school for the specific steps that you should follow.Concussion Awareness Resource:Ages 15 and Up11
RETURNING TOSCHOOL AND SPORTAn athlete is typically ready to progress to the next step when theycan do the activities at their current step without new or worseningsymptoms. If at any step symptoms get worse, they should stopand go back to the previous step. Each step should take at least 24hours to complete. If symptoms do not improve or if the symptomscontinue to worsen, the athlete should return to the physician ornurse practitioner.Concussion Awareness Resource:Ages 15 and Up12
REMINDERRemember:1. Recognize signs and symptoms of a concussion and removeyourself or the athlete from the sport/physical activity, even if youfeel OK or they insist they are OK.2. Get yourself/the athlete checked out by a physician or nursepractitioner.3. Support gradual return to school and sport.Concussion Awareness Resource:Ages 15 and Up13
Rowan StringerThis e-booklet is part of a series of Rowan’s Law concussion awarenessresources. Rowan’s Law was named for Rowan Stringer, a high schoolrugby player from Ottawa, who died in the spring of 2013 from a conditionknown as second impact syndrome (swelling of the brain caused by asubsequent injury that occurred before a previous injury healed). Rowanis believed to have experienced three concussions over six days whileplaying rugby. She had a concussion but didn’t know her brain neededtime to heal. Neither did her parents, teachers or coaches.These resources are not intended to provide medical advice relating tohealth care. For advice on health care for concussion symptoms, pleaseconsult with a physician or nurse practitioner.
follow their school board’s return-to-school plan, which supports a student’s gradual return to learning and return to physical activity. Contact the school for more information. The Return-to-Sport Protocol Most return-to-sport protocols suggest that athletes should rest for 24 to 48 hours before starting any gradual return to sport.
concussion test is a tool or device used to check a What is a concussion test? person's level of functioning after a suspected concussion. There are several types of concussion tests, including neurocognitive, balance, vestibular ocular, motion sensors, and more. These tests do not diagnose concussion, but rather note deficits in
Ontario Ministry of Natural Resources : Picton, Ontario : New York, New York ; Picton, Ontario : Bruce Morrison Tom Stewart Betsy Trometer Ontario Ministry of Natural Resources Ontario Ministry of Natural Resources U.S. Fish & Wildlife Service Picton, Ontario Picton, Ontario Amherst, New York . Don Zelazny Tracey Tomajer
3. onsite medical assessment 14 4. medical assessment 16 5. concussion management 17 6. multidisciplinary concussion care 20 7. return to sport 21. canadian sport concussion pathway 23 guideline development process . evidence stakeholder consultation updates to this guideline. appendix: documen
This policy is aligned with the Canadian Guideline on Concussion in Sport. . the 5th International conference on concussion in sport held in Berlin, Oct 2016. British Journal of Sports Medicine 2017 0:1-10. This policy is aligned with the Canadian Guideline on Concussion in Sport. . medical
Consensus Statement on Concussion in Sport . The detailed clinical assessment of concussion is outlined in the SCAT2 form, which is an appendix to this document. The suspected diagnosis of concussion can include one . psychological test batteries that assess attention and memory
used in the evaluation of concussion; however, none is specifically validated for such use.31–41 SCAT2 includes one such symptom evaluation scheme.7 Increasing evidence suggests that concussion rating scales based on athlete self-report of multiple symptoms are a more reliable and practical way of detecting concussion
Furthermore, a detailed concussion his-tory is an important part of the evalua-tion both in the injured athlete and when conducting a pre-participation examina-tion. The detailed clinical assessment of concussion is outlined in the SCAT2 form (see p 85). The suspected diagnosis of concussion can include one or more of the following clinical .
The risk of concussion is 4 times higher in a previously concussed player than in a player who has never sustained a concussion. Concussion (Mild Traumatic Brain Injury) Structural damage with loss of brain cells does occur with some concussions Repeated concussions additive – slower/ less complete recovery Second Impact Syndrome – 100%