Concussion Awareness & Education University of Guelph Department of Athletics

Background “A concussion is a form of head injury caused by a direct or indirect hit to the head or body that results in the brain shifting within the skull”.

Background “It is a transient neurological event followed by a course of complete recovery over a relatively short period of time and return to normal activity, without any complications in the overwhelming majority of athletes”.

Background First concussion is a biochemical injury to the nerve connections (axons). “Circuits not working”. Brain cells remain in a vulnerable state in the days following a concussion.

Background No accurate biomarker yet (MRI, blood test, x-ray, C-T scan, etc.) It is a clinical diagnosis (how you feel and act)

Background MYTH: You do have to lose consciousness in order to suffer a concussion.

Visual Signs Confusion – in motion. – in response to questions. Blank or vacant stare. Sometimes losses consciousness.

Common Symptoms Dizziness. Persistent headache or head pressure. Nausea or vomiting. Sensitivity to light or sound. “Foggy” thinking. Balance problems. Concentration problems. Fatigue.

Symptoms There are 60 identified concussion symptoms. An athlete with a concussion could have anywhere from 1 to 23 different symptoms (Mean average of 8.1 symptoms).

Symptoms Symptomology may not be noticeable for hours or days after the incident.

How do I recognize a concussion? Did I have an event that jars or shakes my brain? Do I have any one or any combination of concussion symptoms?

Initial Management 1) Standard first aid principles: Rule out with an “open head injury” or “closed head injury” If you suspect you may have a concussion (mechanism or symptoms): Remove yourself from the field of play immediately Seek medical attention and REST (remove all screen activities, mentally and physically rest)

Initial Management After being symptom free for 48 hours a five stage, graduated return to play protocol is initiated. One stage is completed at the rate of one stage per day. If symptoms return at any time during the process, you return to the start of the process.

Initial Management #2) First 24-48 hours, physical and mental (study, computer/phone screens, videos) rest. Followed by gradual addition of activity. #3) Hydrate well.

Recovery “There is no drug or other therapy to accelerate recovery from concussion” (Dr. Charles Tator) REST is the only general strategy proven to help. Do not “tough it out”. Ignore your general athletic voice telling you to ignore your symptoms.

Formal 5 Day Return-to-Sport Strategy After Symptom-free stage… Day 1 – Light Aerobic Exercise 2 – Moderate Exercise 3 – Sport Exercise 4 – Practice without contact risk 5 – Full Practice

STATISTICS 85% of concussions resolve in 7-10 days. Of the 15% remaining, 3-5% of them will have bad/poor resolutions (symptoms lasting 3 months or longer). On rare occasions, returning to play while still having symptoms, has resulted in death (Second Impact Syndrome – “Rowan’s Law” in Ontario).

STATISTICS Of those who do not fully recover within one month… 50% will have some form of mental health issue. Concussions are like snowflakes, no two are alike.

Return to School Start with HPC (Health and Performance Centre Sports Doctor) or physician at SHS (Student Health Services) and they will help you with academic concerns as well as your health concerns.

Prevention of Concussion Follow the rules and regulations of your sport/activity. Respect the well-being of your competitors. Do not take advantage of moments of vulnerability of your opponents. Be physical, not predatory.

Sport and Risk Activities with “No Risk” is unrealistic. Sport and Risk are natural partners. Key is safe participation.

Rowan’s Law Bill 149 – OntGovernment Ontario is on the verge of becoming the first province/territory in Canada to pass a concussion law (virtually every state in the United States of America already has one). (Rowan Stringer was a female rugby player who sustained three separate concussions over a one week period and passed away shortly after the third one)

CTE – Chronic Traumatic Encephalopathy “Dementia Pugilistica” A neurodegenerative disease Accumulation of abnormal proteins in nerve cells in the brain. Resulting from multiple head injuries over a long period of time. Researchers finding it in autopsies of brains of former professional football/hockey players who showed, during life, signs of violence/crime, severe depression and suicide.

Brain Changes post-“concussion” (2017 St. Michaels Hospital – Toronto) Found in university athletes with a history of concussion, changes in size, blood flow and connection in their brains months and even years after the injury. Particularly in areas of vision and planning.

Resources Concussion Awareness Training Tool (cattonline.com) “Parachute” (parachutecanada.org) Centers for Disease Control and Prevention (cdc.gov)

Respect Your personal well-being and long-term health. If you suspect a concussion, remove yourself and access medical help. Your team mates. If you suspect a team mate has suffered a concussion, let your coach, medical or para-medical personnel know. Look out for each other.

Contact Health and Performance Centre 2nd Floor Powell Building (519) 824-4120 x 53039 Student Health Services (519) 824-4120 x 52131 or daily Walk-In Clinic