The UofL Health Sports Medicine Institute is dedicated to providing the best care and treatments for athletes who have suffered concussions.  Our team of experts cares for athletes of all levels and ages, including high school, college, club, recreational, and professional.

In the event of a possible concussion during the practice of a sporting event, evaluation by a trained health care professional who is experienced in concussion treatment is critical.

UofL Health currently provides athletic training and concussion management services to area high schools.  A Certified Athletic Trainer may provide both the interview and examination on the sideline or in the athletic training room.

  • Interview conducted by a medical provider asking about the event and mechanism leading to the head injury. They will also ask about current symptoms, co-occurring injuries, pre-existing medical conditions, including mental health conditions, previous concussions, and course of symptoms since the time of injury.
  • Examination for any neurologic signs or symptoms, including tests of strength, vision, eye movements, hearing, reflexes, balance, coordination, mental status and cognition, and other neurological functions.

Athletic Trainers will determine if an athlete should be withdrawn from activities and facilitate referrals to other medical providers, as well as facilitate return-to-play.

Sports-related concussion management services are located at the following locations:

UofL Physicians – Sports Medicine Institute
Cardinal Station
215 Central Avenue, Suite 201
Louisville, KY 40208
(502) 63-SPORT or (502) 588-4904

UofL Health Sports Medicine
UofL Health – Medical Center Northeast
2401 Terra Crossing Boulevard
Louisville, KY 40245
(502) 210-4600

What can happen if an athlete returns to competition too soon?

Returning to competition too soon could put you at risk for a second concussion.  A repeat concussion that occurs before your brain has recovered from the first one is called Second Impact Syndrome.

Second impact syndrome can:

  • Make your symptoms last longer than they would have if you rested and fully recovered
  • Slow your overall recovery
  • Increase the chances of long-lasting or permanent problems

Long-lasting problems may include difficulties with memory and concentration, headaches, and some physical skills like maintaining your balance.

Return-To-Play Protocol

After a concussion, an athlete should only return to sports practices and activities with the approval and supervision of a healthcare provider.  Return-to-play protocols are a set of procedures and steps for safely returning an athlete to play following a head injury.  

Athletes will be guided through the protocol by their physician, and when available, a certified athletic trainer.  For student-athletes, considering how the student is performing within the classroom is also necessary.

STAGE

PHASE 1


PHASE 2


PHASE 3


PHASE 4


PHASE 5

TRAINING

  • As symptoms are lessening, light stretching and balance training may be performed.
  • Stop if symptoms increase.
  • Light aerobic exercise (e.g. bike for 15 minutes).
  • Athletic Trainer will repeat objective-based concussion tests.
  • Moderate, sport-specific exercise (e.g. running, agility drills, throwing, kicking) for 30 minutes or less.
  • Heavy, non-contact practice. Position-specific and strength training.
  • Athletic Trainer will repeat objective-based concussion tests.
  • Unrestricted return-to-sport.
  • Requires clearance from medical provider.

Click here to learn more about returning to the classroom following a concussion. (Hyperlink to Return-to-Learn education materials).

What can I do to help prevent a concussion?

There are many ways to help reduce the risk of a concussion.

  • Wear a properly fitted helmet. Athlete should have properly fitted equipment in good condition to reduce the risk of serious brain injury or skull fracture. Of note, there is no such thing as a "concussion proof" helmet. 
  • Wear a mouthguard. Recent studies have shown that wearing a mouthguard lowers the rate of sustaining a concussion.  There are a number of theories suggesting why mouthguards may be beneficial.  Some suggest a mouthguard may help absorb a blow from under the chin and biting down on a mouthguard may activate neck muscles reducing head acceleration.  Other studies from the dental profession show that wearing a mouthguard offsets the jaw bones and in return may reduce the forces transmitted to the brain.
  • Strengthen neck muscles. This is particularly important for athletes, as a stronger neck may be able to absorb some of the shock of the blow to the head. 
  • Improve your reaction time and vision. Research suggests the faster an athlete can react to different forces and stimuli, the more they are able to prevent themselves from having a severe head impact.
  • Promote a culture of safety. Educate parents and athletes on the risk of concussion, protocols, and the importance of reporting symptoms.

Click here to find sports-specific prevention and safety tips.

References

  • Honda, J., et al.; The effects of vision training, neck musculature strength, and reaction time on Concussions in the athletic population; Journal of Exercise Rehabilitation; Oct. 2018; 14(5): 706-712
  • Ono, Y., et al.; Association between sports-related concussion and mouth guard use among college sports players: A case-control study based on propensity score matching; International Journal of Environmental Research and Public Health; June 2020; 17 (12): 4493
  • Chisholm, D., et al.; Mouth guard use in youth ice hockey and the risk of concussion: nested case-control study of 315 cases; British Journal of Sports Medicine; 2020; 54: 1019-1017
  • Giannakopoulos, N., et al.; 2013; Neuromuscular interaction of jaw and neck muscles during jaw clenching; Journal of Orofac Pain; Winter 2013; 27 (1): 61-71

Chander, V.; Mouth guards may reduce concussion risk in youth ice hockey players; Reuters; January 28, 2020

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