The recognition and treatment of athletes who have suffered a concussion has become both a national and local priority. An increase in a number of studies has shown that concussions in a limited number of cases can result in significant mental difficulties. These findings have led to mandates from the National Federation of High Schools (NFHS), Indiana High School Athletic Association (IHSAA), and National Collegiate Athletic Association (NCAA). The NFHS mandated rule states “any player who shows signs, symptoms, or behaviors associated with a concussion must be removed from the game or practice and shall not return to play until cleared by an appropriate healthcare professional.” Indiana State Law (IC 20-34-7) enforces the NFHS mandate and includes other provisions. A major provision of the law is that the athlete and the athlete’s parent must sign a consent form stating that they have been educated and they understand the significance of concussion management. The other provision of the law states that a high school or middle school athlete who is suspected of sustaining a concussion or head injury in practice or game, shall be removed from play at the time of the injury and may not return to play until the student athlete has received a written clearance from a physician trained in the evaluation and management of concussions and head injuries, and not less than twenty-four (24) hours have passed since the student athlete was removed from play. A physician trained in the evaluation and management of concussions and head injuries by law must meet all of the three following criteria:
- Must have a license given by a government agency that regulates a specific profession
- Must be listed in the Indiana Code as a health care provider
- Must have training in the evaluation and management of concussions and head injuries
Recovery from a concussion requires limitation and modification of physical activity that includes practice, drills, competition, and physical education classes. In these athletes, mental activities should also be limited and modified to allow the brain to heal. This often requires school accommodations. Activities such as watching TV, texting, playing video games, or surfing the Internet should be stopped or limited based on the doctor’s recommendations. These activities make the brain work harder to process information and can increase symptoms and recovery time. Clinton Central Jr./Sr. High School’s Sports Medicine staff, school nurse, faculty, and counseling staff will work with the managing doctor to identify what the athlete can do academically and with sports activities without increasing symptoms and delaying recovery. The most current evidence-based steps to ensure safe returns to sports activity include the following:
- The student-athlete must be evaluated by a physician trained in the treatment and management of sports-related concussion
- The student-athlete must be symptom-free at rest, including going through normal school days without symptoms.
- Normal neurologic examination administered in the office by a physician trained in sports concussion management.
- Post injury neurocognitive test results must be considered normal for the specific athlete by the managing doctor.
- The student-athlete must be symptom-free with a supervised gradual activity progression. The progression will be directly supervised by a Clinton Central certified athletic trainer.
- The student-athlete must receive written clearance from a physician trained in sports concussion management which includes use of neurocognitive testing.
Utilizing the above standards, as well as experience and judgement, the managing physician will be able to determine when the student-athlete has completely recovered from the concussion.
The Clinton Central Jr./Sr. High School administration, sports medicine staff, and coaches are striving to keep your child’s health in safety at the forefront of the student athletic experience. If you have questions regarding concussion management, please feel free to contact the school’s certified athletic trainer or school nurse.