Patient Care at the ACC
We know that it can be difficult to diagnose and treat concussion, and to this end we have introduced a state of the art computer based cognition testing program (Cognigram).
This allows us to predict with more certainty and therefore safety, when a player is fit to return to play.
With the current concerns regarding long term harm to the brain as a result of recurrent Concussion, it seems sensible and legally prudent to use all means at our disposal to ensure a safe and medically appropriate return to play.
Frequently Asked Questions
How long will it take me to recover?
There are a few different factors including your age, sex and how long you were knocked out for.
The younger you are the longer it normally takes to recover. Females tend to take longer to recover than males. If you are knocked out for a longer period of time then the longer it will take you to recover.
Will I be able to work?
You will be tested on your cognitive state (how your brain is functioning) when you arrive at the clinic. From these results the doctor will be able to determine how quickly you can return to work. You may have to return to work part time for a week or two.
When can I get back into playing sport?
First of all, you have to pass your neuropsychometric test (Scat or Cognigram). Once you have passed this, you will embark on a 6-step return to sport protocol. This will normally take 7 to 10 days.
What is the 6 step return to sport?
Graduated Return to Sport Strategy
Goal of each step
1. Symptom-limited activity
Daily activities that do not provoke symptoms.
Gradual reintroduction of work/school activities.
2. Light aerobic exercise
Walking or stationary cycling at slow to medium pace. No resistance training.
Increase hear rate.
3. Sport-specific exercise
Running or skating drills. No head impact activities.
4. Non-contact training drills
Harder training drills e.g. passing drills. May start progressive resistance training.
Exercise, coordination, and increased thinking.
5. Full contact practice
Following medical clearance, participate in normal training activities.
Restore confidence and assess functional skills by coaching staff.
6. Return to play/sport
Normal game play.
What is the return to school process?
Graduated Return to School Strategy
Concussion may affect the ability to learn at school. The athlete may need to miss a few days of school after a concussion. When going back to school, some athletes may need to go back gradually and may need to have some changes made to their schedule so that concussion symptoms do not get worse. If a particular activity makes symptom worse, then the athlete should stop that cticity and rest until symptoms get better. To make sure that the athlete can get back to school without problems, it is important that the healthcare provider, parents, caregivers and teachers talk to each other so that everyone knows what the plan is for the athlete to go back to school.
Note: If mental activity does not cause any symptoms, the athlete may be able to skip step 2 and return to school part-time before doing school activities at home first.
Activity at each step
Goal of each step
1. Daily activities that do not give athlete symptoms
Typical activities that the athlete does during the day as long as they do not increase symptoms (e.g. reading, texting, screen time). Start with 5-15 minutes at a time and gradually build up
Gradual return to typical activities.
2. School activities
Homework, reading or other cognitive activities outside of the classroom.
Increase tolerance to cognitive work.
3. Return to school part-time
Gradual introduction of school work. May need to start with a partial school day or with increased breaks during the day.
Increase academic activities.
4. Return to school full-time
Gradually progress school activities until a full day can be tolerated.
Return to full academic activities and catch up on missed work.
If the athlete continues to have symptoms with mental activity, some other accomodations that can help with return to school may include:
Starting school later, going for half days, or going to only certain classes.
More time to finish assignments/tests
Quiet room to finish assignments/tests
Not going to noisy areas like the canteen, assembly halls, sporting events, music class, tech class, etc.
Use of a student helper/tutor
Taking lots of breaks during class, homework, fests
No more than one exam/day
Reassurance from teachers that the child will be supported while getting better
The athlete should not go back to sports until they are back to school/learning, without symptoms getting significantly worse and no longer needing any changes to their schedule.