An Athletic Trainer’s Role in Helping Prevent, Assess and Care for a Concussed Athlete

The role a certified athletic trainer (ATC) plays in preventing, assessing and caring for a concussed athlete is critical to an athlete’s return to play and overall health. The ATC is often the first line of defense in injury prevention, which is why it is essential they be on the field, court or arena where injuries may occur. 

As injury cases such as concussions, continue to evolve, keeping up with these progressions requires a careful adaption in the injury assessment treatment methods. To that, ATI Physical Therapy ATCs put a great deal of effort in staying up on monitoring symptoms along with implementing return-to-learn and return-to-play protocols. 

As far as preparation, ATI’s Sports Medicine division is pivotal in ensuring all ATCs are prepared to assess concussions by requiring them to undergo very specific and rigorous training programs that educate the team on current protocols prior to each sport’s season.

Concussion prevention

In an effort to thwart off a concussion, an ATC will continually work with their athletes to provide effective guidance and education on techniques that help with avoiding concussion-enabling situations. In doing this, an ATC will often follow these protocols:

• Ensure: Ensure that the players’ equipment is properly fitted and the playing environment is safe to participate.
• Educate: Educate coaches, parents and players before the start of the season about the inherent risks of a concussion and the proper protocol if a suspected head injury has occurred.
• Assist: Assist with strengthening programs that increase neck stability, which can decrease the frequency of concussions. 

Assessing concussions

In recent years, return-to-play success rates have steadily enjoyed a healthy uptick. With much help from researchers such as Dr. Ellen Shanley and her work on youth football tackling and training methods, concussion assessment protocols and tools continue to improve.  

There are several neurocognitive systems that most high schools utilize, which obtain a baseline test score pre-participation. As a result, if a concussion is suspected, a post-injury test can be performed immediately. In some states, there have also been increased state regulations that all high schools must follow. This has significantly improved the landscape of how concussions are assessed and treated.  

Concussion care

When an athlete is diagnosed with a concussion, an ATC is responsible for looking after the concussed athlete on a daily basis. Since every concussion is unique, each case must be handled individually to ensure the athlete is completing all the required steps and is ready to safely return to action. Traditionally, the stages ATI ATCs follow for a concussed athlete include:

• Education: It is crucial that a concussed athlete and their family be educated on the injury, what to expect and the next steps that need to be taken.
• Contact: After an injury occurs, the ATC is the point-person for any orders from the athlete’s primary physician for school modifications and symptom monitoring. When an athlete is symptom-free, the ATC will be in contact with their doctor, school nurse, coaches and athletic director to ensure the athlete advances on to the return-to-learn phase.  
• Return-to-Learn: The return-to-learn phase is when the athlete returns to school and begins working their way back to a full academic workload.  The ATC coordinates with the school nurses and councilors to ensure the athletes are following physician protocols and safely moving through the return-to-learn phases.  
• Return-to-Play:  Once the return-to-learn protocol is completed, the ATC completes a return-to-play progression with the athlete. This is a step-by-step process that ramps the athlete’s activity level back up. This serves to ensure that the athlete’s symptoms don’t return and that the athlete has the confidence to return to their sport they love to play.   

Spotting a concussion

Spotting a concussion is a method that continues to change in the concussion climate, which is why it is crucial an ATC be current on assessment protocols. In its most common form, a concussion can be spotted when an athletic trainer sees a head-to-head collision. A head-to-head collision is the most obvious indicator of a concussion and almost always warrants a thorough evaluation provided by an ATC. It is important to note that not all concussions come from head-to-head collisions.  Some concussions come from rapid rotation or can even be caused from smaller repetitive blows to the head.

Assessing a concussion in the initial stages can be tricky, which is why it is important athletic trainers connect with their athletes and get to know them personally to spot any unusual changes in their mood and energy. An ATC will put themselves in the middle of the athletes during timeouts and breaks during practices and games to get a read on their athletes, look at their eyes and ensure that everyone is healthy to participate. While an ATC serves as the team’s primary concussion-spotter, it is also important that athletes and coaches catch potential head injuries and communicate any potential issues with the team’s ATC.  

Recently, new technology in helmets can measure and notify athletic trainers when a high velocity impact has occurred. Athletes wearing this technology in their helmets will be pulled from practice or competition if an impact hard enough to cause damage occurs or if several smaller impacts have occurred and the sum of those collisions crosses a certain threshold.

Playing with a concussion

An athlete who continues to play with a concussion is putting their health at an increased risk of sustaining something called second impact syndrome.  Second impact syndrome is a condition that occurs when a second instance or injury occurs to the brain that has already sustained an injury that was not completed healed.  This has the potential to be a life-altering injury. This is why ATCs are so vital in preventing, assessing and caring for head injuries.  If you or someone you know has recently experienced a head injury, get it checked out right away. Stop by an ATI clinic near you or schedule a complimentary screening at ATI Physical Therapy today!