Football is undeniably America’s sport. Americans love it just the way it is–violence and all. After years of medical research, it’s safe to say that football players become concussed directly after blunt, sudden impacts to the head or upper body, like tackles and falls. So, if injuries like this are the problem, what better way to reduce the risk of concussions than to tone it down a bit?
A softening of the game has been discussed in the past, but was quickly dismissed. Despite strong research suggesting that repeated head injuries could lead to brain disease as well as other, potentially permanent disturbances in cognitive function later in life, an alteration to the sport was a no-go. But something had to give, and in 2010, it finally did.
In 2010, the NCAA adopted a concussion safety protocol to be implemented in all sixty-five member schools. It was developed by seasoned physicians, neurologists, athletic trainers, directors, coaches, conference administrators, and the NCAA itself.
NCAA Concussion Management Protocol Overview
Concussion management starts before a season even begins. A concussion safety protocol checklist is distributed to every member school, which includes an outline for the following:
Literature regarding concussions and concussion management are distributed to:
- Student athletes
- Team physicians
- Athletic directors
- Athletic trainers
Each party must sign an acknowledgement stating that they read and understood all of the material.
After the educational materials have been distributed, varsity student-athletes are required to receive a baseline concussion assessment which involves:
- Brain injury and concussion history
- Cognitive assessment
- An evaluation of balance
- Symptom evaluation
A team physician is required to give each varsity student-athlete individual clearance to move forward with the season. If a student-athlete has had multiple TBIs or a concussion in the past, it is recommended that they receive another baseline evaluation 6 months from the initial evaluation date.
Recognition and Diagnosis of a Concussion
Any student-athlete that displays any signs or symptoms of a concussion must be:
- Removed from play or practice immediately
- Evaluated by a certified athletic trainer or team physician (either D.O or M.D) with experience related to concussions
- Removed from play or practice for the remainder of the calendar date if a concussion diagnosis is confirmed
If a concussion is suspected, the pre-participation assessment is to be performed on the student-athlete with the addition of an assessment for skull fracture, intracranial bleeding, and trauma to the cervical spine by a medical professional.
If a concussion diagnosis is confirmed, written and/or oral documentation is to be provided to both the student-athlete and another adult, which can be a roommate or family member. After diagnosis, the remainder of the protocol requires that emergency transportation is readily available if the student-athlete exhibits any of the following symptoms:
- Prolonged loss of consciousness
- Continuously diminishing mental state or cognitive abilities
- Spine injury
- Glasgow coma scale < 13*
*The Glasgow Coma Scale is used to determine the level of consciousness/severity of a traumatic brain injury. The scale measures an individual’s ability to open their eyes and the state of verbal and motor responses. A mild score is between 13 and 15. Anything lower can result in permanent brain damage.
Since symptoms of a concussion can be salient, other complications could arise that need further diagnosis, such as:
- Mood disorders
- Headache disorders
- Sleep dysfunction
- Post-concussion syndrome
- Vision dysfunction (e.g. dizziness or vertigo)
Ultimately, it’s up to the team physician or other medical doctor to give the go-ahead to return to play. A stepwise management plan must be developed by a healthcare official with concussion-related expertise. The management plan requires that the student-athlete limits cognitive and physical activity until they return to baseline. Afterward, they can slowly start to re-introduce all of their usual routines.
When athletes don’t exhibit new or worsening symptoms while performing any of these functions, they’re on the right path:
- Light exercise without resistance training
- Football-related exercise with a lack of head impact
- Non-contact practice with progressive resistance training
- Unrestricted play
- Return to play
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