PERMITTED TO RETURN TO PLAY WHILE SYMPTOMATIC FOLLOWING A CONCUSSION.
a) A student-athlete suspected of sustaining a concussion will be evaluated by the team’s Certified Athletic Trainer who will conduct a “Mild Traumatic Brain Injury Initial Evaluation” and will re- test the student-athlete using the GSC, SAC and BESS (SAC and BESS are conducted if student- athlete is able). The Certified Athletic Trainer will notify the UU Team Physician, Chris Lewis, about the student-athlete’s concussion. Dr. Lewis and the Certified Athletic Trainer will then develop an evaluation and treatment plan
b) Based on the student-athlete’s presence and progression of concussive signs and symptoms and post-injury scores, Dr. Lewis may see the student-athlete for evaluation and will then determine if the student-athlete’s condition warrants further testing, i.e. MRI, CT scans, or appointment with a neurologist.
UU ATEP Student Handbook Page 64 c) Student-athletes will be provided with written home instructions upon discharge; preferably with
a roommate, guardian, or someone that can follow the instructions.
d) An assessment of signs and symptoms will be performed at the time of the injury and then serially thereafter (i.e. 2-3 hours post injury, 24 hours, 48 hours etc). The presence or absence of signs and symptoms will dictate the inclusion of additional neurocognitive and balance testing. (SAC, BESS, ImPACT**).
e) The student-athlete will perform serial post-injury concussion testing using GSC, SAC and BESS. The serial test scores will then be compared to the student-athlete’s baseline scores and to scores from post-injury testing in previous days, in order to determine the discrepancy between baseline normal and post-injury and to track the progression/behavior of the signs and symptoms throughout the recovery process.
f) Student-athletes who sustain a concussion outside of their sport will be managed in the same manner as those student-athletes who sustain a concussion during UU athletics.
3.) If a student-athlete is diagnosed with a concussion and has symptoms that interfere with his or her ability to concentrate and participate in class and schoolwork, the Certified Athletic Trainer should contact Jon Abernathy, Director of Disability and Student Services, to inform him of the student-
athlete’s concussion and the need to miss class. The Certified Athletic Trainer should also include Katie Woodruff, Associate Athletic Director, on the email to Jon Abernathy. Union University faculty and staff should have received the Office of Disability Services (ODS) Concussion Policy, which delineates the accommodations to be made for student-athletes who suffer from concussive symptoms.
a. Faculty and staff are instructed to make accommodations for student-athletes suffering from concussive symptoms for five class days. If the student-athlete continues to suffer from
concussive symptoms that preclude him/her from participating normally in class, beyond the five class-day period, the student-athlete will be re-evaluated by Dr. Lewis. Dr. Lewis may refer the student-athlete to a neurologist for more specific testing and evaluation. The Certified Athletic Trainer will notify Jon Abernathy in ODS who in turn will notify the UU Faculty members. Please refer to Jon Abernathy and the ODS Concussion Policy for more detail.
b. In order for academic accommodations to be made, the Certified Athletic Trainer MUST provide Jon Abernathy with hard copies of the concussion evaluation and testing that was conducted for the student-athlete. The following paperwork should be included: MTBI Initial Evaluation form; Graded Symptom Checklist (GSC); Standard Assessment of Concussion(SAC, if able to perform); Balance Error Scoring System (BESS, if able to perform) and any other notes from physician exam, ER visit, etc. (if applicable).
c. The Certified Athletic Trainer should update Jon Abernathy daily about the student-athlete’s recovery process so that he may update the faculty and arrange accommodations.
4.) During the recovery period, The Certified Athletic Trainer will meet or speak to the student-athlete daily to track the progression of concussive signs and symptoms. The Certified Athletic Trainer will instruct the student-athlete to rest physically and also to allow for “brain rest.”
To allow for “brain rest” means not engaging in anything that may stimulate the brain to the point of making concussive symptoms worsen (i.e. class attendance, socializing, homework, job, computer, television, cell phone, etc). It is imperative that the student-athlete refrain from such activities in order to allow the brain to recover. Dr. Lewis may recommend that the student-athlete return to classes once he/she is asymptomatic during activities of daily living.
5.) Once the student-athlete meets the following requirements, he/she should be ready to begin the Extertional Return to Play Protocol:
a) Asymptomatic for at least 24 hours
b) Able to perform activities of daily living and attend classes with no recurrence of symptoms (function as a regular college student with no signs or symptoms). c) Post-concussion scores have returned to 95 % of the baseline scores.
UU ATEP Student Handbook Page 65 6.) The Certified Athletic Trainer reports the above findings to Dr. Lewis. He would then give the student-
athlete clearance to begin the Exertional Return to Play Protocol (ERTPP) (see below)
Five- Step Graduated Exertional Return to Play Protocol
This exertional protocol allows a gradual increase in volume and intensity during the return to play process. The athlete is monitored for any concussion‐like signs/symptoms during and after each exertional activity. The following steps are to be performed one step per day, for instance: step 1 on the first day the athlete is asymptomatic, step 2 on second day, step 3 on third day, etc. This protocol should be implemented, administered and monitored by a Certified Athletic Trainer.
Exertion Step 1: 20 minute stationary bike ride (10--‐14 MPH)
Exertion Step 2: Interval bike ride: 30 sec sprint (18-20 MPH) / 30 sec recovery (10--‐14 MPH) x 10 reps; and
bodyweight circuit: Squats/Push Ups/Sit-ups x 20 sec each x 3
Exertion Step 3: 60 yard shuttle run x 10 (40 sec rest between reps); and
plyometric workout: 10 yard bounding/10 medicine ball throws/10
vertical jumps x 3; and non-contact, sports‐specific drills for approximately 15 minutes
Exertion Step 4: Limited, controlled return to non-contact practice and monitoring
for symptoms
Exertion Step 5: Full sport participation in a practice
If at any time during the Exertional Return to Play Protocol the athlete begins experiencing concussive-like symptoms, the athlete will stop performing the exercise and will wait 24 hours before attempting the protocol again. After the 24 hour period, the athlete must be asymptomatic before attempting the exertional return to play protocol steps again. The medical staff (Athletic Trainers and Team Physician) will decide, based on the
athlete’s signs and symptoms, at which step in the protocol, the athlete will resume activity. The athlete must be able to complete all five exertional steps, without any recurrence of symptoms, before receiving clearance to return to full participation by the Team Physician.
No student- athlete can return to full activity or participation in practice or competitions until he/she is asymptomatic at rest and during school and exercise, has completed the ERTPP with no recurrence of concussive sign or symptoms and he/she is cleared to return to play by Team Physician, Dr. Lewis.