Concussion: Education and Protocols for Safer Sport

1. Concussion: Education and Protocols for Safer Sport Stephanie Cowle, Parachute

2. Would you skydive without a parachute? • Canada’s national charity dedicated to preventing serious and fatal injuries • Evidence-based solutions, advocacy and education

3. About Me • 10 years in Injury Prevention • Knowledge Translation = Evidence to practice • Collaborate with more than 40 sports, including Skate Canada’s Safe Sport staff • Am *this close* to learning how to skate backwards

4. The Plan In this session you will learn: • the basics of concussion • key components of a concussion protocol • resources available to help you build safe sport

5. Concussion: The Basics

6. A concussion is a brain injury. • It can affect the way a person thinks, feels, and acts. • It can’t be seen on X-ray, CT or MRI.

7. A concussion can happen without a direct hit to the head. A concussion can be caused by: • a blow to the head, face or neck • a blow to the body

8. force of the blow causes the brain to move around inside the skull

9. Skate examples: • colliding with another skater • hitting your head on the ice • sliding hard into the boards • falling during off-ice training

10. Most concussions are not sport-related. • Concussions can happen in sport and non-sport activities. • Youth (10-19) are most likely to have a sport-related concussion. • Falls and car crashes are common causes.

11. Females are at risk, too. • Higher number of concussions in males. • Higher risk among females. • Longer recovery among females.

12. You don’t need to be knocked out. • Only about 10% lose consciousness. • Losing consciousness could be a sign of a more severe injury. (Red Flag) • Most common symptom: Headache

13. Rest, but not TOO much rest. • Rest and sleep are important for brain healing. • Don’t wake the person through the night. • 24-48 hours initial rest. No more “bedroom jail”.

14. Most people get better in 1 to 4 weeks. • Youth: up to 4 weeks • Adults: up to 2 weeks • Longer than this? “Persistent symptoms” • Most people don’t need specialty care.

15. Safe Sport: Concussion Protocol

16. A Canadian Approach to Concussion • F/P/T efforts since 2016 • Public Health Agency of Canada • Sport Canada • 45 NSOs including Skate Canada • Coaching Association of Canada • SIRC

17. Canadian Guideline on Concussion in Sport • parachutecanada.org/guideline • parachutecanada.org/lignes-directrices

18. Concussion Best Practice Pre-season education Head injury recognition Medical Assessment Concussion management Return to school, work and sport ⇣ ⇣ ⇣ ⇣

19. 1. Pre-Season Education Everyone should be aware of: • what a concussion is • potential causes and symptoms • prevention • their organization’s protocol + agree to follow it • how to safely return to regular activities and sport

20. Education: How? • Provide education resources • Post information at rinks and training facilities • Hold pre-season team meetings • Include concussion at meetings/events (just like this!) • Provide access to free training resources

21. 2. Head Injury Recognition • Everyone has a role to recognize • It only takes one sign or symptom Recognition is not diagnosis.

22. Recognition: How? • If a skater sustains a significant impact to and reports anysymptoms or demonstrates any signs of a concussion. • If a skater reports any concussion symptoms to one of their peers, coaches, trainers, parents, teachers. • If anyone witnesses a skater exhibiting any signs of a concussion.

23. Recognition: How? Common signs and symptoms: • Headache or pressure in the head • Dizziness • Nausea • Trouble concentrating or remembering • Unusual emotions (e.g., irritability) • Drowsiness or fatigue

24. Red Flags: Signs of a more serious injury • Loss of consciousness • Seizure or convulsion • Neck pain • Vomiting more than once • Getting more and more confused • Headache is severe and getting worse • Double vision • Weakness/tingling in arms or legs ! Call 911

25. 3. Medical Assessment Emergency? (Red flags) • Emergency medical services will assess and transport to hospital

26. 3. Medical Assessment Not an emergency? (No red flags) • Safely remove the skater to a quiet area. • An experienced, licensed healthcare professional (e.g., AT, PT, MD) can do an initial assessment. • The skater should be checked as soon as possible by a medical doctor or nurse practitioner.

27. Medical Assessment: How? • Remove anyone with suspected concussion from training or competition immediately. • Contact the skater’s parent/guardian or emergency contact to pick them up. Don’t leave the skater alone. • Let the skater/parent/guardian know they need to get checked out.

28. 4. Management No concussion? • Return to activities

29. 4. Management Diagnosed concussion? • Follow a step-wise return to school, work and sport-related activities • Medical clearance before full return to sport

30. Return-to-Sport Strategy • Principles: • At least 24 hours per stage • No new or worse symptoms

31. Return-to-Sport Strategy 24-48 hours initial rest. Stage 1: Symptom-limiting activities • Daily activities that don’t provoke symptoms • Moving around home, reading, etc.

32. Return-to-Sport Strategy Stage 2: Light aerobic activity • Light intensity stationary cycling or jogging • No resistance training. • Start increasing heart rate

33. Return-to-Sport Strategy Stage 3: Individual sport-specific exercise with no contact or head impact activity • Skating drills (e.g., stroking, then turns) • Core, stabilization, flexibility exercises • No twizzles, jumps, spins, lifts, throws • Add movement

34. Return-to-Sport Strategy Stage 4: Non-contact training drills • Run through skating program, starting with singles and progressing to doubles • May progress to off-ice triple jumps • May start progressive resistance training • Coordination and increased thinking

35. Return-to-Sport Strategy Stage 5: Full contact practice following medical clearance by a doctor • Full skating program with jumps • Try adding spins outside program • Full training, conditioning (limit jumps) • Restore confidence and assess skills

36. Return-to-Sport Strategy Stage 6: Return to sport • Normal on-ice and off-ice activity with no restrictions

37. Management: How? • Use the strategy as a guide, but individual recovery will differ • Communication among coach, skater, trainer, parent/guardian – possibly others • Return to school and work before full return to sport

38. Education Recognize & remove Get assessed Gradual return to sport and activity. Communication

39. Safe Sport: Concussion Resources

40. Education & Awareness • Skate Canada Safe Sport poster, brochure • Concussion Ed mobile app

41. Education & Awareness • Parachute concussion guides for coaches/trainers, parents, and athletes • Pre-season concussion education sheet

42. Education & Awareness: Free Training www.cattonline.com Making Head Way www.coach.ca/concussion

43. Education & Awareness Campaign materials at sirc.ca/concussion

44. Concussion Recognition • Skate Canada Safe Sport concussion recognition tool • Concussion Ed mobile app

45. Medical assessment and clearance • Medical assessment letter template • Medical clearance letter template

46. Access these resources and more: skatecanada.ca/safe-sport parachutecanada.org/concussion

47. Thank You! @parachutecanada www.parachutecanada.org