LiveActive Sport Medicine Health and Performance is an official Complete Concussion Management™ clinic.  Concussions have become the focus for both professional and amateur athletes around the world, and LiveActive Sport Medicine Health and Performance strives to be at the forefront of concussion diagnosis, management, and rehabilitation.  We utilize a comprehensive, multi-modal approach to concussions, based on current advances in concussion research.

What is a Concussion?

A concussion is a disruption in neurological functioning following a significant impact to the head or elsewhere on the body.  This causes a biochemical imbalance within brain cells as well as decreased blood flow and temporary energy deficits within the brain. Individuals who sustain a concussion frequently complain of headache, feeling “out of it”, feeling off balance and dizzy. They may also have neck pain, mood and sleep changes and difficulty thinking, remembering and concentrating. Light, noise and “busy” situations may make them feel worse.

Following a suspected concussion, a player should be immediately removed from play, assessed and placed on complete rest in order to recover from the energy deficit. This is particularly true for children and adolescents and in recreational sports where on- site trained medical care is usually absent. For non- sport concussions, stopping all activities and starting complete rest is also necessary. Assessment by a trained and knowledgeable health care professional is recommended within the next 24-48 hours to confirm whether or not a concussion has occurred.

What are “Red Flags” in Concussions

A “red flag” is meant to indicate danger, or high alert. In concussions, red flags are helpful to ensure there are no more serious injuries present, like bleeding into the brain or brain swelling. If “red flags” are present, immediate medical care should be sought.

Here are the “Red Flags” or “Danger Signs” according to Centre for Disease Control, Atlanta, USA

Danger Signs in Adults

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. Contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:

  • Headache that gets worse and does not go away.
  • Weakness, numbness or decreased coordination.
  • Repeated vomiting or nausea.
  • Slurred speech.

The people checking on you should take you to an emergency department right away if you:

  • Look very drowsy or cannot be awakened.
  • Have one pupil (the black part in the middle of the eye) larger than the other.
  • Have convulsions or seizures.
  • Cannot recognize people or places.
  • Are getting more and more confused, restless, or agitated.
  • Have unusual behaviour.
  • Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored).

Danger Signs in Children

Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:

  • Have any of the danger signs for adults listed above.
  • Will not stop crying and cannot be consoled.
  • Will not nurse or eat.

If there are no red flags then rest at home is the best medicine in the first day or two. Then it’s time to have the concussion assessed. The off field assessment, often in your health care provider’s office will include a variety of assessments to gather information about how the athlete/ person feels, balance, memory, coordination and eye movements.

Studies have shown that activity, both mental and physical, in the immediate 1-3 days following concussion can delay the process of recovery. This may mean no school or work, no sports and no activities that make the symptoms (how the person is feeling) worse.

Another major concern surrounding concussions comes from the energy deficit that occurs in the brain following injury.  When the brain is in this low energy state, scientists have established that the brain is extremely vulnerable to additional trauma, where even smaller impacts can lead to another concussion. These second concussions can cause severe brain injuries with potentially permanent or fatal outcomes.

When do Concussions go away?

The time when symptoms go away or improve does not always mean the brain has fully recovered.  Individuals may feel better within days of a getting a concussion. In order to know when the brain has fully recovered and out of this “vulnerable period” testing different aspects of current brain function can be done.  This post injury assessment is multi- modal and evaluates symptoms but also memory, concentration, balance and proprioception, eye movements, reaction time and strength, all shown to be impaired following a concussion. For individuals in high-risk sports (e.g. football, hockey or rugby) or who have completed a baseline test, computer based neurocognitive testing may also be performed.

Fortunately, about 80-90% of people who get a concussion will recover in about less than a month. Many recover in about 2 weeks. Younger athletes take longer. Each concussion is different, so a person’s concussion may take a little less or a little more time.

What is baseline testing?

A baseline test is a battery of tests that measures various areas of brain function that could potentially become affected following a concussion. It is completed when an athlete is healthy, and does not have a concussion. At LiveActive Sport Medicine baseline testing includes the evaluation of:

  • Memory
  • Concentration
  • Visual Processing/Visual Movements
  • Reaction Time
  • Balance and Proprioception
  • Motor Strength
  • Neurocognitive Testing

Baseline testing has been used for high level or high-risk athletes for many years. High- risk athletes are those who play contact or collision sports like hockey, football, rugby but also those where concussions occur often- like soccer, basketball, skiing and snowboarding. Most research on baseline testing has been done with university and college athletes.

The reason that the test is termed a “baseline” is because it is done before an athlete gets injured.  By comparing how an athlete performs on the same tests before and after a concussion we may better know when the athlete has fully recovered.

Baseline testing is done prior to beginning of the sports season, and is suggested on a yearly basis. Baseline tests in very young children may not be as helpful as in those over the age of 10.

What’s new in Concussion Management?

Before, it was recommended that concussed individuals rest until all symptoms were gone. However, for many, symptoms changed over time and often patients felt worse and experienced more distress. Now it is felt that any activity, excluding organized sports, that does not worsen symptoms may be acceptable. This is important for everyone with concussions but especially for the small numbers who continue to have symptoms after one month.

Researchers have shown that continued rest after 5- 7 days may not be as helpful as once thought. A groundbreaking study by researchers in Ottawa showed that children who rest too long are more likely to have persistent symptoms. Children, who rested less and began light activity after about 7 days, did better. Other scientists in Buffalo have also shown that exercise, particularly in those with symptoms at 3 – 4 weeks, is beneficial to recovery. There are many suggested reasons for this and include improved brain circulation, restoring more normal routine and social connections and maintained fitness.

LiveActive Sport Medicine and Complete Concussion Management™:

Complete Concussion Management™ is a concussion research company that educates healthcare practitioners on cutting-edge concussion therapies and management strategies based on the most current medical research so that they may provide the highest quality of concussion treatment and follow-up outside of professional sports.

The LiveActive Sport Medicine Certified Complete Concussion Management™ practitioners are continuously updating their knowledge of current research and treatments in order to manage these injuries properly and safely to optimize adequate recovery, reducing the risk of further injury and long-term brain damage.

LiveActive Concussion Services:

  • Post-injury diagnosis and injury management
  • Concussion rehabilitation for Post-Concussion Syndrome
  • Coach & trainer education and certification programs
  • Comprehensive baseline testing

The CCMI Network:

  • LiveActive Sport Medicine can work with any CCM clinic across Canada because of the large network of specialized CCM concussion clinics.  Athletes tested at LiveActive Sport Medicine can access any CCMI clinic.
  • All of these clinics have received the same training, are conducting the same tests with the same equipment.  This means that if you are out of town for a tournament and you get a possible concussion, you can book an appointment at that clinic and be assessed. The LiveActive Sport Med info desk is notified that you have a concussion and will be ready to help with your recovery when you return home.