May Mailbag

Dustin.Fink Dustin Fink

As the sports season winds down at the high school I am finally getting to the various emails I have received. I do truly enjoy the many stories and questions I get here, often times they are very learned for me; which translates to more information for you the reader.

I picked out one such email and gained permission to reprint it here. The sole purpose of this email is to get feedback about the return to learn aspect of concussions. Tom would like you to give it a read and make comments below.

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Return To Learn in the High School

I am an athletic trainer in a high school in the north suburbs of Chicago. We have a concussion program in place and see about 80 concussion a year in our athletics. I am fortunate to have some control over the return to learn side of concussions in my school. I have found that this is essential in order to properly manage a concussion. I find when physicians only see an athlete once and set accommodations for a determined amount of time, it does a disservice. The same is true if the time between physician evaluations is too long, especially when kids are kept out of school for long periods of time. I find many concussion students don’t need to be out of school, and those that do usually have their symptoms decrease significantly within 1-3 days. Β Many times concussions progress rapidly and accommodations are not needed or can be quickly decreased. Sometimes they are needed and need to be adjusted based on what symptoms the student has when they return to school.

The shotgun approach for accommodations does not work well. When schools receive a general accommodations sheet, the accommodations tend to not be followed by the school or the student. Student and teachers are looking for clear instructions. Students need to be evaluated regularly and counseled through the concussion with specific accommodations based on current symptoms and evaluation. I think the athletic trainer is the person best equipped to manage the return to learn side of concussions in the high school. It seems to work best when the physician and the athletic trainer coordinate together to handle the return to learn side of concussions. Schools need to have an in-school healthcare professional monitor concussions, communicate with the treating physician, counsel the concussed athlete and manage school accommodations.

I would be interested in hearing physicians and other secondary school athletic trainers view on this subject.

Tom O’Connell, ATC, LAT