Sports Concussion Program

Bumps, blows or jolts to the head can cause brain injuries known as concussions. When these injuries happen, the brain moves rapidly back and forth, and this motion results in a chemical imbalance that affects the proper functioning of the brain.

Symptoms of a concussion include:

• Headache
• Dizziness
• Cognitive symptoms, such as difficulty concentrating, short-term memory problems or slowed mental processing
• Sleep symptoms, such as difficulty falling asleep or staying asleep, increased fatigue or altered sleep schedule
• Emotional symptoms, such as irritability, sadness or anxiety

How we help youth and young adults

In May 2009, the Zackery Lystedt Law went into effect in the state of Washington. This law requires all student athletes with suspected head injuries to be removed from play until cleared by a licensed health care provider trained in the evaluation and management of sports-related concussions.

The goal of our Sports Concussion Program is to provide leadership and advanced care for adolescent, teen and college athletes with concussions. The program brings together the vast knowledge and expertise of:

• Our sports medicine specialists at MultiCare Orthopedics & Sports Medicine
• Pediatric neuropsychology and neurology specialists at Mary Bridge Children’s

The MultiCare Sports Concussion Program offers:

• A unique partnership between sports medicine and neuropsychology experts
• Neurocognitive assessment using the ImPACT system, a computer-based testing tool
• Case collaboration with community physicians through our long-running Concussion Board
• Prompt, high-quality care

Concussions can affect a student’s academic performance in many ways:

• Slower processing speeds
• Lapses in short-term memory
• Reduced/impaired concentration
• More time needed to learn new concepts
• Shorter attention span

Temporary cognitive struggles following a concussion can create anxiety in student athletes and their families. Coaches, teachers, school administrative staff, medical providers, family and other caring adults all have a role to play in supporting students during this time.

It’s important to note there is no one-size-fits-all approach or designated length of time for concussion recovery. For a return to learning to be effective, all involved need to understand this and be flexible. The process of returning to school will likely involve some trial and error.

Create a plan

A licensed health care provider should initiate a student’s return to school and create a written plan for school staff so they can facilitate this process.

There should be a staff member at each school who serves as the primary point of contact for the student, family and concussion management team and advocates for the student’s needs. This can be the school nurse, athletic trainer, or school guidance counselor; the appropriate person for this role may differ by school.

When a student returns to school, the focus should be on mastery learning — completing schoolwork that shows the student has mastered a subject before moving on to additional subjects. This focus on essential academic assignments reduces anxiety about falling behind in school when it is difficult for students to keep up with a full workload. Anxiety can be a factor in slower recovery if assignments mount up.

Early intervention is also key — developing a plan for returning to school early in the injury course can:

• Alert teachers and school staff that help is needed
• Decrease anxiety about falling behind in school, which can complicate recovery for the student athlete
• Lead to better communication and trust between medical providers, school staff and families 

Follow a phased approach

Not all student athletes will necessarily need to go through each phase listed below when they return to learning following a concussion. There will be variability from person to person, so flexibility in the application of these phases is important. In cases of mild concussion, some students may not need a return-to-learning plan.

Please note that students with longer recoveries may require a specialized learning plan such as a 504 plan or an individualized education program (IEP).

MultiCare Sports Medicine physicians collaborate with other licensed and trained professionals, such as athletic trainers at Olympic Sports & Spine, to guide student athletes safely through their return to sports after a concussion.

We use multiple tools — such as the results of clinical exams and neurocognitive assessments — and consider a number of factors when deciding the appropriate timing for a student’s return to sports. Some of those factors include how well a student’s symptoms have resolved and how well they have tolerated a return to school and physical activities.

Six steps for returning to play

Student athletes typically follow a gradual approach when returning to sports by following the steps below. Athletes should spend 24 hours at each step before advancing to the next. However, depending on the status of their overall recovery, they may remain at a certain step for longer or they may need to return to a preceding step if symptoms recur.