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Concussion Management Protocol for Park City Soccer Club
  • Baseline ImPACT testing completed
- Can be done anytime but ideally recommended before season begins
- Ideally this should be done annually especially for younger athletes
- If no individual Baseline test completed, should injury occur, athlete will be required to be cleared with medical and impact testing that is compared to age/gender norms
Should Injury Occur:
  • Acute Management Steps:
1.       Immediate Medical Triage / Record time of initial incident and Mechanism of injury
2.       Referral to Medical facility or EMS if warranted
3.       Any concern for head injury – athlete should be pulled from day of competition or training until further assessment      
4.       Parents given home care instructions and advised to go to website for follow up contact information for post injury assessment
5.       Coach informs PCSC Administration of incident
ANY signs/symptoms à NO return that day to sport
  • Further Assessment:
1.       Athlete monitored over 24-48 hrs by responsible individual for worsening symptoms or delayed responses.  Any worsening of symptoms à Medical Facility to be evaluated clinically with any additional testing as indicated; imaging studies.
2.       If no problems and symptoms improved or resolved, initial follow up evaluation to include:
·         Medical evaluation & clearance medically
·         Post concussive symptom survey (PCSS) – completed by athlete
·         SCAT – Sport Concussive Assessment Tool
3.       Coach / Parent / Trainer contact Think Head First CIC to notify for post injury ImPACT testing when symptom free & athlete is medically cleared.
  • Post Injury ImPACT Assessment:
1.       If the Medical Personnel clears athlete medically and athlete symptom free, then the post injury ImPACT screen can be completed.
2.       Think Head First CIC notified to arrange online ImPACT post injury screen. This testing is possible to accomplish online from anywhere with an internet connection.  Instructions will be given on how to access the post injury testing.
3.       Once test completed, Think Head First CIC will review ImPACT result and will subsequently and advise athlete, parent, coach and trainer if cleared by ImPACT post injury results to begin Return to Sport Progression

Return to Sport Recommendations
3 Basic Requirements Necessary to BEGIN Return to Sport Progression:
  1. Asymptomatic at Rest – REST from all activity and cognitive stress until all symptoms resolved.  Never return to sport if there are any symptoms.
  2. Normal medical exam – Normal Neurological screen – Normal sideline evaluation
  3. ImPACT Normal - post injury ImPACT test returned to baseline levels
Return to Sport Progression - General Guidelines:
- The following represents a generalized progression in activities that can be scheduled once the athlete is symptom free at rest. Generally, 1 or more levels can be completed daily before progressing to the next level.
- If ANY signs/symptoms return with any level of activity, stop and rest until symptoms clear and then begin at level where symptoms occurred.
Initial Recovery Conditioning:
  1. Activities of Daily Living – rest with light walking around home, etc
  2. Light Cognitive activity – reading, limited school work or computer work (short duration/15-20 minutes at a time with plenty of recovery between work intervals
  3. Low levels of physical activity such as hike, light jogging, stationary bike, etc for 20-30 mins with no return of symptoms.
  4. Light resistance training – lower weight, higher repetition weightlifting – No multi joint, high valsalva type exercises (Bench Press, Squats, Cleans)
  5. Moderate levels of physical activity - Increase intensity of aerobic activity with use of short 15-30 sec intervals interspersed within 20-30 mins of aerobic activity
  6. Moderate intensity resistance training – multi joint, higher resistance weight training but still below normal typical routine.
Sport Specific Conditioning with team à progression into full training à competition:
  1. Light warm-up at moderate speeds with emphasis on stretching, flexibility and limited core work. Participation in half the team warm-up. Individual skill work with short periods of juggling and individual foot skills concentrating on dribbling maneuvers and touch. Work periods alternate with recovery with 2x recovery to work.
  2. Full supervised warm-up with team. Continue with foot skills and combine with partner/coach and progress to training in pairs with emphasis on shadow dribbling and paired passing drills. Progress to 1 v 1, 2 v 2 in a limited controlled space. Emphasis on work rate not contact. Start to do limited/stationary paired heading drills. Allow player to participate in numbers up playing situations as offensive only neutral player with no contact.
  3. Full training load with contact – player can progress to all skills with interval training loads emphasizing high intensity work with periodic rest. Player can participate in all drills and small sided games as well as full scrimmage with time limited based on demand, exertion and fatigue.
  4. Return to full competition. Limited to short periods in the beginning of games and each half where the intensity tends to be less than the more contested moments near the end of the half or conclusion of the game. Increase load gradually with longer playing stints.