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411 on Athletic Trainers and Concussions

Published July 28, 2014

Q&A with Tim Hoskins: Assistant Manager of Sports Medicine at Vanderbilt Bone & Joint.

InFocus: Do we have an Athletic Trainer in each high school?

TH: Yes we have a Certified/TN Licensed Athletic Trainer in every Williamson County high school, which means eight Full Time athletic trainers. They arrive at their respective high school at 2 p.m. and stay until all practices and home games are finished.

InFocus: How do they handle multiple events going on at the same time?

TH: We always consult with the athletic directors about what event takes priority if multiple events are occurring at one time. A plan is always in place for safe play and access to care.

InFocus: What is the role of an athletic trainer?

TH: The role of the athletic trainer is basically to provide sports medicine care to the athletes of that given school – evaluation, treatment, assessment of injuries and concussions; and on occasion, we do some general/basic rehabilitation. We practice evidence based medicine to insure that we are using the most up to date methods.

Our role is primarily to prepare athletes for practice by taping, bracing, stretching and supervising practices and games for safety and emergent care. We also make assessments of those injuries and discuss that information with the parent/guardian. We pride ourselves on providing a safe environment for our student athletes to participate in. We also work with school administrators on Emergency Action Plans and review those yearly.

InFocus: A new law was enacted January 1, 2014, pertaining to concussions, is that correct?

TH: Yes, Public Chapter 148 of the 108th General Assembly was passed relating to youth sports-related injuries. You can read the public chapter here: http://www.tn.gov/sos/acts/108/pub/pc0148.pdf.

InFocus: What are common concussion symptoms parents and coaches should be looking for in their children/athletes? Take us through the steps from determining that a child has a concussion to returning to sports play.

TH: Some common signs and symptoms of a concussion include:

  • Headache
  • Pressure in head
  • Neck pain
  • Nausea or vomiting
  • Dizziness
  • Blurred vision
  • Balance problems
  • Sensitivity to light and/or noise
  • Feeling slowed down
  • Feeling “in a fog”
  • Difficulty concentrating or remembering
  • Fatigue or low energy
  • Confusion
  • Drowsiness
  • Trouble falling asleep
  • More motional
  • Irritability
  • Sadness
  • Nervous or anxious

Parents, if your child has sustained a concussion, some things you should watch out for include:

  • Athlete is difficult to wake up or sleepy all the time.
  • Athlete is not fully aware or has severe confusion.
  • Athlete has a severe headache.
  • Athlete has numbness/tingling or weakness in arms or legs.
  • Athlete has worsening symptoms.
  • Athlete has changes in vision.

Use these steps in the moment of a suspected head injury:

  1. Remove the athlete from play.
  2. Do not let athletes persuade you that they’re “just fine” after having sustained a bump or blow to the head.
  3. Ensure that the athlete is evaluated by a health care provider (MD, DO, or Clinical Neuropsychologist with Concussion Training). All should be experienced in evaluating concussions.
  4. Keep the athlete out of play until a health care provider clears them for participation and they have completed a step-wise return to play program.
  5. It is recommended athletes playing collision sports do a baseline ImPACT test prior to the start of the season. (Completed at the high schools). In the event an athlete sustains an injury during the following two years of their baseline test, the athlete will repeat the test once symptom-free for 24-48 hours. Those post-injury scores will be compared to baseline scores. If an athlete has already sustained an injury without getting baseline tested, the ImPACT testing can still be given and the scores compared with normal age-matched athletes.

The athletic trainers can manage the return to play protocol – they will monitor the player, including during the five-day return to play protocol. Communication also takes place between the athletic trainer and the treating physician.

InFocus: What advice do you have for new parents or parents whose child has never been injured pertaining to your athletic trainers?

TH: I would advise getting to know your athletic trainer. Usually our athletic trainers will have a parent meeting of some sort, though this is not always the case if there are scheduling conflicts. We have links on the WCS WEBSITE for our athletic trainers, and we are in the process of updating that information to include a headshot of the athletic trainer, a short bio of the athletic trainer, and their contact information and assigned school so parents/guardians will know who to look for on the field. We want to be accessible to our communities.