North Shore Concussion Care
North Shore Concussion Care is now part of NSSM!
Athletes are at risk of concussion when participating in many sports. Sports include rugby, ice hockey, field hockey, football, lacrosse, skiing or boxing but are not limited to these.
Workers who work in dangerous environments including those at risk of falling, as well as people involved in motor vehicle accidents can present with symptoms of acute concussion or post concussion syndrome.
Members of the general population may suffer a concussion from an accident around the home which resulted in taking a blow to the head.
We can provide updates to parents on their child’s injury from diagnosis to return to play via the Concussion Tracker App available for download at no extra cost.
Each time the patient comes in for reassessment and treatment the app is updated so parents or caregivers know exactly what stage their child is at in their recovery and what activities are permitted at each stage of that recovery.
The athlete’s safety is the primary concern for everyone involved. Coaches are often left not knowing how to proceed when they suspect a concussion and are doubtful about making the call. Witnesses are not always present at time of injury and the athlete can often misremember details. At North Shore Concussion Care we understand what coaches are often up against.
For some children, sport is the most enjoyable activity in a school week, while for others, it’s an activity they are reluctant to participate in. These children react to injury in different ways.
Though not as often, this can be the case with more senior athletes as well. An individual who is not that keen to play may appear to be more seriously injured; while the other who loves their sport may actually understate the injury or totally deny symptoms in hopes of remaining on the field which puts them at much greater risk for more serious injury.
Having a Baseline Test prior to participating in higher risk sports is another tool that our Physiotherapists can use to help with a diagnosis when symptoms are not apparent. If the athlete is diagnosed with a concussion then they must pass the Baseline Test and the Chicago Blackhawks Test prior to returning to contact sport. Recovery time varies among athletes but the vast majority are cleared for play at approximately 21 to 30 days post injury. Having a previous Baseline Test is not necessary prior to being treated for concussion.
Coaches look to parents to collaboratively make a decision on a child’s ability to return to sport, giving parents a unique influence. Some parents may play down the child’s symptoms in order to have them continue in their sport or sometimes not wanting to see the child miss out on a tryout. Other times parents are overly concerned for the child’s safety and the child is held back from participating in their sport when they are not at greater risk for injury than the rest of the team.
Parent education is key to a better understanding of what concussion really is and what to expect in the various phases of recovery. Our physiotherapists can be there to address concerns of parents and coaches and facilitate communication among all involved. Ask us about the Complete Concussion Management Tracker App which gives all of those involved an up to date look at the athletes current stage of recovery.
Administration and policies also affect how the coach perceives the severity of injury.
Serious mistakes have been made in the past with improper handling of injuries. Rowan’s Law was created after Rowan Stringer suffered three concussions within one week resulting in her tragic death. Since then laws have been implemented for coaches, trainers, and teachers to guide us in better management of injured children. Liability is huge in school and rules are put into place to not only protect the child but the administration as well. More pressure is put on the coaches when deciding when to allow a player to participate or to sideline a player following a potential concussion injury.
In some schools once a player is pulled from practice or a game they must have a doctor’s note prior to being allowed to return to play. Unfortunately the return to play criteria is often based on symptom resolution which we now know should not be the only criteria for a safe return to play. Objective testing prior to full contact is necessary. The coach can count on us at North Shore Concussion Care to ensure that the athlete has passed all tests prior to being cleared for full practice or competition.
We are available for free telephone consultations for coaches. We also offer no charge presentations on concussion management for coaching staff and teachers.
Immediately following our concussion assessment the patient’s physician is sent a letter with all the pertinent information including our diagnosis, date and mechanism of injury, symptoms at the time of injury and assessment, and our plan of management.
We follow the protocols outlined by Complete Concussion Management. They are currently developing an app specifically for physicians.
North Shore Concussion Care is a dedicated concussion prevention, care & recovery practice. NSCC provides proper management of the steps involved for complete concussion resolution. The protocols we follow are evidence based and we are updated monthly on the latest research findings regarding concussion. North Shore Concussion Care is now recognized by Complete Concussion Management Inc.™ (CCMI) and joins a network of clinics around the world offering evidence-based concussion care. From initial pre-season multimodal baseline testing to concussion treatment and rehabilitation, our partnered CCMI practitioners collaborate with primary care physicians to co-manage concussions, helping patients and athletes safely Return to Learn, Work and Play.
What is a Concussion?
A concussion is a brain injury caused by acceleration or deceleration of the brain within the skull following a significant impact to the head or elsewhere on the body. The impact causes a biochemical imbalance within the brain cells, resulting in decreased blood flow and temporary energy deficits within the brain. Symptoms may include loss of consciousness, headache, pressure in the head, neck pain, nausea or vomiting, dizziness, or balance problems, among others.
It can be difficult to predict recovery time and symptom resolution alone is not a safe indicator for return to sport. The higher the severity of symptoms in the first day or two can be indicative of prolonged recovery time. The lower the severity of symptoms in the first day, the more favorable the prognosis. Pre-existing anxiety or depression can lead to prolonged recovery. Rest is no longer considered best practice, 3 to 4 days maximum and guided by symptom exacerbation.
Concussion Baseline Testing (Individual)
Concussion Baseline Testing (Team)
Concussion Initial Assessment
Concussion Subsequent Treatment
Return to Sport Testing (Includes Impact Retest)
Return to Sport Testing (No Impact Test)
ICBC Concussion Initial Assessment
ICBC Concussion Subsequent Treatment