2010 Massachusetts
Health Advisory
What schools are covered by this new
law?
The law specifically states that public
and other schools subject to MIAA rules
are required to participate.
However, because sports related
head injuries and concussions can have
such serious consequences for students,
including long term health and
educational issues if they are not
properly managed, the Department
strongly encourages all schools whose
students engage in extracurricular
athletics to include these trainings as
part of their athletic programs.
The decision about when an athlete is
cleared to return to play falls upon the
student's physician. This decision
is sometimes made in consultation with
the concussion specialist.
Who needs to participate in a Sports
Head Injury and Concussions Awareness
Course?
The law says that the following people
must participate in this training
program:
·
Coaches
·
Athletic trainers
·
Parent volunteers for any extracurricular athletic activity
·
Physicians employed by the school or who volunteer for any
extracurricular athletic activity
·
School nurses or nurses who volunteer for any extracurricular
athletic activity
·
Athletic Directors
·
School marching band directors
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Return-to-Play -
When should an athlete return to
competition?
There are no hard and
fast rules for when athletes are
permitted to return to the sport they
love aside from the accepted practice
that "same game" returns are
strongly discouraged. It was previously
thought that athletes could return to
play if they had only received a grade 1
concussion and they quickly returned to
baseline. This is no longer the
standard of care for concussion
management. The grading system is
less emphasized than previously and
individual athletes are measured using
sideline tests that measure cognitive
functions such as concentration, memory,
and orientation.
Return to play should be carefully
managed by the team physician and
trainer. No player should go from
zero percent play to 100 percent play
without monitored, "symptom free"
exertion. In the context of youth
sports, CAMP offers preseason training
and support to coaches, parents, and
players about concussion and the
consequences of returning to the game
before being fully healed. As with
other medical history, it is a good idea
to have an idea which athletes may be
more vulnerable to concussion before
competition begins. Returning to
play after concussion requires a
stepwise process that monitors athletes
at each phase of their return.
Athletes are followed during recovery
with exertional testing and should not
play if they are at all symptomatic.
In cases where no physician or trainer
are available coaches and parents often
supervise the specific exertion protocol
outlined by the physician or concussion
specialist. A specific return to
play protocol outlining gradual increase
in activity has been established by the
Concussion in Sport Group as follows (Aubry,
Cantu, Dvorak, Graf-Baumann, Johnston,
Kelly, Lovell, McCrory, Meeuwise,
Schasmasch, 2001. Clinical J. Sports
Med.)
- Rest
- Aerobic exercise (.e.g.,
stationary bicycle)
- Sport Specific training (e.g.,
running, skating)
- Non-contact drills (includes
cutting and other lateral movements)
- Full-contact controlled training
- Full-contact game play
CDC Heads Up
- Facts for Physicians U.S. Dept. of
Health & Human Services
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