Sports are a wonderful way for children and teens to stay physically fit, make friends, and learn to be team players. But accidents happen, and concussion is a real risk. That’s why Marin County instituted its Concussion Management Program.
In this podcast, MarinHealth Athletic Trainer Marcella Shorty explains how she assesses potential concussions right on the sports field, based on the Sports Concussion Assessment Tool, a step-by-step evaluation for a potential head injury. Some youngsters may not realize they have concussion symptoms, while others try to mask the symptoms so they can get back in the game. Shorty makes sure kids are benched and parents are called so their child can be evaluated by a healthcare professional.
Concussions and Sports: What Parents Need to Know
Featured Speaker:
Marcella Shorty, M.Ed., ATC, CES
Marcella Shorty is a MarinHealth athletic trainer. She currently works with all of the athletic teams at Tamalpais High School. She previously worked at the University of Carolina, Stanford University, and Temple University. She received her bachelor's degree in athletic training at the University of New Mexico and a Master of Education Degree in Athletic Training at Temple University. Transcription:
Concussions and Sports: What Parents Need to Know
Bill Klaproth: The risks and dangers of concussions have finally been recognized over the past few years. We of course hear about concussions in football, but other sports carry the risk as well. So let's talk about the Marin County Concussion Management Program designed to help students and parents navigate concussions in sports with Marcella Shorty, Marin Health Athletic Trainer working at Tamalpais High School.
This is the Healing Podcast brought to you by Marin Health. I'm Bill Klaproth. Marcella, thank you so much for your time. It is great to talk with you. So you're an athletic trainer working with students at Tamalpais High School. Can you tell us a little bit about your role?
Marcella Shorty: Sure. My role as an athletic trainer is to evaluate, treat and provide care for athletic injuries and illness that the students might have. I also work to help prevent injury and as well as rehabilitate once they get an injury.
Bill Klaproth: Right. Well, thank you for that. And, of course, we want to talk about concussions on this podcast because it is a hot topic and very worrisome for a lot of parents and students. So can you tell us a little bit about the Marin County Concussion Management Program?
Marcella Shorty: Yes. The ConcussionSmart Marin Program comprises of healthcare professionals. We formed a coalition to coordinate countywide protocols for educating, reporting and treating concussions hopefully to provide a more consistent way to treat concussions that we can all follow and help each other out.
Bill Klaproth: So then what happens if a student gets a head injury during a sporting event and you suspect it might be a concussion? What happens then?
Marcella Shorty: Say we're at a football game and the student comes off to the sideline and looks a little dazed or not acting right, I would immediately remove them from the game and you start to evaluate and examine for a possible concussion. One tool that I have that I use is called the SCAT5. SCAT5 is short for Sport Concussion Assessment Tool. And it's a step by step evaluation that includes the student's concussion history, current symptoms, a cognitive screening, a neurological screening, a balance examination and delayed recall ability, all of which can be affected by head injury.
So then, we go through that test. It kind of helps me determine whether it might be a concussion or not. If it turns out there's a lot of symptoms that are pointing to a concussion, then I would contact the parent or guardian and we get them to their primary care physician or urgent healthcare center for more evaluation by a physician.
Bill Klaproth: Right. Are you administering that test on the sidelines then?
Marcella Shorty: Yes, we are. It's a sideline test and we go through it step-by-step.
Bill Klaproth: Okay. So the player is removed, you go through the evaluation step-by-step. And then after the game, you will make a recommendation on sending that student for further testing. Is that right?
Marcella Shorty: Correct. Speak with the parents and tell them what our findings are. We have a couple forms that we send with the student and the parents, so they can give it to their physician and tells what our findings are and then go from there.
Bill Klaproth: So then what happens then? Are there rules for how soon a player can go back to their sport after they have a concussion or a suspected concussion?
Marcella Shorty: Yes. That's part of the protocol that we follow. So the student, once they go to the doctor or the physician and they make a diagnosis of concussion or not, the student has to then follow the protocol where they have to be symptom-free for up to 48 hours. And at that point, we can start a return-to-play progression.
And the return-to-play progression is a series of days you add activity. So the first day, it might do something simple like walking a mile. If the student remains symptom-free for 24 hours, you can go to the next activity, which might be jogging for five minutes So there's a system that we progress each activity daily. But if the student does have a symptom, then we have to go back. So they have to always remain symptom-free. And we also have to follow the physician's guidelines for that.
Bill Klaproth: Absolutely. Good to know there is a definite procedure in place before kids can return to play. So the big question is how common are concussions? We see these players take these hits and they do look a little bit wobbly and sometimes they go right back in. But I would imagine there's a big percentage of kids who take the hit, they don't want anybody to see anything and they just get right back in the game and keep playing, which isn't good. So this probably happens a lot more often than we think. So do you treat lots of kids with concussion issues each year?
Marcella Shorty: Absolutely. The CDC estimated there's between 1.6 and 3.8 million concussions in sport and recreational activity a year. Like you just said, many go unreported. A lot of times they don't know they're having a concussion and a lot of times they don't want to admit they have a concussion symptom. They don't tell anybody. Even in high school sports, it's estimated there are 300,000 concussions over a school year So that's quite a few concussions over a year.
Bill Klaproth: Wow. That is a lot. I didn't think that many.
Marcella Shorty: Well, football is probably the highest sport where you can get a concussion, but really it happens in every sport. Any kind of contact sport, you have a higher risk of getting concussion.
Bill Klaproth: Absolutely true. And I'm glad we're paying more attention to concussions now. Ten years ago, there wasn't this level of attention or scrutiny. And we've been talking about football mainly in this podcast, but there are other sports too, where kids can get concussions. Soccer, heading the ball; hockey, of course; even baseball, a home plate collision. So there are many sports where kids are at risk for concussion. Is that correct?
Marcella Shorty: Exactly. Anytime you get like hit in the head or like a body blow that kind of shakes your head a bit, then you have a possibility for concussion. So like women's soccer for sure, boys and girls; basketball when they collide or they fall and hit their head on the courts; water polo, the ball hits your face or your head. So, yeah, almost every sport, you can get a concussion. Anytime a child falls or like a whiplash kind of sensation in their head, there could be a possibility.
Bill Klaproth: Yeah. Well, even think about skateboarders falling at skate parks, how dangerous that can be.
Marcella Shorty: Exactly. Even if you do you have a helmet on, like the football players. They do wear helmets and they have pads, but still the velocity of the hit can sometimes be a little more than their body can handle.
Bill Klaproth: Right. So we know kids are playing in organized sports all the time away from school, right? Little League and football and soccer and those things. What should a parent do if they think their child might have suffered a concussion while playing soccer in the local neighborhood soccer field?
Marcella Shorty: So common symptoms that a child might complain of would be like headache, dizziness, they feel like nauseous, blurry vision, sensitivity to light also and just kind of feeling out of it or foggy, if they complain about something like that. And then parents can also look for if the child kind of a period of dazed or confused, answers questions really slowly, has trouble remembering anything that happened before the hit or after the hits. Sometimes even behavioral changes, like very emotional, they can't concentrate or focus. So those are all some warning signs for the parent to look for.
Bill Klaproth: Absolutely. And if a parent recognizes any of these symptoms, what should a parent do if they fear their child might have a concussion?
Marcella Shorty: First thing, we would take out of activity. So don't say, "Oh, shake it off so you can go back in." If you really feel that way, take them out and get them to your healthcare professional, which is your primary care physician or urgent care center and the follow your physician's instructions from there.
Bill Klaproth: This is something that is really serious, so if you suspect that your child might have a concussion, best thing to do is call their physician. And if they're in the middle of a game and you see this happen, the child is woozy or wobbly, best thing to do is pull that kid out of the game. You don't want to let that kid keep playing, right?
Marcella Shorty: Correct. You don't want to have what we call a second impact syndrome where you have a concussion along the first concussion. That just makes the worst case scenario and some serious injury to the brain.
Bill Klaproth: Yeah, really important. And again, better safe than sorry. If the game is over and the child is at home and you're recognizing some of the symptoms that Marcella said earlier, best to call the physician. Better safe than sorry, right?
Marcella Shorty: Absolutely. Always err on the safe side. That's what I have to do in my job as well.
Bill Klaproth: Yeah. So true. Wow This is really interesting and an important discussion because kids want to play sports and we want them to play sports. But we've got to do it safely and we do have to monitor the concussion risk because it is real. Marcella, thank you so much for your time. This is really informative. Thank you again.
Marcella Shorty: Thank you.
Bill Klaproth: That's Marcella Shorty. And to learn more, visit ConcussionSmartMarin.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Healing Podcast brought to you by Marin Health. I'm Bill Klaproth. Thanks for listening.
Concussions and Sports: What Parents Need to Know
Bill Klaproth: The risks and dangers of concussions have finally been recognized over the past few years. We of course hear about concussions in football, but other sports carry the risk as well. So let's talk about the Marin County Concussion Management Program designed to help students and parents navigate concussions in sports with Marcella Shorty, Marin Health Athletic Trainer working at Tamalpais High School.
This is the Healing Podcast brought to you by Marin Health. I'm Bill Klaproth. Marcella, thank you so much for your time. It is great to talk with you. So you're an athletic trainer working with students at Tamalpais High School. Can you tell us a little bit about your role?
Marcella Shorty: Sure. My role as an athletic trainer is to evaluate, treat and provide care for athletic injuries and illness that the students might have. I also work to help prevent injury and as well as rehabilitate once they get an injury.
Bill Klaproth: Right. Well, thank you for that. And, of course, we want to talk about concussions on this podcast because it is a hot topic and very worrisome for a lot of parents and students. So can you tell us a little bit about the Marin County Concussion Management Program?
Marcella Shorty: Yes. The ConcussionSmart Marin Program comprises of healthcare professionals. We formed a coalition to coordinate countywide protocols for educating, reporting and treating concussions hopefully to provide a more consistent way to treat concussions that we can all follow and help each other out.
Bill Klaproth: So then what happens if a student gets a head injury during a sporting event and you suspect it might be a concussion? What happens then?
Marcella Shorty: Say we're at a football game and the student comes off to the sideline and looks a little dazed or not acting right, I would immediately remove them from the game and you start to evaluate and examine for a possible concussion. One tool that I have that I use is called the SCAT5. SCAT5 is short for Sport Concussion Assessment Tool. And it's a step by step evaluation that includes the student's concussion history, current symptoms, a cognitive screening, a neurological screening, a balance examination and delayed recall ability, all of which can be affected by head injury.
So then, we go through that test. It kind of helps me determine whether it might be a concussion or not. If it turns out there's a lot of symptoms that are pointing to a concussion, then I would contact the parent or guardian and we get them to their primary care physician or urgent healthcare center for more evaluation by a physician.
Bill Klaproth: Right. Are you administering that test on the sidelines then?
Marcella Shorty: Yes, we are. It's a sideline test and we go through it step-by-step.
Bill Klaproth: Okay. So the player is removed, you go through the evaluation step-by-step. And then after the game, you will make a recommendation on sending that student for further testing. Is that right?
Marcella Shorty: Correct. Speak with the parents and tell them what our findings are. We have a couple forms that we send with the student and the parents, so they can give it to their physician and tells what our findings are and then go from there.
Bill Klaproth: So then what happens then? Are there rules for how soon a player can go back to their sport after they have a concussion or a suspected concussion?
Marcella Shorty: Yes. That's part of the protocol that we follow. So the student, once they go to the doctor or the physician and they make a diagnosis of concussion or not, the student has to then follow the protocol where they have to be symptom-free for up to 48 hours. And at that point, we can start a return-to-play progression.
And the return-to-play progression is a series of days you add activity. So the first day, it might do something simple like walking a mile. If the student remains symptom-free for 24 hours, you can go to the next activity, which might be jogging for five minutes So there's a system that we progress each activity daily. But if the student does have a symptom, then we have to go back. So they have to always remain symptom-free. And we also have to follow the physician's guidelines for that.
Bill Klaproth: Absolutely. Good to know there is a definite procedure in place before kids can return to play. So the big question is how common are concussions? We see these players take these hits and they do look a little bit wobbly and sometimes they go right back in. But I would imagine there's a big percentage of kids who take the hit, they don't want anybody to see anything and they just get right back in the game and keep playing, which isn't good. So this probably happens a lot more often than we think. So do you treat lots of kids with concussion issues each year?
Marcella Shorty: Absolutely. The CDC estimated there's between 1.6 and 3.8 million concussions in sport and recreational activity a year. Like you just said, many go unreported. A lot of times they don't know they're having a concussion and a lot of times they don't want to admit they have a concussion symptom. They don't tell anybody. Even in high school sports, it's estimated there are 300,000 concussions over a school year So that's quite a few concussions over a year.
Bill Klaproth: Wow. That is a lot. I didn't think that many.
Marcella Shorty: Well, football is probably the highest sport where you can get a concussion, but really it happens in every sport. Any kind of contact sport, you have a higher risk of getting concussion.
Bill Klaproth: Absolutely true. And I'm glad we're paying more attention to concussions now. Ten years ago, there wasn't this level of attention or scrutiny. And we've been talking about football mainly in this podcast, but there are other sports too, where kids can get concussions. Soccer, heading the ball; hockey, of course; even baseball, a home plate collision. So there are many sports where kids are at risk for concussion. Is that correct?
Marcella Shorty: Exactly. Anytime you get like hit in the head or like a body blow that kind of shakes your head a bit, then you have a possibility for concussion. So like women's soccer for sure, boys and girls; basketball when they collide or they fall and hit their head on the courts; water polo, the ball hits your face or your head. So, yeah, almost every sport, you can get a concussion. Anytime a child falls or like a whiplash kind of sensation in their head, there could be a possibility.
Bill Klaproth: Yeah. Well, even think about skateboarders falling at skate parks, how dangerous that can be.
Marcella Shorty: Exactly. Even if you do you have a helmet on, like the football players. They do wear helmets and they have pads, but still the velocity of the hit can sometimes be a little more than their body can handle.
Bill Klaproth: Right. So we know kids are playing in organized sports all the time away from school, right? Little League and football and soccer and those things. What should a parent do if they think their child might have suffered a concussion while playing soccer in the local neighborhood soccer field?
Marcella Shorty: So common symptoms that a child might complain of would be like headache, dizziness, they feel like nauseous, blurry vision, sensitivity to light also and just kind of feeling out of it or foggy, if they complain about something like that. And then parents can also look for if the child kind of a period of dazed or confused, answers questions really slowly, has trouble remembering anything that happened before the hit or after the hits. Sometimes even behavioral changes, like very emotional, they can't concentrate or focus. So those are all some warning signs for the parent to look for.
Bill Klaproth: Absolutely. And if a parent recognizes any of these symptoms, what should a parent do if they fear their child might have a concussion?
Marcella Shorty: First thing, we would take out of activity. So don't say, "Oh, shake it off so you can go back in." If you really feel that way, take them out and get them to your healthcare professional, which is your primary care physician or urgent care center and the follow your physician's instructions from there.
Bill Klaproth: This is something that is really serious, so if you suspect that your child might have a concussion, best thing to do is call their physician. And if they're in the middle of a game and you see this happen, the child is woozy or wobbly, best thing to do is pull that kid out of the game. You don't want to let that kid keep playing, right?
Marcella Shorty: Correct. You don't want to have what we call a second impact syndrome where you have a concussion along the first concussion. That just makes the worst case scenario and some serious injury to the brain.
Bill Klaproth: Yeah, really important. And again, better safe than sorry. If the game is over and the child is at home and you're recognizing some of the symptoms that Marcella said earlier, best to call the physician. Better safe than sorry, right?
Marcella Shorty: Absolutely. Always err on the safe side. That's what I have to do in my job as well.
Bill Klaproth: Yeah. So true. Wow This is really interesting and an important discussion because kids want to play sports and we want them to play sports. But we've got to do it safely and we do have to monitor the concussion risk because it is real. Marcella, thank you so much for your time. This is really informative. Thank you again.
Marcella Shorty: Thank you.
Bill Klaproth: That's Marcella Shorty. And to learn more, visit ConcussionSmartMarin.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Healing Podcast brought to you by Marin Health. I'm Bill Klaproth. Thanks for listening.