Management of Sports-Related Concussions: Staying Ahead of the Game, 2nd Edition: Summary 33
CASE STUDY
A 15-year-old high school soccer player (a sophomore in school) states he was injured during a soccer match approximately one week ago when he was struck in the left frontal aspect with a ball kicked by an opponent. He denies any loss of consciousness and was removed from activity for the remainder of the match by the athletic trainer upon sideline evaluation.
He did not have to go to the emergency department on the day of injury for evaluation. His immediate symptoms included dizziness and headache. His subacute symptoms include difficulty remembering/ concentrating, difficulty sleeping, and sensitivity to noise. The patient states his symptoms are better with rest in a controlled environment and worst with activity, especially with eye movements. He states his symptoms are slightly better in the morning hours. The patient states he has integrated back into school and uses limited adjustments when needed. He states he is having difficulty getting to sleep, but he is eating three good meals per day and taking in enough water as recommended. He has not had any imaging (MRI or CT scan) performed to date. The patient's current goals are to return to school unrestricted and to return to competitive soccer activity. 1. What components would be important to include as part of an initial evaluation on the sideline? 2. What components would be important to include as part of an initial evaluation in the clinical setting? 3. What aspects of this case and injury history should be considered as part of the initial plan of care? 4. What would some of the immediate (initial) goals be for this athlete’s plan of care? 5. What are some of the exercise recommendations to consider throughout this rehabilitation plan of care? 6. What aspects of this case should be considered as part of the return to play/learn decision making? Key Recommendations Concussion management is a complex and evolving field that requires a multidisciplinary approach. Key takeaways include: ○ The importance of proper education and awareness for all stakeholders
○ The need for comprehensive sideline and clinical evaluations ○ The value of individualized, active rehabilitation approaches ○ The importance of gradual return-to-learn and return-to-play protocols ○ The complexity of medical disqualification decisions
By staying current with the latest research and guidelines, sports medicine professionals can provide optimal care for athletes with concussions, ensuring safe and successful returns to both academic and athletic activities.
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