Dr. Boyd is a pediatric sports medicine physician, specially trained in diagnosis and management of sports concussions. Using the latest in concussion diagnostic tools, including ImPACT testing, athletes with recent concussions are evaluated and given a customized treatment plan. Once symptoms have resolved, further testing is performed to assess readiness to return to sport. The overall goal of treatment is to return the athlete back to their sport in the timeliest but safest manner.
Sports Concussion Facts
What is a concussion?
- An athlete does not need to lose consciousness to sustain a concussion.
- Under reporting of concussion symptoms is common at ALL levels of sports participation.
- Symptoms of concussions can be delayed hours after the injury occurs.
- Delayed symptoms and longer recovery are more common in high school and college athletes.
- An athlete who sustains a concussion is more likely to suffer a second concussion.
- Athletes with prior concussions require longer recovery times.
- Concussion symptoms can last weeks or months if not treated appropriately.
A concussion - also known as a mild traumatic brain injury - is caused by a bump, blow or jolt to either the head or the body that causes the brain to move rapidly inside the skull. A concussion changes how the brain normally functions.
Concussions can have serious and long-term health effects, and even a seemingly mild "ding" or a bump on the head can be serious.
Symptoms are typically noticed right after the injury, but some might not be recognized until days or weeks later. Delayed symptoms are more common in high school and college athletes.
Signs of a concussion observed by parents, friends, teachers or coaches
Symptoms of a concussion reported by athlete
- Loses consciousness
- Appears dazed or stunned
- Forgets plays
- Is unsure of game, score or opponent
- Moves clumsily
- Answers questions slowly
- Shows behavior or personality changes
- Cannot recall events prior to hit
- Cannot recall events after hit
Athletes that are not fully recovered from an initial concussion are at risk for recurrent, cumulative, and even catastrophic consequences of a second concussive injury.
- Balance problems or dizziness
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish
- Feeling foggy or groggy
- Concentration or memory problems
This can be prevented if the athlete is allowed time to recover from concussion and return to play decisions are carefully made. No athlete should return to sport when symptoms of concussion are present and recovery is ongoing. The best way to prevent prolonged recovery with concussion is to manage the injury properly from the start.
Sports Concussion Evaluation
When a young athlete sustains a concussion, it can be difficult for athletes, coaches, and parents to assess the extent of damage to the brain. Symptoms may not appear until hours or even days after the injury, and may be so subtle that they remain undetected by family, friends, or teachers. Some athletes may downplay symptoms so they can return to everyday activities more quickly.
Most athletes make a full recovery within 2 weeks following a concussion. But others may experience ongoing academic and neurocognitive issues, especially if the brain isn't allowed time to heal before returning to school and sports activity. Healing and recovery time is crucial to preventing further, and possibly permanent, damage. If an athlete returns too quickly and gets a second injury, even a mild one, it can cause a severe, possibly life-threatening injury.
Many factors help sports medicine physicians develop a timeline for return to play. How an athlete feels at rest and during exercise is very important. It is not uncommon for an athlete to feel better, but not yet have achieved full brain healing. Computerized neuropsychological testing with programs such as ImPACT can help a trained sports medicine physicians determine if the brain is recovered enough to allow safer return to sports.
Our office is now using ImPACT to help in this decision process. Computerized testing is most helpful when an athlete takes the test before the sports season - or before an injury has occurred. This 'baseline test' gives the best estimate of the athlete's 'normal' results. If there is an injury and it is not clear whether the athlete has fully recovered, the test can be repeated and compared to the baseline. If an athlete has a concussion but there was no baseline test to compare, national standards to approximate the pre-injury level are available
Our mission is to provide young athletes with prompt evaluation, proper treatment and medical clearance for sports-related concussion. Every athlete will receive a comprehensive evaluation, including a medical exam and neurocognitive testing and, if indicated, the ImPACT test. This will be followed by an individualized treatment plan, which may include assistance in communicating with coaches, trainers and teachers, initial home care and a transition back to sports activity when ready.
The primary goal of concussion management in our clinic is to return athletes to their sport in the safest and timeliest manner possible.
Neurocognitive testing has been used in the evaluation of mild traumatic brain injury for many years but more recently with sports concussions. Neurocognitive testing has recently been called the "cornerstone" of proper concussion management by an international panel of sports medicine experts.
ImPACT testing for concussion is a nationally recognized, research-based computer test that establishes a baseline of responses that can be used to assess and manage their injury, if they experience a concussion.
ImPACT has been used in college and professional sports for more than five years. The test is currently being used in the NFL, NHL, NBA,NASCAR, USA Olympic Team, NCAA, and thousands of high schools across the country. The California Interscholastic Federation (CIF) now encourages the use of neurocognitive testing in managing sports related concussion.
More information about concussion, neurocognitive testing and the ImPACT test in particular can be obtained at www.impacttest.com
ImPACT's series of tests are very sensitive to the subtle changes in brain function that are not always detected by CT, MRI, or neurological examination.
ImPACT consists of seven user-friendly computerized tests that measure various aspects of cognitive functioning:
There are two types of tests offered by ImPACT - a baseline test and a post-injury test. Ideally, a baseline test is taken before an injury occurs. If the athlete then sustains a concussion, he or she takes a post-injury version of the ImPACT test. Results are compared with their baseline data to assess changes in neurocognitive function.
- Attention Span
- Reaction Time
- Visual Memory and Verbal Memory
- Working Memory
- Response Variability
- Sustained Attention and Selective Attention
- Non-Verbal Problem Solving
Athletes who have sustained a concussion can benefit from ImPACT even if they haven't first taken a baseline test. ImPACT has collected sample data from hundreds of athletes of all ages. By establishing normal test scores for every age, ImPACT can detect post-injury changes when a baseline test isn't available.
Post-injury ImPACT testing is covered by most major health insurance plans
ImPACT baseline testing for concussion is especially recommended for those who participate in sports (recreational, team/club, school or elite) that are at higher risk for blows to the head.
Following any concussion during the season, the athlete may repeat the computerized test The results help determine when it is safe for the athlete to return to their sport or activity.
Baseline tests are kept on file by the provider or organization who administered the test.
It is recommended that young athlete undergo baseline testing every 2 years.
Anyone who has sustained a concussion must wait 3 months post concussion before taking the ImPACT baseline test
Baseline testing is not currently covered by any health insurance plans.
The most cost-effective and time efficient way to administer baseline tests is group testing through a school or sports organization. Unfortunately, this is not available to most young athletes. At our office, we do offer individual baseline tests at any time during the year.