KORT Report: Volume One, Edition Eleven

The KORT Report is a weekly segment that will discuss the state of physical therapy, training, and injury prevention within the world of athletics on both a local and national level. If there is a specific topic you’d like to know or hear more about, email KORT Report suggestions to cjung@catholicsportsnet.com.  

A common phrase after a hard hit, a collision, a club to the head or even a fall to the ground: so-and-so just got their bell rung.

Hits to the head in any sport have become the big issue in sports medicine. Whether it is football, soccer, field hockey or softball, a student-athlete’s safety is of primary concern for parents, coaches and schools.

Any student-athlete can sustain a head injury or a concussion and not be aware of it. The old school phrases such as “bell rung,” or “dinged-up”, or “seeing stars” are being replaced with a wealth of information about protecting athletes from further damage to their brains.

Kevin Brown, a KORT physical therapist and head trainer at Eastern High School, has been the point person for the KORT network state-wide to create and implement ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) testing for student athletes in their care. He discussed the test and its application and implication with LouisvilleCatholicSports.com.

“The goal of the ImPACT test is to have an objective measure of where a student-athlete is at cognitively,” said Brown. “That’s what we’re finding in concussion cases, that even when an athlete is symptom-free, there is still a cognitive deficit. Whether it’s having trouble paying attention in class or forgetting things, the ImPACT test is an objective measure of where the athlete is cognitively compared to a baseline measurement taken before an athlete begins to train or play.”

The ImPACT test has gained wide recognition as the first of its kind in its attempt to assist doctors and trainers to look for signs of brain damage or cognitive brain malfunction due to concussions. From the ImPACT web site (www.impacttest.com), here is the basic information about what it is and who created it the process:

Developed in the early 1990's by Drs. Mark Lovell and Joseph Maroon, ImPACT is a 20-minute test that has become a standard tool used in comprehensive clinical management of concussions for athletes of all ages. ImPACT Applications, Inc. was co-founded by Mark Lovell, PhD, Joseph Maroon, MD, and Michael (Micky) Collins, PhD.

KORT, Brown, doctors and sports medicine professionals are very aware of the importance of this type of testing on athletes of all ages. They’re also acutely aware of on-going studies of athletes, particularly football players and boxers, who have had multiple concussions and how those have affected quality of life.

But getting that baseline reading, the reading from an unaffected brain, is an important step in following the brain health of an athlete.

“The test is not mandatory,” said Brown. “But we are offering this service at a minimal cost ($1). And even if the athlete doesn’t test before their season and does suffer a concussion, they can then participate and their scores would be compared to national data compiled by ImPACT based on age, sex, and other factors.”

While ankle sprains, separated shoulders, bumps and bruises can be easily detected, documented and treated, injuries to the head have a way of manifesting themselves in other ways in an athlete. Sensitivity to light and sound, vomiting and nausea are just some of the outcomes of a concussion, no matter how hard the head gets hit. Being able to treat the concussion without further damaging the brain is a vital part of the process.

You injure your ankle and typically your body will tell you when it is ready to return to activity. You injure your brain and that timing isn’t always so clear. Thus, the need exists for strict protocols in allowing an athlete to return to play.

“We have a protocol which is based on the latest recommendations at the last international meeting on concussions,” said Brown. “Everyone is following these recommendations including the NFL, NCAA and all the way down, as far as progression in returning an athlete to play after a concussion. We are incorporation ImPACT into this process. It’s another tool for us to use to say, ‘Yes, the athlete is back at baseline. Or, no, the athlete is not back to baseline standards.’”

Concussions are treatable and athletes are capable of returning to action, but that process is dependent on information that the trainer or health care professional receives from the athlete.

“The return to play progression is based all on the athlete reporting symptoms,” said Brown. “If they’re not reporting symptoms, then they can move on to the next step towards getting back on the field or court. They can say they are not having symptoms, even though they are, and all we have to do is look at the data from their ImPACT test pre-injury to post-injury and determine if there is still some cognitive deficit.”

Treating concussions with precise protocols is a necessary step for all athletes. Recognizing the signs and symptoms are important, but taking action to treat them is vital in caring for the safety of all athletes.

For more information on the ImPACT test go to www.impacttest.com.

For more information on KORT and KORT's services, go to www.kort.com.