McFarland Clinic

Caring for Concussions: The Clinic's Team Approach

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August 8, 2012

Concussions in sports have become a very popular topic over the last few years. The Center for Disease Control

(CDC) reports that 1.6 to 3.8 million sports concussions occur every year. Concussions have always been known to be dangerous, but the lasting effects of repeated head injuries in NFL athletes, well after they are done competing, has brought attention to the injury all the way down to the teen athlete.

The Sports Concussion Institute reports 53 percent of all high school athletes have already sustained at least one concussion by the time they start high school sports. This is frightening considering the brain continues to develop and mature until age 25.  Medical professionals agree that high school athletes take longer to recover from concussions and have a greater severity of symptoms than adults.

It is because of this that the medical professionals at McFarland Clinic have come together to create a team approach to concussions that better protects the student athlete,” says McFarland Clinic Physical Therapist and Athletic Trainer Chris Hanfelt.


The Sports Concussion Institute defines a concussion as a complex pathophysiological process that affects the brain, typically induced by a direct or indirect blow to the body causing neurological impairments.  These impairments can go away in seconds, minutes, days or weeks. At their worst, they can create long-term cognitive impairment or even result in death.

Some of the most common symptoms include headaches, nausea, loss of memory or concentration, emotional changes, sleep disturbance or changes in energy level or appetite.

The severity of a concussion is most accurately diagnosed by seeing how much damage there is to the brain through diagnostic testing and a thorough neurological exam performed by a primary care physician, neurologist or neurosurgeon.  Concussions are also characterized by the functional neurometabloic changes in the brain that require cognitive and postural stability tests to determine severity.

“The sports medicine team of physical therapists and athletic trainers at McFarland Clinic are trained to determine when a student athlete may have sustained a concussion by finding these mental or physical deficits.  They can also help to assess when/if a student athlete needs to be removed from sports, and also to help safely return them to competition,” says Hanfelt.

One of the most objective tests to determine both when a student athlete has sustained a concussion and when they can safely return to participation is a baseline test.  A baseline test is defined by the Sports Concussion Institute as a neuropsychological exam designed to measure cognitive skills and abilities such as intelligence, problem solving, memory, concentration, impulse control and reaction time.  This is important because an estimated 47 percent of athletes do not report any symptoms after being diagnosed with a concussion.  In other words, the damage may go unnoticed, and further issues may result.

“The McFarland Clinic Sports Medicine team uses the SCAT 2 test because of its reliability and strong correlation in helping to determine a concussion.  A simple balance test is also administered to give another layer of objectivity in determining if a student athlete may have a concussion,” says Hanfelt.

In the state of Iowa, a student athlete who is thought to have sustained a head injury or concussion may not return to play until cleared by a licensed medical professional. At the high schools where McFarland Clinic provides sports medicine coverage, an athletic trainer or physical therapist will complete a neurological screen and administer the baseline test to determine whether or not the student athlete is displaying concussion symptoms.

“If it is determined a concussive event has taken place, the student athlete is referred to their primary care physician and is not allowed to return to activity until cleared by their doctor. Once cleared, the student athlete will go through a minimum five day “Return to Play Protocol.” This can be done either at the high schools (if athletic trainers are present) or by a physical therapist at any of our McFarland Clinic Physical Therapy locations,” says Hanfelt.

For those student athletes with concurrent injuries such as musculoskeletal strains or sprains, weakness or vestibular impairments, the physical therapists will be able to help rehabilitate the student athlete back to sports quickly and safely. Once the student athlete passes the five day “Return to Play Protocol”, and all other injuries are healed, the student athlete is then returned to the primary care physician for the final OK to return to sports.

“A team approach with athletic trainers, physical therapists and primary care physicians all working together will give our student athletes the best chance to safely participate in the sports they love,” says Hanfelt.

For more information on the McFarland Clinic Physical Therapy Department in your area, contact:

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