Proper concussion protocol key to recovery for young athletes

HEBER, Utah — Standing in a cool, quiet office next to the football stadium at Wasatch High School in Heber, Caden Luke, 17, runs through a series of assessments to determine how well he’s recovering from a concussion.

Two weeks earlier, Caden took a hard hit while playing 7-on-7 with his teammates.

“I went to block the ball, bounced off another guy, bounced into me, got knocked out, all the good stuff,” Caden said.

The impact cut his lip and knocked him out.

“I remember not being able to see at all — super blurry,” said the senior, a safety on the varsity team.

Over the next several days, he had headaches in addition to an unexpected symptom: anxiety in social situations.

A few days after getting the concussion, Caden went to dinner with some friends.

“He came home and he said, “I felt super anxious and I got hot flashes,” his mom Camille Luke recalled.

She said that is very unlike her son, who has always been super social.

“That was pretty concerning for me. And I text Dynna, I said, ‘This was one of his symptoms. Is this normal?’ And she said, ‘Absolutely, that’s his brain getting overstimulated.’”

Dynna Farr is the athletic trainer at Intermountain Healthcare for Wasatch High School who diagnosed Caden immediately after the injury.

She’s seen a fair share of concussions.

“Concussions are so common in high school athletics,” Farr said.

And not just in contact sports like football or girls’ soccer.

“I’ve had concussions with swimming, I’ve had concussions with tennis,” she said. “If you can fall down or you can hit your head, you can get a concussion in the sport.”

Farr does baseline testing with many of the athletes, so she has a reference for a post-injury assessment.

“Then I’m not comparing anybody to norms,” she said. “It allows me to compare the kid to the kid.”

Concussions are a traumatic brain injury caused by a bump, blow or jolt to the head or body. Those hits can damage the brain tissue and change how it functions. Depending on the severity of the injury, they can also be life-altering.

For the best chance of recovery, the brain needs plenty of rest.

“If they keep pushing through symptoms, that concussion is going to stick around longer and they won’t be on the field as quickly as they’d like to be,” Farr said.

If a concussion is suspected, Farr assesses the athlete’s symptoms, balance, cognition, and eye tracking to confirm the injury.

“I assess it right after the hit. I assess it 10-15 minutes later. I assess it before I send them home with their parents,” Farr said.

And she repeats those assessments over the next several weeks as the student recovers, to know when they are ready to safely return to the classroom, and eventually to the field.

Farr provides the athlete and their parents with a concussion care plan, including the return to learn and return to play protocol, as well as a list of symptoms to watch for.

“She’s got a schedule clear through the end of July — what’s going to be happening each week and until he progresses back up to full contact and football,” Camille Luke said.

School administration, counselors and teachers are also notified so they can support the student’s healing.

The students are given accommodations in the classroom for up to three weeks or as long as they are experiencing symptoms that impact their routine.

“That could be any type of adaptations,” Farr said. “For example, if they’re sensitive to light, wearing sunglasses in the classroom, or needing to take breaks from mental activity – so having 20 minutes on and then 20 minutes where they can go sit in the hallway.”

The return to play protocol begins after those three weeks, or when symptoms subside.

The five-to-seven-day process allows Farr and the coaches to make sure no symptoms spike.

“If you’re having symptoms, that’s your body telling you, ‘Hey, I’m not ready for it.’ And if they do, we back off, we wait for those symptoms to go under control, and then we try again the next day,” Farr said.

“Risk is so high going back on the field after you’ve had a concussion without going through that graduated return to play protocol,” she added.

Her most important message to the athletes is to tell someone if they suspect an injury.

“If you feel off, if you feel weird, if you even just had a hit and had a headache, then I need to know,” she said. “Tell mom or dad, tell your coach.”

Emilia Brown went to Farr last December. The 17-year-old senior is on the Wasatch Girls Varsity Basketball team.

“We were doing warmups,” Emilia recalls. “I had, like, three balls sort of come and hit me in the face.”

Emilia didn’t think the impact was serious, but over the next few days, she knew something was wrong.

“I was vomiting the entire weekend,” she said. Then, during practice the next week, “we were running and I almost passed out.”

That’s when she stopped by Farr’s office.

“And she was like, ‘Yeah, you definitely have a concussion,’” Emilia said.

“It lasted for about a month and a half. It was a pretty rough one,” she said. “I went to physical therapy for it.”

Emilia said over the next couple of months, she had headaches and would get dizzy easily. She said her vision also changed.

“I struggled in school, just focusing on the board and seeing it,” she said. “The board would hurt my eyes really bad.”

Today, she feels mostly back to normal.

“I get headaches still,” she said, but “my balance has gotten back to the way it was.”

She’s back on the court and competed with the Wasatch High Unified Sports team last month at the Special Olympics in Orlando.

As for Caden, his assessment showed he’s making good progress.

“I’ll be ready to go as soon as the fall hits,” he said.

Intermountain Healthcare has more information on signs and symptoms of a possible concussion on their website.