With her personal and professional experience with concussions, Dr. Katie Gaskin @theathletedoctor has dedicated herself to increasing awareness of the importance of pre-concussion safety protocols and post-concussion rehabilitation. One of the most essential components of this is completing Concussion Baseline Testing, which provides health practitioners with useful information regarding the athlete's "normal" brain and body function. After sustaining a potential concussion, the Baseline Tests are completed again to look for potential differences in comparison to the initial Testing results. This points health professionals to the areas of the brain that have been affected by the concussion, which helps guide post-concussion rehabilitation. The most important thing to remember with concussions is to ACT FAST - delaying concussion rehab increases the risk of Second Impact Syndrome.
"When I was 18 years old, I sustained my first diagnosed concussion. It was during my first season playing NCAA Division 1 hockey; I had fallen to the ice after getting hit, then was cross-checked in the face as I was trying to get up. My head whiplashed backward, and I was immediately dizzy while trying to get off the ice. After making my way back to the bench, my team’s Athletic Trainer luckily stepped in to evaluate me, and declared that I would not be playing for the rest of the game. I was told to sleep as much as possible in darkness, avoid looking at screens, and wear earplugs. As a freshman desperately wanting to get back on the ice as soon as possible, I listened. I followed their direction for a week.
I was itching to get back on the ice. Regardless of the fact that I was still experiencing daily headaches, dizziness, cognitive fatigue, and difficulty concentrating, I told my coach and training staff that I felt back to normal. Back then, our concussion baseline testing consisted of testing memory recall through a computerized software. Luckily, my veteran teammates had told me at the beginning of the season to purposely not do well on our baseline testing; this way, if I did sustain a concussion during the season, I would pass the test and be able to get back on the ice, even if I was still experiencing memory deficits and symptoms. I thought I was so smart. Being an athlete is all about making sacrifices and pushing through pain anyway, isn’t it?
To my absolute delight, I passed my return-to-play test and was allowed to get back on the ice within a week. After a week of still experiencing mild dizziness and headaches at practice and difficulty concentrating during class, I was set to suit up for our next game against one of our rivalry schools. During the first period of play, I was fighting for the puck in the corner of our defensive zone, and felt an opposing player hook her stick around the back of my skate - yanking my leg into the air and causing me to fall backwards. As my body impacted the ice, I was helpless as my neck whiplashed and the back of my helmet smacked the ice. Dizzy and mildly disoriented, I shot back up and continued fighting for the puck. After my shift, our Athletic Trainer asked me if I was okay. “Yep, all good.” I just wanted to play. I didn’t want to lay in my bed in darkness for another week. It didn’t seem to help with my first concussion anyway. Luckily, she could tell that something was off, and she took me out of the game.
I haven’t felt the same since.
I know now that I experienced Second Impact Syndrome, which occurs after sustaining multiple concussions within a short time period. When the brain has not been given an appropriate amount of time to recover and associated deficits have not been properly rehabilitated before returning to work or play, these deficits can become chronic. Second Impact Syndrome can be fatal - the swelling around the brain can become so severe that its blood supply is compromised. I consider myself very lucky to still be here. Rowan Stringer, a 17 year old rugby player from Ontario, was unfortunately not so lucky. She tragically passed away in 2015 due to Second Impact Syndrome after sustaining her second concussion within a few days.
After beginning my professional hockey career with the Toronto Furies in the Canadian Women’s Hockey League, I was fortunate to have access to Complete Concussion Management (CCM) Baseline Testing and Rehabilitation. CCM is an incredibly comprehensive software and protocol that takes into account all of the cognitive and physicals systems that may be affected by concussion, including the vestibular (balance) system, visual system, cognitive (thinking and concentrating) systems, and physical systems. Lucky for me (and much to my competitive dismay), the Baseline Tests were objective, which prevented me from purposely getting a lower score so I could return to playing before my concussion was fully rehabilitated.
I still suffer from post-concussion symptoms on a daily basis. I am incredibly fortunate to have had world-class health practitioners in my corner, all of whom have helped me get back as close to my “normal” as possible. If a system like CCM had existed when I sustained my first concussion, I most likely wouldn’t still be experiencing symptoms today.
It has become my mission to promote concussion awareness and safety to prevent this from happening to more people. I am proud to now be offering Concussion Baseline Testing and Post-Concussion Rehabilitation at MVMTLAB Sports Performance Clinic using the CCM protocol and software. The idea behind Concussion Baseline Testing is to complete it as soon as possible - BEFORE a concussion happens. Baseline Testing will include a variety of cognitive and physical tests, which will provide us with objective benchmark scores on which to compare to. After sustaining a potential concussion, we will go through the Baseline Testing again, which will provide us with guidance as to what areas we should focus on while creating your rehabilitation program. You will then be able to safely return to work and/or return to sport when your scores match your original Baseline Testing scores.
Concussions are no joke. Due to our inability to view brain trauma from the outside, it is often difficult to say whether or not an individual has sustained a concussion, or when it is safe for them to return to normal activities. With something as potentially serious as brain injury, it is best to take the subjectivity and guesswork out. When in doubt, sit it out - and ask for assistance from a qualified health practitioner. Your brain will thank you later. "