​​Smitty's Plan for O​rthopedic Rehabilitation & Training

FREquently asked questions

WHAT IS THE INITIAL TREATMENT AT HOME?   
Important ideas to follow:

  • Keep your child in a Quiet, Dark or Dimly Lit Room
  • Do Not Allow Reading or use of TV, Computer, Video Games, Cell Phones, or Radios
  • Student-Athletes should not operate a motor vehicle until cleared by appropriate professionals.
  • Keep a close eye on your child for the first two hours at home.
  • During sleep, observe breathing and look for unusual restlessness or movement patterns. 
  • Only give acetaminophen (Tylenol) for headache or other pain. Do not give medication for nausea or additional pain medication of any kind.


WHEN DO I TAKE MY CHILD TO THE EMERGENCY ROOM (ER)? 
You will need to visit the closest ER room if the symptoms are worsening, the headache can’t be controlled with acetaminophen, there is recurring vomiting and speech difficulty arises. Also, look for unusual eye movements, increasing confusion, balance issues or shaking, like with a seizure. Don’t forget, you can also call 911 if you are unable to travel to the ER yourself. There is no magic test or scan performed at the ER that can diagnose concussions. Majority of the time, they will or a CT Scan that unless you have cranial swelling, it will be negative. 

SHOULD I BE EVALUATED BY A HEALTHCARE PROVIDER? 
There should be a follow-up with the athletic trainer or team physician the next day after the athlete has awakened and you have seen and spoken with them. If symptoms other than a headache persist the following day, then the athlete should be evaluated by a physician, physician assistant or nurse practitioner that day. 

​​WHAT IS THE RETURN TO LEARN PROTOCOL?
Any Athlete that has been diagnosed with a Head Injury should go see the school nurse so their teachers are notified of an injury. In Pittsylvania County, there is a protocol set up for schools to accommodate student-athletes with difficulties returning to the classroom after a Head Injury. Coach and athlete should contact the school nurse so appropriate plan be activated.

WHAT IS THE RETURN TO PLAY (RTP) PROTOCOL?
Any Athlete that has been diagnosed with a Head Injury must have a certified healthcare provider to sign off on the athlete's participation for High School Athletics. The protocol consist of a graded return to activity that slowly progresses athletes back to full participation. The RTP Protocol will begin when the athlete goes 24 hours with o symptoms or asymptomatic and then progresses through the following steps:

  • Day 1: Symptom limited activities
  • Day 2: Light aerobic activities
  • ​Day 3: Sport specific activities
  • ​Day 4: Non-Contact Sport specific drills
  • ​Day 5: Full Practice with contact


WHAT IS POST CONCUSSION SYNDROME (PCS)?
Post-Concussion Syndrome, or PCS, is the persistence of concussion symptoms for greater than six weeks post-injury. The majority of concussion symptoms will resolve within about two weeks, and with proper recovery almost all dissipate within a month. In cases where symptoms linger past six weeks, doctors may diagnose Post-Concussion Syndrome.

WHAT IS SECOND IMPACT SYNDROME?
Second Impact Syndrome (SIS) refers to the catastrophic events which may occur when a second concussion occurs while the athlete is still symptomatic and healing from a previous concussion. Even if SIS is not an established problem, there is NO debate that repeat concussions significantly worsen long-term outcomes. After athletes sustain one concussion, they are three times more likely to sustain a second concussion compared to other players who have not been concussed. Repeat concussions, even when mild, can increase the risk of post-concussive symptoms (PCS) such as headaches, memory loss, difficulty concentrating, etc. Chances of PCS are even more increased if the second injury occurs too soon, before recovery from the first has taken place. The higher the rate of concussions, the higher the risk of long-term cognitive dysfunction. The condition is often fatal, and almost everyone who is not killed is severely disabled