Concussion symptoms and concussion-like syndrome Precaution measures in place and recommendations for training and competition
INFORMATION SHEET FOR NATIONAL FEDERATIONS Concussion symptoms and concussion-like syndrome
Precaution measures in place and recommendations for training and competition
Following recent articles in various news magazines the Executive Committee of the International Bobsleigh & Skeleton Federation (IBSF) consulted their Medical Committee which reiterates the importance of precaution measures and issued the following recommendations for training and competition.
Concussion symptoms and concussion-like syndrome
The IBSF, through its Medical Committee would like to reiterate to National Federations the importance of concussion and concussion-like syndrome and their associated precaution measures: Observe as closely possible symptoms of concussion and concussion-like syndrome RECOGNISE and REMOVE, and IF IN DOUBT, SIT THEM OUT. 1
Signs & Symptoms requiring Urgent Medical Assessment2
• Severe neck pain/pain in cervical spine
• Deteriorating consciousness
• Increasing confusion or irritability
• Severe or increasing headache
• Repeated vomiting
• Unusual behavior change
• Seizure (fit)
• Double vision
• Weakness or tingling/burning in arms or legs
Signs & Symptoms of concussions:
• Balance or coordination difficulties
• Amnesia for the circumstances surrounding the injury (i.e. retrograde/anterograde amnesia);
• Cognitive slowness
• Light/sound sensitivity
• Visual disturbance
1 Part of British Skeleton Concussion Policy
2 Part of British Skeleton Concussion Policy
Please note that the signs and symptoms of concussion listed above, although frequently observed or reported, is not an exhaustive list.
Athletes suspected of having a concussion shall be evaluated by the Medical Personnel (e.g. physician, physiotherapist) in a distraction-free environment. In all circumstances, the Medical Personnel shall assess the athlete in person and be solely responsible for determining whether the athlete is diagnosed with a concussion. If no Medical Personnel is available, the athlete should be sent to the nearest hospital for examination.
Differentiate real concussion and concussion-like syndrome To the best of our knowledge, concussion-like syndrome does not include cognitive impairment. Main symptoms involve cervical spine and neck-shoulder muscles – manual therapies, massages or physiotherapies will be needed to handle most of the symptoms.
We want to encourage you all to monitor and report concussions and also concussion-like syndromes. Please use the existing injury registration forms (see https://www.ibsf.org/en/insideibsf/downloads –> Medical) to report daily symptoms to the Medical Committee of the IBSF. These data will help further research and improvements for the sliding sports.
Use ImPACT Testing
• ImPACT test is a battery of neurocognitive tests which measures visual and verbal memory, reaction time and processing speed to help to determine if an athlete can safely return to activity (concussion care). It exists as an FDA cleared online tool for baseline and post-injury testing.
• ImPACT baseline testing has been introduced by the IBSF in 2015 as a requirement to obtain an IBSF license. An athlete needs to do a baseline test every two years or annually for athletes under the age of 18. All ImPACT testing related expenses are fully covered by the IBSF.
• ImPACT post-injury testing is also offered by IBSF to all National Federations and its athletes not only during IBSF events but also during national events and again free of charge. In order to be able to do post-injury testing, each National Federation needs to register Medical personnel that will receive the access details to allow their athletes to do the online testing. After the test completion, the authorized Medical personnel or the athlete can request the detailed ImPACT comparison reports (baseline – post-injury1 –post-injury2…).
Injury registration process at IBSF events
In case of a crash during official IBSF training or competition the following process will start:
• Each athlete has to be checked by dedicated Medical Personnel at the track. The Medical Check (documented on the injury registration form) will determine if a concussion is suspected and further examinations e.g. ImPACT re-testing (post-injury testing) is recommended.
• If a concussion is suspected, the IBSF will un-license the athlete for the purpose of safeguarding.
• A “Fit to slide” form, signed by medical doctor, has to be presented to reactivate the license before next training or competition run.
Return to sliding/”Fit to slide” If Medical Personnel concludes after his/her examination that the athlete shows no evidence of a concussion, the athlete may return sliding.
If Medical Personnel suspects or diagnoses a concussion or concussion-like syndrome, the athlete shall be immediately removed from sliding and shall not return on the track on the same day. Athletes showing observable signs that are not attributed to an injury of a different part of the body shall not return to sliding and shall be re-evaluated on the next day. After a brief period of rest (24 to 48 hours after injury), the concussed athlete is encouraged to become gradually and progressively more active as long as these activities do not cause or worsen symptoms. All activities and increase in training loads should be monitored with the Medical Personnel (e.g. via tele medicine).
Awareness on the daily training load
All Coaches and Support staff should increase awareness to concussion and concussion-like syndrome – resulting in an appropriate training load to their athletes and monitor adequate recovery time. Prior to any additional training, special attention shall also be given to athletes, after crashes respectively hard hits or talkings about vibration. A limit of the daily training runs to max three per session with a morning and afternoon session with an appropriate period of rest in between is recommended.
Strengthening of the neck muscle to stabilize cervical spine Although actually not supported by strong scientific evidence, but for purpose of precaution, the IBSF Medical Committee recommends to specifically focus on the training of the neck-shoulder area in order to stabilize the head-position during sliding, and tentatively reduce occurrence of the concussion-like syndrome.
Use of new skeleton helmet
IBSF selected a new standardized certified helmet especially designed and produced for the sport of skeleton by SUOMY. The helmet is already available and used.
Lausanne, 04 January 2021