A local expert is hoping a step-by-step concussion treatment program that focuses on getting young athletes ready for school before sport – becomes more widely used.
Often doctors focus on getting young athletes back into the game first but Dr. Marni Wesner with the University of Alberta’s Glen Sather Sports Medicine Clinic says there needs to be a focus on “return to learn” first.
“Return to Learn has sort of been the new sexy thing in concussion management,” Wesner said.
“It’s the idea that you need to mentally use the brain before you physically use the body when returning to sport after concussion.”
Fifteen-year-old Matthew Bakker went through the Return to Learn program after suffering a concussion after a basketball game injury.
“I landed on the back of my head when I was taking a charge from a player and then later in the game I hit my head again on the ear and then I hit my head a couple more times,” Bakker said.
“I had a headache. I was very tired. My ear hurt a bit. I slept a lot. I ended up sleeping on the bench for my next game.”
Bakker said he wasn’t aware that he had suffered from a concussion.
“I didn’t even notice. I just tried to tough it out,” he said.
It wasn’t until days later when Bakker’s family realized the severity of the situation.
“He blacked out and fell and hit our fireplace,” said Bakker’s mother Shirley.
“We were very scared at that point in time. Very scared.”
Bakker’s recovery began at the Glen Sather Clinic, going through the Return to Learn, seven-step program.
Seven-step 'Return to Learn' program
The first step of the program requires complete physical and mental rest.
Wesner says that step is hardest part for teenagers.
“We say no TV, no reading, no computers, no texting, no Xbox, no Wii, nothing,” Wesner said.
“The more you can do physical and mental rest in the early part of the concussion, the faster the concussion settles and they get back to sports and they get back to school much faster.”
Bakker said that first step was most challenging.
“It was just brutal,” he said. “Sitting in a room doing nothing was the worst thing I’ve ever done in my life. It was awful.”
The next steps in the program get young athletes back to school, then slowly working on light activity, non-contact sports and finally back to contact sports before returning to game play.
“The treatment for concussion is rest. Rest is physical rest as well as mental rest so when you’re getting back to activity after concussion, you want to mentally use the brain before you physically use the body,” Wesner said.
The program was developed a few years ago, and although it’s not new, Wesner says she’d like to see it more widely used.
“I think most people are well-versed on the ‘return to sport’ but the concept of return to learn are the newer things that are coming out,” Wesner said.
“Anybody who is interested in concussion management can certainly learn this. It’s not a difficult concept to pick up and it’s not difficult principals to learn. It’s being able to tell the child no you can’t go to school, no you can’t text, you can’t play computers, that’s the hard part.”
The Return to Learn program can be intrusive and disruptive, Wesner says, but effective – especially to avoid future injuries.
“A part of the concept of Return to Learn and Return to Play is making sure the brain is physically ready for a second hit, a second trauma, a second injury in the sport,” Wesner said.
“There is a concept of second-impact syndrome where if you get a second hit while you’re still suffering from symptoms of the first, symptoms can certainly be more severe, more significant and more prolonged, and that’s what we’re trying to prevent.”
'When in doubt, sit it out'
The Bakker family says the steps program has been helpful.
“It gave my son control and gave him the ability to take the steps to see what he could do, the next steps, the whole process he was able to back off when he needed to back off and we just knew where we stood and that was huge,” Shirley said.
Bakker missed three weeks of school and a number of basketball games while he recovered from the concussion.
“I missed my chance to play in front of scouts and stuff,” he said.
He admits, if he had a second chance, he would have asked for help sooner.
“When in doubt, sit it out. If you’re not feeling right, you probably aren’t right,” Bakker said.
“It’s probably better to miss once game then miss six or seven games and feel like crap for a couple of weeks.”
According to figures from Statistics Canada, there are 30,000 concussions or related head injuries each year in Canadians aged 12-19.
Wesner is speaking at a concussion management workshop on April 20 called Concussion in Sport.
The event takes place from 8:30 a.m. to 12:30 p.m. at Commonwealth Stadium and is recommended for patients, athletes, coaches or health care professionals interesting in learning more about concussion management.
With files from Carmen Leibel