First, you need to understand
a concussion is a brain injury!

So why get a Baseline Test?
If you or your child has a history of participating in competitive sports, you are likely used to the minor aches and pains that can occur along the way, but what about the larger unexpected impacts that can happen as well? While many athletes and spectators accept injury as “part of the game,” there are some injuries, such as a concussion, that can have a resounding impact on the individual well after they hang up their uniform. So how can therapy help to protect and treat athletes before, as well as after, these unwanted head injuries occur so that they can get back into the game safely?

First, you need to understand… a concussion is a brain injury!
It occurs when the contents of the brain are tossed, or jolted, against the side of the skull. This causes a metabolic cascade of change to occur within the brain tissue, interfering with normal function and making it more vulnerable for a minimum of 2-4 weeks after the injury. A concussion can happen after a blunt force trauma, blow or jolt to the head or body, such as when two players collide on the field or someone slips on the ice and hits their tailbone hard. While our bodies are extremely resilient, repetitive injuries to the head, even at a subconcussive level, can add up and create bigger problems within. So, what can you do about it? The first step is to be prepared. This is done through education about concussions, and then taking a baseline test well before any injury ever occurs.

Concussion baseline testing can play a pivotal role in the prevention and treatment of these potentially serious injuries. Through complete and thorough evaluation, concussion specialists can determine an athlete’s susceptibility to potential injury and develop a treatment plan aimed toward optimal physical function and safety well before a player even gets on the field. Physical red flags like slower reaction time, impaired peripheral vision and muscle imbalances can all be identified early and strengthened, helping to not only enhance the athlete’s abilities but make them safer on the field as well. This testing also provides a guide map back to full recovery in the event of an injury, helping to prevent a more severe injury from occurring while the player is still highly vulnerable and healing.
If you know where you are starting from, you will have a better chance of getting back there!

An athlete should obviously be injury-free before the sport season starts. If you get a baseline assessment in this condition, you will have a picture of what you look like in your optimal, pre-injury state of health and functionality.

There are three key reasons baseline testing is a good idea:
1. It gives us a benchmark for your physical and cognitive strengths and weaknesses ahead of a potential injury, identifying any red flags related to functional performance that can set you up to be more susceptible to injury on the field.
2. It assists in the diagnosis of a brain injury, of any magnitude, by providing the physician information about your pre-injury state.
3. Following injury, it helps to provide the roadmap for recovery, highlighting the systems and functional areas that need help.

To be safe and thorough, do more than just a computer baseline test.
There are many different components to a baseline test, beyond the most frequently used computerized test called ImPACT. ImPACT is an online test for older children and adults aged 12-59, and is a tool designed to provide basic data related to neurocognitive functioning. It is most frequently used with high school athletes, primarily because it is easy to administer to large groups and is less expensive than many of the more comprehensive evaluations. ImPACT Pediatric is intended for kids from 5-11, and was designed to assist in the decision-making process for identifying and treating concussions in a younger population. Subtests on both the pediatric and regular imPACT reflect multiple cognitive processes. These include verbal and visual memory, cognitive speed, reaction time and what symptoms are being exhibited (obviously most important to examine after an injury). While both tools provide valuable information and are certainly better than nothing, they have some limitations.

In high schools, it can be harder to monitor when given to a group all at once and unfortunately many adolescents are known to cheat to lower their scores in order to avoid detection of a concussion later. Another limitation involves the missed opportunities for prevention when the test is given, but the results are not interpreted by a specialist at the time and instead stored in the event of a later injury. While this is helpful for guiding recovery later, it does not lend itself to prevention, enhancement of performance and safety on the field before an injury.

Another more complete testing involves an evaluation with a concussion specialist, ideally a PT, OT or athletic trainer trained in concussion assessment and recovery. One-on-one assessment decreases the chance of fudging the results, and the concussion specialist can provide immediate feedback for ways to enhance performance. This kind of evaluation includes not only key elements of the athlete’s neuro-cognitive abilities but also looks at balance, vision, coordination and reaction time, critical for safety and sports performance.

How often should you get a baseline test?
Younger athletes who are in their peak growing years are developing and changing rapidly. This means that baseline testing should be performed, at a minimum, once a year. With new research suggesting that even subconcussive hits may be cumulative, individuals involved in high-impact sports like football, hockey and wrestling should receive a new baseline test before and after every season. If there is any decline seen in this testing from season to season, problems should be further assessed and addressed to make sure that the athlete is NOT being placed in an even riskier situation by continuing to play.

Just like no two people are the same, every concussion is unique. By receiving a more in-depth and personalized baseline test, concussion specialists can better understand what your strengths and weaknesses are, helping to make you a better athlete and safer on the field. In addition, you set yourself up for a more complete recovery if you know where you are starting from! Don’t forget – a game occurs only on a day in your life, but your brain is with you for your whole life! Play it smart and set yourself up for success on all fronts!