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    We’ve probably all seen someone get hit in the head- whether it was during a professional sports game, high school athletics event, or even little league practice. You may have caught yourself wondering- did they get a concussion? Nicole Clements, MS, LAT, ATC, is a Certified Athletic Trainer for Pullman Regional Hospital’s Regional High School Athletic Training Program, serving Potlatch High School and has treated her fair share of athletic injuries, including concussions. Nicole breaks down what a concussion is, what the warning signs are, and how she uses concussion protocols to keep student-athletes safe.


    What is a concussion?

    A concussion is a traumatic brain injury (TBI). It occurs when the body stops suddenly or violently, causing the brain to slam into the skull. It can result in cognitive and physical symptoms lasting anywhere from a few days to several months, or even years.


    Nicole cautions that, “concussions are serious injuries and should be taken seriously!” Typically if they are treated correctly, recovery can be relatively quick and easy. But ignoring a concussion can lead to worse injuries to your brain, and can impact your cognitive ability for the rest of your life.


    What are the initial warning signs of a concussion?

    Typically headache, dizziness, nausea, confusion, sensitivity to light and noise, drowsiness, and feeling “off” are some of the tell-tale signs something might be up, following a blow to the face or head. 


    As an Athletic Trainer, Nicole looks for signs that an athlete may be confused or ‘out of it’- such as stumbling, off their game, shaking, or rubbing their head. “Anytime an athlete takes a hard hit, or fall, I monitor them closely for signs of a concussion. This isn’t always indicative though, because not all hard hits lead to concussions and not all concussions are caused by hard hits.” 


    What should you do if you have a concussion?

    The best thing for a concussion is rest- both physically and cognitively. Avoiding things like bright lights and screens (like televisions, computers, tablets, and phones) is advised, as well as sleeping however much you need to. It’s also important to avoid physical activity, like exercise and sports. 


    Nicole recommends that if a concussion doesn’t seem to be going away and you’re still experiencing symptoms after a few weeks, it may be time to ask your primary care physician about seeing a specialist. There are exercises and therapies that can aid in the healing process that a specialist can recommend, based on your specific situation.


    Why do athletes undergo baseline concussion testing?

    Nicole explains that “since not everyone has the same balance, reaction time, and recall ability, evaluating the progression of the concussion against anything other than the athlete’s initial baseline numbers would be inaccurate.” 


    Concussion symptoms are usually the first things to clear up in a patient, but things like balance and reaction time can take longer to recover after someone sustains a concussion. Seeing these delays shows that a patient may not be fully healed yet. “Athletes who struggle with balance or reaction time post-concussion are at a higher risk of being injured, which we certainly don’t want. That’s why concussion testing is so important,” Nicole says.


    “We get a baseline with our high school athletes so we can know what each person’s ‘normal’ is, and can compare that to when evaluating the athlete returning to play. If an athlete is below their baseline levels, I know that they’re not ready to return to their sport yet,” explains Nicole.


    What is standard concussion protocol?

    Nicole explains that her team follows graduated return to play (RTP) policies, state guidelines, and national recommendations for safely returning to play. “Our protocol consists of a five-step process: before beginning, the patient must be symptom free for at least 24 hours. Each day after, more exertion and a higher level of activity is gradually increased, until the 5th day, which is full activity with no restrictions.” 


    After each step, the athlete is evaluated by an athletic trainer to ensure that no symptoms have returned. If the patient remains symptom-free, they are allowed to continue to the next step. If they do have returning symptoms, we stop the RTP protocol and start over again at the first step once they are again symptom free.

    Can concussions be prevented?

    You can take steps to ensure you’re doing your part to prevent concussions and other traumatic brain injuries during sport, and in your everyday life. These include:

    • Wearing a helmet (or other appropriate headgear) when playing contact sports, riding a bike, motorcycle, skateboard, or other wheeled devices, riding a horse, and skiing and snowboarding
    • Never participate in sports or ride/drive moving devices when under the influence of alcohol or drugs
    • Get an annual wellness exam by your primary care provider and an annual eye exam to evaluate prescriptions, identify new areas of concern, and ensure you’re up-to-date on routine screenings and vaccinations


    If you’re interested in learning more about the Regional High School Athletic Training Program and its mission to keep local student-athletes safe, please visit

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