Concussion Protocols

• Contact your Head Athletic Trainer. Set up an appointment to be evaluated and to review the protocols.
• If you have been to the emergency room or doctor already, please bring that paperwork. Doctors’ notes will not supersede state law governing concussion protocols.

For junior high school student athletes, please contact your Junior High Coordinator or Head Athletic Trainer to connect you with the correct high school athletic trainer.

Midland ISD Parent Concussion Manage Information and MISD Initial Evaluation Form.

• Meet with the Athletic Trainer and/or School Nurse to discuss appropriate action.
• MISD Initial Evaluation Form
• Midland ISD Concussion Daily Symptoms Checklist

The athlete must meeting four criteria before starting the MISD Return to Play Protocol (6-Day Return to Play).

1. Must be completely asymptomatic (See Daily Symptom Checklist)
2. Email to nurse to send to teachers for class information.
3. Must be released in writing by the treating physician before starting the Return to Play Protocol.

Once the 4 Criteria are met the athlete will begin the MISD Return to Play Protocol (6 Day Return to Play).  

• Day 1 – 24 hours of no symptoms
• Day 2 – Light aerobic exercise (ex: stationary bike for 20-25 min)
• Day 3 – Moderate aerobic exercise (ex: running 1 mile)
• Day 4 – Sport Specific non-contact exercise (ex: sprints, push-ups, or sport-specific drills)
• Day 5 – Full Contact Practice
• Day 6 – Full Release to Activity

* Each step must be 24 hours with no return of symptoms. The athlete will complete the Daily Symptom Checklist during the MISD Return to Play Protocol (6-Day Return to Play)

On Day 6 of the 6-Day MISD Return to Play Protocol, the athlete will have all of the following on file with the Athletic Trainer of the High School for which the athlete is zoned.

• Daily Symptom Checklist
• Doctor release
• UIL Concussion Manage Protocol/Return to Play Form – Signed by parent & athletic trainer

• Television (Especially violent or action movies)
• Video Games
• Ipods
• Texting
• Computers 
• Large crowds
• Bright Lights
• Academics (The treating physician will guide the athlete in this area) 

• Plenty of rest
• Stay well hydrated
• Eat a well-balanced diet (High Carbohydrate diet)
• Take medication as prescribed by the doctor
• Follow Physician/Athletic Trainer instructions

A concussion is a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include: 

1. Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an ‘‘impulsive’ force transmitted to the head. Forces that cause the head to shake/move violently (Does not have to be head contact!)
2. Concussion typically results in the rapid onset of short-lived impairment of neurological function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours.
3. Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies. This means that CT Scans & MRIs will typically be negative since they look at actual brain structural damage.  Concussions are brain FUNCTIONAL issues! 
   • Dr. Robert Cantu – What Happens to the Brain During Concussion
4. Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course. However, it is important to note that in some cases symptoms may be prolonged. Although a large percentage of concussions heal in about 2 weeks every concussion is different in terms of symptoms experienced, symptom severity and recovery time.

Consensus Statement on Concussion in Sport—the 4th International Conference on Concussion in Sport Held in Zurich, November 2012.

Common Symptoms of a Concussion

Yes, however, we highly recommend that athletes be seen by physicians with concussion management experience.  Ask your Athletic Trainer about local physicians that specialize in this area.

No, chiropractors do not meet the Texas State Occupational code that is required in HB 2038 – Natasha’s Law.

No, emergency room physicians cannot clear an athlete for return to play.  In most cases where an athlete is at the emergency room for a concussion, it is soon after the initial injury and they are trying to rule out a more serious condition (subdural hematoma or intracranial bleed).   The emergency room physician will require a follow-up with the primary care physician.

No, HB 2038 – Natasha’s Law requires that a concussed athlete must complete the School District Return to Play protocol.  Recent changes to the law allow a chiropractor to rule a kid out for a concussion on the sideline but they still cannot release an athlete back to play.

The Return to Play Protocol is developed by a Concussion Oversight Committee (Made up of local physicians and the high school athletic trainers) based on current scientific peer-reviewed concussion studies.

No, although these doctors are excellent at dealing with sport-related concussions the primary role of the COT is to help establish a written district Return to Play Protocol in conjunction with the MISD Athletic Trainers.

Yes, if your child wishes to participate in any UIL related sponsored sport then they must complete the MISD Return to Play Protocol.  This includes concussions suffered in the off-season or summer.

No, concussions are one of the few injuries that have a specific state law governing UIL sports and the process for returning to activity.