The Athletic Trainer’s Role in Caring for Traumatic Brain Injuries
March is National Traumatic Brain Injury Awareness Month, a time to highlight the critical role healthcare professionals play in preventing, recognizing, and managing brain injuries. For athletic trainers (ATs), this month is a reminder of their frontline role in identifying and managing traumatic brain injuries (TBI) in athletes across all levels of play.
Recognizing TBI on the Field
Traumatic brain injuries, including concussions, are common in contact sports such as football, soccer, and wrestling. ATs must be highly skilled in recognizing the signs and symptoms of TBI, which may include headaches, dizziness, nausea, confusion, memory loss, and balance issues. Since symptoms are not always immediate, ongoing evaluation is essential. Tools like the SCAT5, Balance Error Scoring System (BESS), and computerized neurocognitive tests assist ATs in making informed return-to-play decisions.
Immediate and Acute Care
When a suspected TBI occurs, ATs must act quickly to remove the athlete from play and conduct a thorough sideline assessment. The priority is ruling out more severe conditions such as cervical spine injury or intracranial bleeding. The “if in doubt, sit them out” principle guides clinical decision-making, ensuring athletes do not return to play prematurely.
ATs also play a key role in emergency management, particularly in cases of severe brain injuries. If an athlete exhibits loss of consciousness, persistent vomiting, worsening headache, or declining neurological status, immediate referral to emergency medical services is necessary.
Return-to-Play and Academic Adjustments
Managing TBI extends beyond initial assessment and treatment. ATs collaborate with physicians and other healthcare providers to implement a gradual return-to-play protocol, ensuring that athletes do not experience symptom exacerbation during physical exertion. The standard progression includes:
- Symptom-limited rest
- Light aerobic activity
- Sport-specific exercises
- Non-contact training drills
- Full-contact practice
- Return to competition
Beyond return-to-play decisions, ATs advocate for academic accommodations for student-athletes recovering from TBI. Light sensitivity, difficulty concentrating, and memory impairments can hinder learning, necessitating adjustments such as reduced screen time, extended test-taking time, and modified class schedules.
Prevention and Education
While ATs are instrumental in treating TBI, they also play a pivotal role in prevention. Proper tackling techniques, helmet fitting, rule enforcement, and strengthening neck muscles can reduce the risk of brain injuries. Educating athletes, coaches, and parents about the dangers of playing through a concussion is crucial in fostering a culture of safety.
Advocating for Policy Changes
Athletic trainers are strong advocates for policies that enhance TBI safety protocols. Concussion laws, baseline testing requirements, and mandatory return-to-play protocols have significantly improved athlete safety. ATs continue to push for advancements in concussion research, helmet technology, and sideline assessment tools to further protect athletes from long-term complications.
National Traumatic Brain Injury Awareness Month serves as a powerful reminder of the important work athletic trainers do in preventing, recognizing, and managing TBI. From on-field assessments to return-to-play decisions and academic support, ATs are vital in ensuring athlete safety and long-term brain health. By continuing to advocate for education, prevention, and policy improvements, athletic trainers remain at the forefront of concussion management in sports.
