Dr. Joseph Waeckerle: Concussion clinics offer more options

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By Dr. Joseph F. Waeckerle, NFL Evolution columnist

The growing awareness of concussions has spurred the growth of head trauma clinics throughout the country. But, specifically, what does a concussion clinic do?

Multidisciplinary concussion clinics are becoming more available as a primary or referral facility for effective clinical management and rehabilitation of concussions.

Concussion clinics offer the expertise of various concussion specialists, including:

  • Sports medicine physicians.
  • Neuropsychologists.
  • Neurosurgeons/neurologists.
  • Otolaryngologists, who treat diseases of the ears, nose, sinuses, larynx, mouth and throat.
  • Neuro-ophthalmologists, who treat visual problems that are related to the nervous system
  • Neuroradiologists, who use clinical imaging to treat diseases of the nervous system.
  • Physical medicine and rehabilitation physicians.
  • Neuro-vestibular physical therapists, who treats issues involving balance.
  • And exertion training experts.

These specialists are trained and experienced in concussion care and provide such care on a regular basis. They collaborate with their colleagues regarding best-care principles and practice. And they offer patients an individualized, multidisciplinary approach providing the latest in evidenced-based management.

At the clinic, the potentially concussed or concussed individual is evaluated extensively to determine the presence and severity of a concussion. The evaluation includes a detailed history, comprehensive physical exam including a neurological exam, neuropsychological testing and balance testing.

The attending health care professional assesses the results of the evaluation and develops a personalized management plan. The management plan may include referral to various specialists in the clinic for further evaluation and specific treatment; recommendations for cognitive (thinking) treatment; recommendations for physical therapy with balance, motion, gait training; vision training; medication management for lingering symptoms that delay recovery; and prescribed follow-up evaluations to determine progress and further needs.

At an appropriate time, general and sport-specific physical activities including return-to-play protocols are introduced to prepare for the rigors of competitive play.

The clinics might also make available state licensed athletic trainers or physical therapists to provide sports team care and coverage on site. They coordinate definitive concussion management at the clinic as they are integral members of the clinic staff as well.

In addition, many concussion clinics serve the community by offering educational and training programs for interested and involved parties from families to schools to other health care professionals. These programs present current best practice guidelines that can be incorporated into the athletic programs and injury management strategies.

Families and individuals who want to learn more about concussion clinics should begin by discussing their options with their primary care providers.

Dr. Joseph F. Waeckerle is clinical professor of emergency medicine at the University of Missouri-Kansas City School of Medicine. He also is editor emeritus of Annals of Emergency Medicine. He has practiced Emergency Medicine and Sports Medicine and has been a team physician at the grade school, high school, college, and profession level for over 30 years. He currently serves on the NFL Head, Neck, and Spine Injury Committee and the Mackey White Brain Injury Committee of the NFL Players Association.

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