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Minnesota Athletic Trainer Outlines RTP Protocol

St. Peter High School athletic trainer Allison Kanaman, responding to growing concerns about concussions and new rules from the Minnesota State High School League, has instituted an extensive return-to-play protocol and treatment program designed to ensure athletes are ready to get back on the field.

“I’m not saying take out the risks and contact in sports,” Kanaman said. “Sports are great for middle school, high school and college athletes. But there are things that we can take control of to prevent the risk of injuries. Obviously we can’t prevent everything, but if we can take the steps to try to reduce the risk and afterward treat it properly.”

 

The biggest thing, says Kanaman, who also serves St. Peter/Le Sueur-Henderson/Tri-City United/Cleveland Bulldogs hockey, is ensuring students report their injuries.

“If they sustain another head injury before the first one heals, then it can lead to more serious life-threatening cognitive issues in the future,” she said.

Athletic trainer helps

LS-H Activities Director Dave Swanberg, who also coached hockey and football, believes athletic trainers are critical in determining when athletes are ready to return to play.

“Athletes want to hurry back to play, their coaches and many times their parents want them to return to action as soon as possible,” Swanberg said. “That’s when your athletic trainer is worth their weight in gold. … They diagnose, treat and aid in our baseline testing. Having a certified athletic trainer is much better than having a coach try and diagnose and/or treat a concussion.”

St. Peter girls soccer coach Karl Larson agrees that an athletic trainer is the key to deciding return to play for any concussed athlete.

“Athletic trainers are medical professionals, and that’s why we have them on the sidelines,” Larson said. “It’s simply too tempting for a coach to put a player back on the field, particularly if the player is good and the stakes of the game are deemed to be significant. It is admittedly difficult for players to sit out … but in the end the players’ long-term well-being outranks any single game victory.”

Before coming to St. Peter two years ago, Kanaman worked three years as a trainer while attending at the University of Wisconsin-Stevens Point where she treated concussions and gave a presentation on the subject.

“It’s easier to spot them now just because of the experience I’ve had,” Kanaman said. “I can usually tell right away.”

Kanaman said 70 to 80 percent of St. Peter student athletes’ head injuries that she’s tested have been concussions.  Football has the highest number of concussions, but is the sport also has the greatest number of athletes.

Time out after a concussion varies. The minimum time out, set by the MSHSL, is five days.

“Everybody experiences concussions differently. That’s why it’s hard to develop a treatment plan and find ways to prevent them. Symptoms are subjective, so we can’t objectively measure them,” said Kanaman.

As a coach, Swanberg has dealt with athletes who’ve been concussed, but the injury is difficult to diagnose.

“The biggest difference is there are no X-rays that can be taken to see exactly what the problem is,” Swanberg said. “The athlete has to be honest and sincere about how they are feeling and let you know exactly what their symptoms are.”

Concussions vary greatly

The symptoms for removal from the game vary, but include headache, fogginess, difficulty concentrating, confusion, difficulty with memory, nausea, tiredness, sensitivity to light and sounds, and mood changes.

“They can be cleared by any medical professionals, which includes a trainer,” Alger said. “So if there’s a trainer on the sidelines, they can go through their protocol. She can clear him there on the spot or say you’re done for the night.”

ImPACT testing is a computerized exam St. Peter and LS-H offers to athletes in partnership with the Mankato Clinic through a grant. The test provides prompt evaluation of a potential head injury/concussion.

“The treatment and diagnosis of concussions is where a lot of progress has been made,” Swanberg said. “We now have better research to help us make informed decisions regarding concussions. We have better access to educational materials and training techniques to teach and properly instruct.”

Kanaman emphasizes the importance of proper diagnosis and treatment of concussions, and ensuring students aren’t playing again before they’re ready.

“It takes time to heal,” she said, “and your head needs time to heal. People have so many issues with that because they can’t see the injury, and it’s only experienced by the person. But it’s a huge injury. So it needs to be taken seriously.”

Kanaman, who played basketball and volleyball in high school, never got a concussion playing sports, but suffered one in a car accident.

“Experiencing a concussion myself, I can’t imagine somebody playing with one,” Kanaman said. “But they’re experienced differently by everyone. Mine was severe. I had a lot of memory loss. It took my two months before I stopped experiencing symptoms. But some people have one day of rest and they’re good to go again.”

 

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