About Twin Cities Orthopedics
For over 70 years Twin Cities Orthopedics has proudly offered a full spectrum of medical care, devoted to the diagnosis, treatment, rehabilitation and prevention of injuries and conditions that affect the body's muscles, joints and bones. Our physicians are experienced, board-certified (or board-eligible) specialists, surrounded by excellent support teams. As one of the largest orthopedic practices in the country, our size and strength allows for a larger depth of knowledge. No matter how common or obscure your need, we have the capability to offer the best treatment. Our team of 85 physicians, 30 physical therapists and 50 certified athletic trainers use the latest medical technology and knowledge, providing you the best quality care available.
 

Twin Cities Orthopedics – Sports Medicine Services
TCO’s experienced specialty trained orthopedic physicians, physical therapists and certified athletic trainers are committed to the comprehensive care of musculoskeletal injuries. Twin Cities Orthopedics offers 28 convenient neighborhood clinics in the metro area to help meet the needs of our student athletes.
TCO’s programs include:

• 5 Access Acute Injury Walk-In Clinics
  • Open 8 a.m. – 8 p.m./7 Days/Week
  • Burnsville, Coon Rapids, Edina, Maple Grove & Waconia
• Virtual Clinic Free Online Injury Evaluation – TCOmn.com
• Specialty Programs:
  • Sports Injury Prevention, Dartfish Technology, Functional Movement Screening (FMS), ACE – Athletic Competition Enhancement, Golf Medicine, Baseball & Softball Throwing, various Educational Seminars & Conferences throughout the year.

What is a concussion?
A concussion is a mild traumatic brain injury (TBI). It occurs from either a direct blow to the head or elsewhere on the body that results in an impulsive force transmitted to the head (indirect blow). A TBI can cause a disturbance in brain function and information processing. Brain functions that control one’s coordination, learning, memory, and emotions are most commonly affected by a concussion injury.
 
Signs and Symptoms
A concussion can present with a wide array of symptoms that may or may not include:

• Altered mental status including confusion, inappropriate emotions, agitation or abrupt change in personality
• Blurred vision/double vision/seeing stars or black spots
• Dizziness, poor balance or unsteadiness
• Excessive or persistent headache
• Excessive fatigue/feel slowed down
• Feel “in a fog”
• Loss of consciousness
• Amnesia/memory problems
• Loss of orientation
• Vomiting
• Poor balance/coordination                                                              
• Ringing in ears
• Excessive sensitivity to light or loud noise                         
• Vacant stare/glassy eyed

When am I safe to return to activity?
A concussion patient should be free of symptoms and have returned to their normal sleeping and eating patterns as well as typical concentration levels at school and work before resuming high levels of activity.  Once normal activities have resumed and there are no symptoms at rest, he/she is ready to try more demanding activities that increase his/her heart rate. 
***Under no circumstances should anyone return to activity while experiencing concussion signs or symptoms. There should be no return to activity on the same day concussion symptoms are noted or a formal diagnosis of a concussion is made***
 
Return to play protocol Return-to-play decisions are complex. An athlete may be cleared to return to competition only when the player is free of all signs and symptoms of a concussion at rest and during exercise. Once free of symptoms and signs of concussion, a stepwise symptom free exercise process is required before a player can return to competition.
Each step requires a minimum of 24 hours.
The player can proceed to the next level only if he/she continues to be free of any symptoms and or signs at the current level.
If any symptoms or signs recur, the player should drop back to the previous level.
 
The return to play after a concussion follows a stepwise process:
1. No activity, complete rest until all symptoms have resolved. Once asymptomatic, proceed to level 2.
2. Light aerobic exercise such as walking or stationary cycling, no resistance training.
3. Sport specific exercise—for example, skating in hockey, running in soccer; progressive addition of resistance training at steps 3 or 4.
4. Non-contact training drills.
5. Full contact training after medical clearance.
6. Game play.
 
The final return to competition decision is based on clinical judgment and the athlete may return only with written permission from a health care provider who is registered, licensed, certified, or otherwise statutorily authorized by the state to provide medical treatment; is trained and experienced in evaluating and managing concussions; and is practicing within the person's medical training and scope of practice.
Neuropsychological testing or balance testing may help with the return to play decision and may be used after the player is symptom free, but the tests are not required for the symptom free player to return to play.

Eagan High School
4185 Braddock Trail • Eagan, MN 55123
Tel: 651-683-6900 • Fax: 651-683-6910