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Shift Concussion Management


We emphasize a multifaceted approach with several important pillars for the complete management of concussions: education, awareness, research, baseline testing, physical testing, therapeutic strategies and return-to-play preparation. We believe that partnership and communication provides the most successful results and ensures that our athletes receive a high standard of care following concussive injury.


Currently, there is no “gold standard” for the detection of a concussive injury. Diagnosis is typically based on the presence of any combination of symptoms known to commonly result from concussion. Traditional return to play decisions as such, have become reliant on the “wait-until-symptoms- resolve” paradigm. Recent advancements in concussion management have resulted in the widespread use of computer-based neurocognitive testing protocols, and evidence now shows that concussed athletes demonstrate subtle cognitive deficits that persist beyond symptom resolution: emphasizing the fact that return to play once “symptom-free” is no longer an accurate measure of readiness.


That is why at Breakaway, we assess and manage each athlete as a whole and tailor our rehabilitative strategies to the individual needs of each athlete. We emphasize testing protocols that provide objective data from many different areas of athletic performance (cognitive, visual, vestibular, neuromuscular, etc.) to aid in the development of individualized intervention strategies

Baseline Concussion Testing 


Concussions can produce a wide array of symptoms, which poses a challenge for coaches, trainers, parents, and health professionals involved in the care of an injured athlete. The time-course for recovery also varies widely from athlete to athlete, making it impossible to employ a “cookie-cutter” approach to concussion rehabilitation and return-to-play timelines. Currently, there is no reliable diagnostic test or marker that can be used to identify a concussion when it’s occurred, or similarly, determine when a concussion has resolved.


For this reason, a growing emphasis has been placed on objective baseline testing protocols that can be used to track an athlete’s recovery and serve as a tangible measurement for return-to-play readiness. By measuring an athlete’s “normal” level of functioning, we are better able to gauge the level of impairment that may exist post-injury by performing comparative testing. The Shift Team believes this requires a multifaceted approach and that no single test should be used in isolation.


Baseline values can vary widely from one athlete to the next, and in young developing athletes, these measures can change dramatically from year to year. It is therefore important to have record of each player’s baseline level of physical and neurocognitive functioning before the start of each season. Should an athlete sustain a concussion during the season, Shift Practitioners have the ability to compare post-injury testing to baseline values. This allows for a more accurate and objective assessment an otherwise elusive injury, and provides important information when making return-to-play decisions.


Additional testing can be done to assess balance, ocular motor, visual and cognitive function using Sway and King Devick testing!


Post Concussion Management


What to do if you’ve sustained a Concussion

Following a suspected concussion, it is recommended that you consult a Medical Physician (Family GP or Sport Physician) as early as possible for medical evaluation. Most sport-related concussion injuries do not require emergent care. It is also important that the athlete remain under close observation over the first few hours following their injury, and should not be left alone or allowed to drive. See our FAQ page for a full list of concussion signs and symptoms.


When to go to the hospital:

Emergency evaluation is warranted in situations of deteriorating mental status such as increasing confusion and difficulty recognizing people or places. Other symptoms requiring immediate medical attention include worsening headache; worsening nausea or vomiting, and excessive drowsiness or lethargy.

When a concussion is suspected, we also recommend booking an initial assessment as early as possible with one of Shift’s healthcare providers. To find a clinic near you, visit our clinic locator tool in the contact menu. Even if you have not had a baseline assessment with Shift, we will assess your injury and provide you with a management strategy to aid in your recovery.

Assessments and subsequent visits/therapy are covered under most extended healthcare benefit packages (eg. Chiropractic, Physiotherapy, Osteopathy). For inquiries about appointments and fees, please contact us at 1-855-223-1002 or


What to expect at your Assessment

Our Healthcare Providers will conduct a thorough post-injury evaluation in order to gain a complete picture of your injury and how it’s impacted you. This includes a detailed interview in order to obtain information on:

  • How the injury occurred

  • How you felt immediately after

  • How you’re feeling currently

  • History of previous concussions

  • Current and past medical conditions

  • Previous trauma/injury

  • Medications

The physical examination provides us with insight into the severity of your injury, as well as specific impairments that may need to be addressed as part of an ongoing management strategy. This portion of testing may include a combination of the following:

  • Computerized neurocognitive testing

  • Balance testing

  • Strength and Coordination testing

  • Screening of visual motor skills

  • Vestibular (or equilibrium) testing

  • Gait assessment

  • Generalized neurological screen

  • Orthopedic assessment of secondary injuries (e.g. neck, shoulders)

The above testing procedures may not all be completed on the first visit. The assessment methods used are tailored to the immediate needs of the athlete and each Healthcare Provider uses his/her discretion on a case-by-case basis.


Management Strategies

Following a concussion, the “sitting in a dark room” approach is only effective for so long. Concussions, like other sports injuries, should be properly managed and rehabilitated. While complete physical and cognitive rest is the mainstay of concussion care, having a health professional guide you through this step-by-step may prove to be invaluable.

Recovering from a concussion can be a difficult and frustrating time. At Shift, we understand that each athlete is affected differently and as such, requires individualized care. Management strategies are used to limit the amount of impairment as well as expedite recovery as much as possible. These strategies may include any one or a combination of the following and are case-dependent:

  • Individualized resting strategies and home instruction

  • Specific recommendations around employment/academic demands

  • Manual therapy for associated complaints (neck pain, whiplash etc.)

  • Visual motor rehabilitation

  • Vestibular therapy

  • Physical exertion testing and exercise plans for return-to-sport

Once symptom free, it is recommended that each athlete undergo a step-wise process of physical exertion testing. Similar to weight training, athletes recovering from a concussion should not skip to 100% exertion from 0% in a short time frame. Physical exertion testing is important not only for physical re-conditioning, but to guard against symptom relapse and help prevent premature return-to-sport. Our Shift professionals can guide you through this process.


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