Sports injuries: A roadmap to recovery

08/13/2018

By Sue Cody

W2W Chad Rankin 
Chad Rankin stands on the sidelines of high school football games, ready to assess player injuries and offer treatment and advice. He can perform tests to see if there are signs of a break, a bruise, muscle strain or concussion. All this is provided at no cost to the athlete or the school.

​“Even before competing, athletes and all adolescents should get a complete wellness exam with their primary care provider,” says Safina Koreishi, MD, and medical director for the Columbia Pacific Coordinated Care Organization.

Rankin is a certified athletic trainer who can help athletes prevent injuries as well as offer advice. He is employed by Columbia Memorial Hospital (CMH), and his services have been offered to athletes at Seaside, Warrenton, Astoria and Knappa school districts since 2011.

​“Giving back to the community is part of the mission of CMH as a Planetree hospital,” Rankin says. “The hospital has given me the freedom to get the job done.”

“Chad Rankin and Columbia Memorial Hospital are a huge asset to our schools and athletic programs,” says Astoria High School Athletic Director and Football Coach Howard Rub.


Assessment

Most of the injuries Rankin sees are to ankles, knees and elbows. He offers treatment on the sidelines and follows up with the student, coaches, parents and teachers.

He carries a desk size bag of equipment that includes ice packs, kinesio tape, dynamic tape, braces and a big metal rod he calls the boom stick. The tape can help activate or deactivate different muscle groups. The rod is used to rollout tight calves or quad muscles.

​Rankin can recommend when it is necessary for the athlete to go to the his/her primary care physician, emergency room, urgent care, see a sports specialist or orthopedic doctor. Many of the injuries can be treated at home with RICE (rest, ice, compression, elevation).

“Coaches have been excellent to work with. If there is an issue, they defer to me,” Rankin says.

“Chad is the best,” says Rub. “The fact that you can have an expert immediately evaluate an injury on the spot or within the next 24 hours is remarkable. Most high schools and middle schools don’t have that luxury.”

 Concussions

“A concussion is the most complicated sports injury you can sustain,” Rankin says. Each concussion is unique. The same individual can sustain multiple concussions and experience different symptoms each time.

​Rankin does a baseline ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) test for athletes before the fall, winter and spring sports seasons. He schedules 20 kids in the computer lab at a time to take the exam that tests long-term and short-term memory, reaction time, attention span, etc.

​ImPACT is given to seventh, ninth and 11th graders. The test takes about 30 minutes. “We do our best to get baseline tests for every kid, every other year,” Rankin says.

When an athlete sustains an injury that can potentially be a concussion, Rankin has the tools to reevaluate the brain function, by repeating the test.

“We can see if there are deficiencies in their memory, cognitive, visual, motor speed or reaction time, and say something isn’t quite right,” he says.

​If the student is experiencing headaches, can’t sleep or can’t concentrate in school, he might have a concussion. “The first thing I tell them is, ‘Don’t hit your head again,’” Rankin says.

Over a six-year span, the number of concussions Rankin has seen has grown exponentially from 43 in 2011 to 104 in the 2016-17 school year. “Those are the ones reported to me,” he says.

​Rankin likes to provide a roadmap to recovery. After evaluation, he sends an email to the principal, education director, PE teacher and parents. If there is a head injury, he advises parents to seek a medical evaluation from a doctor and gives them a concussion information packet.

“The followup is literally like being at the collegiate or professional level,” says Rub. “He is a huge asset to our families. We don’t need to be spending extra money and time at doctor visits, when it isn’t necessary to go back to the doctor yet.”

​Communication is key, Rankin says. Sometimes, what is overlooked are the academic accommodations. In one case, years ago, a student was hit hard in a football game and acted punch drunk on the sidelines. Rankin sent him to the ER for immediate evaluation and told him not to return to school the next day. But he did go to school and scored poorly on an important test. That is why Rankin works with the schools.

​Many athletes are overachievers and feel an obligation to keep up with school work. But rest after a concussion is important for the brain to heal. They can always take a makeup test.

The protocol has changed from full rest because it was found that taking everything away from one’s normal routine, may lead to depression. It is better to stick fairly closely to the normal routine.

​Rankin suggests taking short walks if it doesn’t hurt your head; listening to TV without watching it; limiting screen time; doing puzzles; occupying your time without exacerbating the symptoms. It is important to avoid caffeine and sugar and to keep hydrated. Rankin says it is better to get eight full hours of sleep at night than to nap during the day.

​After a concussion, a doctor needs to clear the student for full participation in sports.

Rankin was given a Community Recognition Award for his services by the Astoria School District.