Concussion Management

Concussions can occur in sport, at the workplace and in motor vehicle accidents. When most people hear the word concussion, they think of contact sports such as football or hockey. While there are high occurrences of concussions in these sports,those involved in workplace accidents and motor vehicle accidents are susceptible as well.

ShiftLogo Dr. McKay is a Shift Concussion Management Certified Provider. He is able to conduct and analyze baseline testing, post-concussion testing and provide treatment for those suffering from a concussion.

What is a Concussion?

A Concussion changes the way our brain functions – causes it to work less optimally. It may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head. A Concussion may or may not involve loss of consciousness (loss of consciousness is not a diagnostic requirement). In fact, less than 20% of concussions result in a loss of consciousness. While it is common that concussions occur in sport, they also can occur at the workplace and motor vehicle accidents.


Visible clues of suspected concussion

  • Loss of consciousness or responsiveness
  • Lying motionless on ground / Slow to get up
  • Unsteady on feet / Balance problems or falling over / In-coordination
  • Grabbing / Clutching of head
  • Dazed, blank or vacant look
  • Confused / Not aware of plays or events

Components to Concussion Management

» Pre-Injury: Baseline Testing

» Post-Injury Assessment and Care

» Return to Pre-Injury Status


» Pre-Injury: Baseline Testing

Concussions can produce a wide array of of symptoms which pose 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-participation timelines. For this reason, a growing emphasis has been placed on objective pre-participation (baseline) testing protocols that can be used to track an athlete’s recovery and serve as a tangible measurement for return-to-play. 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.

To conduct Baseline Testing, we employ computerized neurocognitive testing (ImPACT®) as part of all baseline and post-injury assessment protocols. This type of testing provides us with a snapshot of how an athlete’s brain is functioning both pre and post injury by measuring things like reaction time, processing speed, memory, and attention/concentration. These cognitive processes are often affected by concussive injury, and so this type of testing provides us with important information when managing an athlete’s recovery. In addition to neurocognitive testing, we perform a physical test (Sway™ System) that measures balance and reaction time.

Results from these tests are kept on file and used for comparison, should an injury occur.

Who would benefit from Baseline Testing?

If you play a sport that puts you in a position vulnerable to a hit, fall or to equipment hitting your head, you are a candidate for Baseline Testing. Baseline Testing is recommended for all athletes amateur to professional level. It is recommended that the test be taken before the season starts for a sport, every two years (when concussion free) to provide an accurate comparison should you suffer a concussion.

What is imPACT®?

ImPACT® stands for “Immediate Post-Concussion Assessment and Cognitive Testing”. It is a computerized neurocognitive test that measures:

  • Attention span
  • Working memory
  • Sustained and selective attention time
  • Response variability
  • Non-verbal problem solving
  • Reaction time

Note: computer-based neurocognitive tests that are designed for concussion assessment (eg. ImPACT®) are valuable and valid tools that provide objective information on various aspects of neurocognitive performance; however, these tests are not meant to replace a full neuropsychological assessment that would be provided by a qualified Neuropsychologist. When more complex or comprehensive testing is required, specialist referral may be indicated.

» Post-Injury Assessment

If you suspect you have concussion, you should seek medical assistance immediately.
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.
Once medical assistance is performed, we are able to move forward toward your concussion evaluation and testing.

If you have suffered a concussion, it is important to be diagnosed, treated and given management strategies to enable you to get better as soon as possible. At your Assessment and Treatment appointment, Dr. McKay will do a thorough post-injury evaluation and physical examination (Sway™ System) to see how your injury has impacted you. You will also do a computerized imPACT® test. If you have a Baseline Test on file, Dr. McKay will be able to see the changes that occurred post-injury, or if you have not done one in the past, he will be able to use the results as a measurement on the severity of your injury.

Dr. McKay will also recommend if treatment is necessary and most likely give you some exercises or stretches that will aid in your recovery. He may also make some recommendations regarding rest, work and rehabilitation. He may also may make recommendations to see other complementary health care providers as necessary, based on your injury.

How long will it take to get over my concussion?

Most people may recover from their concussions in a week to several weeks, but it depends on the severity and the care received following their concussion. If you suffer a blow to the head or neck and suspect a concussion, you must stop any activity immediately and seek medical attention. Studies have shown that recovery time is prolonged should an athlete continue to “play it out” once suffering a concussion and cause further damage resulting in longer recovery time and further damage. To ensure the quickest recovery possible, it is important to get adequate rest from both physical and mental activities – any activities that require concentration (eg. texting, computers, smartphones, television, reading), eat healthy, drink plenty of fluids (no alcohol) and get enough sleep.

» Reassessment: Return to Pre-Injury Status

Returning to play after suffering a concussion will only occur once all symptoms of the concussion have cleared. Should you still suffer symptoms, there is a risk of furthering the injury and delaying full recovery time. Returning to activity will be a gradual one, as symptoms may still exist and show once physical or mental activity is increased. Dr. McKay will be able to assess your progress and give you a graduated program to return to your full pre-injury status. In addition to a physical test (Sway™ System) to measure balance and reaction time, you will also do another imPACT® exam to give a measurement of progress since your injury.

Once you no longer show concussion symptoms, Dr. McKay will be able to give you the go ahead to return to play and full sport participation. He will also be able to give you and your coaches a guideline for return to play.


Please see our FAQ page for more information.

Concussion Management services are available at the Richmond office.
Please call us at: 604 232-0112 or email us for an appointment.

Common symptoms of a concussion

  • Headache
  • Dizziness
  • Neck pain
  • Nausea or Vomiting
  • Loss of balance
  • Poor coordination
  • Trouble focusing on objects or words
  • Poor concentration
  • Feeling “foggy”
  • Confusion
  • Amnesia, or poor memory
  • “Flashing lights”
  • Blurred or double vision
  • Seeing “stars”
  • Irritability or emotional changes
  • Ringing in ears
  • Slow to follow direction
  • Decreased playing ability
  • Easily distracted
  • Vacant stare
  • Drowsiness/fatigue
  • Difficulty falling asleep
  • Feeling “off” or not like oneself