Craig Magri
Trainer
Colorado Mammoth

Craig Magri graduated from San Diego State in 1994 with a bachelor of science degree in athletic training. Since then he has accomplished himself with years of experience in the physical therapy field. He started his career as trainer of the San Diego Gulls, a minor league ice hockey team. After that he spent four years at a prominent physical therapy center in San Francisco that treated athletes from some of California's professional teams. He now works with the Colorado Mammoth and HealthONE.

Concussions

Playing a high impact sport such as lacrosse has the greatest risk of sustaining cerebral concussions. A cerebral concussion is defined as an agitation of the brain by either a direct or indirect blow. Signs and symptoms of concussions range from dizziness and disorientation to amnesia and loss of consciousness. Cerebral concussions are graded on a scale of I through III, with I being mild and III being severe.

Signs, Symptoms, and Return to Play

Grade I
Grade I concussions are the most common type in sports and are associated with confusion, dizziness and mild headaches. There is no loss of consciousness or memory. An athlete may return to immediate play only if all signs and symptoms have been resolved for 20 minutes. If symptoms return with increased activity the athlete must stop play for another 20 minutes. If symptoms persist stop all activity.

Grade II
Grade II concussions involve all of the signs and symptoms of a Grade I concussion but also include post traumatic amnesia. Post traumatic amnesia is the inability to recall events that have occurred since the time of injury. An athlete is immediately pulled from the game and may not return to play until all symptoms have resolved for at least one week. Difficulty in concentration, recurring headaches and irritability, which are signs of post concussion syndrome, my last for several weeks following a Grade II concussion.

Grade III
Grade III concussions are the most severe and life threatening. Signs of Grade III concussions include all those of Grades I and II plus the loss of consciousness and retrograde amnesia. Retrograde amnesia is the inability to recall events that happened prior to the injury. Any athlete who sustains a Grade III concussion should be immediately taken to the hospital by an ambulance. An athlete may return to play in one month after all signs and symptoms have resolved. A neurological exam is also required prior to any return of activity.

Second Impact Syndrome

It is very important that any and all symptoms of a concussion have resolved prior to returning to play. Returning to play too soon increases an athlete's risk of Second Impact Syndrome. Even the slightest impact to the head following an unresolved concussion may lead to catastrophic brain swelling which can lead to a coma and possibly death. With Second Impact Syndrome in mind the guidelines for returning to play after a second concussion in a season are much stricter.

Grade I
Return to play in 2 weeks if symptom free while at rest and with increased activity for one week.

Grade II
Minimum of 1 month no participation. May then return to play only when symptom free for one week.

Grade III
terminate the season.