S: The patient is a 22 year old female that participates in Crossfit.

She came in at 9:30am complaining of

a severe headache, falling asleep in class, blurred vision, nausea, and sensitivity to light and sound. She
reported that the previous day she was Olympic lifting during her open gym performing a Split Jerk.
When she attempted a 135# 1 rep max she missed the arm extension, failing the lift and dropped the
bar on her head. She claims she had no signs or symptoms until after her 530am workout the following
morning that included high intensity rowing. She has had no previous history of head injury. No baseline
assessment was ever performed.
O: The patient appeared emotional and fatigued when describing what happened to her athletic trainer.
Her focus was also slightly diminished. Her cognition and memory seemed unaffected.
Upon observation there was no obvious deformity.
Upon palpation there was tenderness at the parietal bones just superior to the occipital.
No special tests were deemed necessary.
A: Possible grade I concussion
P: Instruct patient to go home and sleep and not to take any NSAIDs. The patient can have
acetaminophen for her headache. She is not to participate in physical activity and must limit brain
stimulation (no tv, cell phone, or computer use). She will undergo exertional testing when completely
symptom free for 24 hours. Once she passes the exertional test without return of symptoms she may
return to play.
-Alice Jose, ATS
2.3.14

Once symptom free for 24 hours the athlete may perform exertional testing
10 push-ups
10 sit-ups
15 airsquats
500m row
1000m row
5 strict pull-ups