Interviews Dr. Mandelbaum about the Importance of Taking a Concussion Test Before Suffering a Concussion



If you participate in a sport where collisions happen frequently, you might want to take a concussion test now.

I’m not just talking about sports like football and boxing where hitting is the point of the game. In the NCAA, more concussions are reported in women’s soccer than in men’s football. It’s also one of the most common injuries in basketball.

And I have one friend who gave up bicycling after sustaining his eighth concussion — while wearing a helmet.

But why take a concussion test if you haven’t had a blow to the head?

Get a Concussion Test Baseline

Concussions are tricky to diagnose. You may not be aware of how badly you are injured. Pumped on adrenalin, most athletes just want to get back in the game. And some deny their symptoms.

So most professional and large college teams are now administering concussion tests to all their athletes at the beginning of each season. They want to get a baseline measurement so that if an athlete gets badly knocked around, a trainer on the sidelines can quickly see if the test score changed.

You can choose from several concussion tests. If you are part of a team, you might want to buy one test that everyone can share. In all cases, you should get someone else to give you the test, preferably someone with appropriate medical training.

These three concussion tests were recommended by Bert Mandelbaum, an orthopedic sports physician who holds positions with FIFA and Major League Baseball among other organizations:

Sports Concussion Assessment Tool

An international group of leading concussion experts developed the the Sports Concussion Assessment Tool, now in its third version (SCAT3). It takes about 20 minutes to administer, and relies on observations about whether you seem dazed, how well you can answer questions and memorize facts, and how well you can balance.

The authors of the test advise that only medically trained people administer this test. For lay people, they recommend the simplerConcussion Recognition Tool, on which a baseline score is probably not useful.

Both are available for free.

King-Devick Test

The King-Devick Test was developed in 1976 as a test of eye movements as they relate to reading performance. Since 2011 multiple studies have shown a close correlation between scores on the King-Devick and a wide range of neurological conditions, including concussion.

You read single digits displayed on cards, a laptop or an iPad. Lines of the numbers become increasingly difficult to track with successive cards.

You read as quickly as possible without errors. Often your speed will improve when you take the test again because you have become more familiar it. If you get hit on the head, take the test. If you need more time to complete it than before, you should stop playing and consult with a physician to get a thorough evaluation.

For an individual, the test sells for $50, but it can cost as little as $5 per athlete for a team.

Impact Test

The Impact Test is computerized and takes about 25 minutes to complete. Its maker offers certification courses and recommends that it be administered by a specially trained athletic trainer, school nurse, athletic director, team doctor or psychologist.

It measures player symptoms, verbal and visual memory, processing speed and reaction time. Unlike the King-Devick the Impact alternates modules so your speed should not improve.

The Sideline Impact is an abbreviated version of the Impact Test available as an iPhone application. It takes five minutes to administer and measures concentration, short-term memory and orientation.

The Sideline Impact app sells for $3.99. But the manufacturer warns it should not be used for “return to play” decisions… which makes me wonder just how it should be used.

For more options, check out this list at

Just See a Doctor?

Some experts have criticized these tests on the grounds that they really aren’t necessary. They argue that if you suspect you might have a concussion, you should skip the tests and just see a doctor.

That’s my recommendation, too. But I think a lot of people will have trouble following it in the real world of sports. These tests might come in handy in cases where athletes don’t experience, or don’t show, obvious signs of concussion.

Say someone hits you hard in the head with an elbow. Or you fall against a goal post. Your head hurts, but you’re not seeing stars. You just want to keep playing.

It those cases, it would be great to have someone on the sidelines say, “Just take this quick concussion test, then if everything is fine you can go back in.”

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