Sports Medicine

All TVS student athletes in grades 7-12 are required to have a pre-participation physical examination performed by a physician to determine if they are physically capable of participating in athletics. At minimum, these exams are required every other year when entering seventh, ninth, and 11th grades, or when updates are needed due to significant time-loss injuries or illness since the last exam. The physical exam form should be accompanied by a completed medical history form signed by a parent or guardian. No student will be allowed to participate in any TVS practice or game without completing and returning their pre-participation physical examination and medical history form to the TVS athletic trainers.

Preparticipation Physical Exam Form

Medical History Form

Trinity Valley School Concussion Policy

Based on current standards of care and in compliance with Texas state law, Trinity Valley School has established this concussion policy. All athletic trainers, coaches, student-athletes, and parents shall follow these procedures and policies stated from here forth concerning the care and diagnosis of concussions. On a yearly basis, each student-athlete, his/her parent/guardian, and all coaches must read and sign the Concussion Acknowledgement Form prior to athletic participation.

Definition – a concussion is a complex pathophysiological process affecting the brain caused by a traumatic physical force or impact to the head or body, which may include temporary or prolonged altered brain function resulting in physical, cognitive, or emotional symptoms or altered sleep patterns; and/or involve loss of consciousness.

Diagnosis – Any student-athlete suspected of a concussion shall be removed from practice or competition for further evaluation by an athletic trainer or physician. Concussion evaluations may be performed on the sideline, practice field, court, or in a controlled environment. The athletic training staff will use peer-reviewed, research-based methods to evaluate and diagnose the injury. Evaluation will consist of verbal communication, functional testing, and symptom scoring. If a concussion is still suspected and/or diagnosed, the student shall not return to activity that day and the procedures below must be followed.

Cognitive Rest – A student diagnosed with a concussion will need cognitive as well as physical rest to allow the brain to heal. No two concussions are the same and do not present with the same symptoms or timeline for recovery. Each student-athlete’s case will be handled individually based upon the initial symptoms. The athletic trainers will communicate with the appropriate division heads and school nurse to make academic accommodations as needed based on their symptoms. Accommodations can be as simple as extended time for assignments, to no tests or quizzes during this time, or the student may need to stay at home while symptoms are present. Once the student-athlete has passed the ImPACT test and is symptom free, the athletic trainer will inform the division head that the student has returned to normal cognitive function and no longer needs academic accommodations because of the concussion.

Treatment and Return to Play – Every student-athlete diagnosed with a concussion must be evaluated and cleared by a physician and must complete the TVS concussion return-to-play (“RTP”) protocol. The athletic training staff will communicate with the appropriate school official to make adjustments to the student-athlete’s academic affairs to allow cognitive rest. Once the athlete is asymptomatic for 24 hours, he/she may begin the RTP process.

Return to Play (“RTP”) Protocol

• Step 1- Rest, until symptom free (physical and cognitive rest)
• Step 2- Once asymptomatic for 24-hours take neurocognitive test*
  *Does not apply to middle school students; instead, wait 48 hours once asymptomatic with no increase or return of symptoms as a result of classwork. Symptom score sheet will be used to track student’s symptoms from injury through 48 hours of being asymptomatic.
• Step 3- Begin the RTP protocol.
• RTP occurs over a minimum of five steps. Must wait 24 hours between each step.
• RTP 1- light aerobic activity (bike or elliptical) 10-20 minutes
• RTP 2- aerobic (jogging or elliptical) & resistive training for 20-30 minutes
• RTP 3- sport specific functional drills or non-contact practice
• RTP 4- full contact activity
• If symptoms return during any step, the student-athlete must go back to the previous step and begin again after 24 hours.
• Total days missed will vary and are determined by how long it takes for symptoms to resolve, and/or if any steps have to be repeated.
• Step 4 – The student-athlete will be cleared to return to full participation after the following requirements are met: completion of the RTP protocol (Steps 1-4) while remaining symptom free; written consent given from the treating physician and the parent/guardian; and all documents submitted to a TVS athletic trainer.

Concussion Acknowledgement Form

Parent Concussion Guide

TVS Return to Play Form

Any student-athlete who sees a physician, nurse, or physical therapist for any illness/injury must present a written note to the athletic trainer’s office documenting that he/she is cleared for further participation in athletics. Without proper documentation, the student-athlete will not be allowed to participate in any athletic practice or event until proper documentation is submitted.

Injuries need to be reported immediately when possible. Otherwise, new injuries need to be reported and seen during before school treatment hours (during fall season as noted below) or the student’s lunch period. The small window of time before athletics begins is usually not sufficient for both evaluation and treatment. Failure to appear at designated treatment times is not an acceptable excuse to miss a practice, as all athletes will be expected to be present for team practices.

The number of heat illness-related incidents has increased nationwide. In response, many secondary schools and colleges have adopted heat policies to better protect their student athletes from the threats posed by these extreme temperatures. Because the majority of fall sports in North Texas are played during the hottest time of the year, it would not be prudent for us to cancel practices frequently and still expect our athletes to perform at a high level of competition without experiencing a period of acclimation conditioning.

Research from the National Weather Service indicates that a heat index of 105 can be dangerous to high-risk individuals. This high risk group contains the elderly, the very young, persons who have sustained/suffered from heat illness previously, asthmatics, and those with cardio/pulmonary disorders. In light of this information, we adhere to the following procedures for Trinity Valley School PE and Athletics:

Pre-Season Upper School Practices (prior to school starting in August):

1. If a heat index of 106 degrees is reached and maintained for 5 minutes during an outdoor practice session, the session will be moved indoors, postponed, or rescheduled.
2. If a heat index of 106 degrees is reached before a practice is scheduled to begin, the practice will be moved indoors, postponed, or rescheduled.

During the School Year:

1. At temperatures of 95 degrees or above, all K-5 physical education classes shall remain indoors.
2. At temperatures of 100 degrees or above, all outdoor middle school, grades 6-8, practices will be modified in the following manners:
   1. duration
   2. frequency of water breaks (mandatory team breaks are taken every 20 minutes at minimum)
   3. location, if possible (indoors vs. outdoors)
3. At a heat index of 106 degrees, all outdoor upper school sports practice times will be adjusted.
   1. In the case that a heat index of 106 degrees is reached during school, students will report to study hall immediately following classes and practices will begin at 6:30pm, or at the earliest time after the heat index has dropped below 106.
   2. If the heat index levels are anticipated to exceed 106 degrees for an extended period of time, practices may instead be held from 6:30-8:30am.

The overall health and safety of our student athletes is of utmost importance to everyone associated with Trinity Valley School athletics. This policy is designed to make participating in athletics at TVS during these hot fall months as safe as possible.

In conjunction with altering practice times, we ask that all athletes report to all activities properly pre-hydrated and adequately fueled through nutrient-rich foods.
Hydration Tips:
17-20 fl. oz. two hours before practice/game
At least 7-10 fl. oz. (water) 10-20 minutes before practice/game
Nutrition Tips:
4:1 carbohydrate to protein ratio
example: turkey sandwich on wheat bagel
simple grab-n-go pre-practice snacks: fruit, granola bar, bagel with peanut butter

Water is available to all athletes at all times throughout practices. In addition, team water breaks are required approximately every 20-30 minutes. During break time, athletes gather in the shade of the pavilion with mist sprayers, fans, water, and Gatorade.

Any athlete displaying or reporting symptoms of heat illness will be removed from activity immediately. If your child is taking any medications that may increase his/her susceptibility to heat illness, please inform the child’s coach, the athletic trainers, and the school nurse.

The Thor Guardian lightning prediction system located in the southwest corner of our campus is designed to provide early warning of a possible lightning strike. When the system activates, one long horn will sound and the strobe light on top of the unit will flash visibly. Coaches will remove teams from this potentially harmful environment immediately, and all others outside should move to shelter at once.

We request that parents and spectators respectfully adhere to these procedures as role models for our student-athletes. The best options for safe shelter are the breezeway or the gyms. The system will remain active, and all fields must remain cleared, until the Thor Guard gives the “all clear” signal of three horns, and the strobe light stops flashing.

Also a concern during the Texas summer, ozone consists of pollutants that chemically react in the presence of sunlight. The ozone can decrease lung capacity by up to 20% due to inflammation and swelling of lung passageways. Athletes with asthma will be encouraged to pre-treat with their inhaler before activity begins. Any athlete complaining of not feeling well will be allowed to discontinue activity until symptoms cease.

Over-the-counter medication will only be distributed to student athletes at the time of an injury or when the athletic trainer deems appropriate. Students seeking daily dosage of any over-the-counter medications should consult their physician.

Taping and bracing can be used for preventative measures, for acute injury, and during post-injury rehabilitation. Taping is usually done at the discretion of the TVS athletic trainers, or by written request from a physician treating the injury. Injuries should not be expected to be alleviated by taping alone. Appropriate treatment and rehabilitation should be done under the direction of the athletic trainers.

Ankle braces are required during participation in upper school football and girls’ volleyball. Bracing is also recommended by the TVS athletic trainers for upper school boys’ and girls’ basketball, and boys’ volleyball. There are many options for supportive ankle braces on the market. Each athlete may choose to buy their own, or ankle braces are available from the TVS athletic training department for $30 per pair.

For sports in which mouth guards are required (football, field hockey, lacrosse), the TVS athletic trainers will provide each athlete one at the beginning of the season. Replacement mouth guards will be provided thereafter for $1.00 each.