HeadStrong in Iowa: What Parents and Athletes Need to Know

Sep 21

5 min read

Lisa Brekke, PT, DPT

A concussion can be a confusing injury for athletes and families. Symptoms can look different from one athlete to another, and recovery does not always follow a predictable timeline.

For Iowa high school athletes, knowing what to do after a suspected concussion, where to seek care, and how programs like HeadStrong can help with the financial side of treatment can make the recovery process a little easier.

What Is a Concussion?

A concussion is a type of traumatic brain injury that affects how the brain functions. It can happen after a direct blow to the head or body, a fall, or another force that causes the brain to move rapidly inside the skull.

A concussion does not require loss of consciousness. Symptoms can include:

Headache or pressure in the head
Dizziness or balance problems
Nausea
Sensitivity to light or noise
Blurred or double vision
Difficulty concentrating or remembering
Fatigue or changes in sleep
Feeling slowed down or "foggy"
Irritability or changes in mood

Symptoms may appear immediately or develop over time, which is one reason appropriate follow-up after an injury is important.

What Does Good Post-Concussion Care Look Like?

Good concussion care is more than simply telling an athlete to "rest until they feel better."

A thorough evaluation considers the athlete's symptoms, physical and cognitive function, balance, vision and eye movements, exertion tolerance, and other factors that may be contributing to symptoms. Care should then be individualized to the athlete and adjusted as recovery progresses.

Early in recovery, athletes may need a short period of relative rest followed by a gradual return to regular activities. Light physical activity can be introduced as tolerated rather than keeping an athlete completely inactive for an extended period.

Good concussion care may include:

Education about the injury and expected recovery
Symptom monitoring
Return-to-learn planning
Gradual return to physical activity
Management of headaches, dizziness, balance problems, or visual symptoms
Vestibular and balance rehabilitation when appropriate
Exercise progression
Coordination with parents, schools, coaches, athletic trainers, and other healthcare providers
A gradual return-to-play progression

If symptoms are not improving as expected, become worse, or persist beyond the expected recovery period, additional evaluation or referral may be appropriate.

Where Does Physical Therapy Fit In?

Physical therapy can be an important part of concussion recovery, particularly when an athlete has symptoms involving dizziness, balance, vision, motion sensitivity, exercise intolerance, neck pain, or difficulty returning to physical activity.

A concussion can affect multiple systems involved in movement and balance. A physical therapist trained in concussion management can evaluate these areas and develop an individualized treatment and exercise program.

This might include:

Vestibular rehabilitation
Balance and coordination training
Gaze stabilization and visual-motor exercises
Cervical assessment and treatment
Graded aerobic exercise
Sport-specific activity progression
Education and strategies for managing symptoms

Physical therapy does not replace medical evaluation. Instead, it can be an important part of a multidisciplinary approach to concussion recovery. CDC guidance specifically identifies vestibular rehabilitation as an appropriate intervention when vestibulo-ocular dysfunction is present.

Who Can Evaluate a Concussion in Iowa?

For Iowa interscholastic athletics, a licensed healthcare provider trained in the evaluation and management of concussion and other brain injuries can evaluate a student with a suspected concussion.

Iowa's definition includes:

Physicians
Physician assistants
Chiropractors
Advanced registered nurse practitioners
Nurses
Physical therapists
Athletic trainers
Neuropsychologist

The provider must be appropriately licensed and trained in concussion evaluation and management.

For athletes removed from participation because of a suspected concussion, Iowa rules require evaluation by a trained licensed healthcare provider as soon as feasible and written medical clearance before beginning the return-to-play protocol.

What Are Return-to-Learn and Return-to-Play?

Recovery isn't just about getting back on the field.

Return-to-Learn

Return-to-learn is the gradual process of returning to school and cognitive activities. Some athletes may temporarily need accommodations such as breaks, reduced workload, or adjustments to screen time and other activities that increase symptoms.

Return-to-Play

Return-to-play is a gradual, step-by-step progression back to sports participation.

The current CDC 6-step progression moves from regular activities to light aerobic activity, moderate activity, heavy non-contact activity, practice/full contact when appropriate, and finally competition. Each step typically takes at least 24 hours, and an athlete should not progress if new or worsening symptoms occur.

In Iowa, an athlete removed from participation must have written medical clearance before beginning the return-to-play protocol. Contact or collision activities cannot be introduced until the athlete has written clearance and has returned to pre-injury academic function.

What Is HeadStrong?

HeadStrong is a concussion insurance program available through the Iowa High School Athletic Association (IHSAA) and Iowa Girls High School Athletic Union (IGHSAU).

HeadStrong is designed to help with the medical expenses associated with concussion care for eligible Iowa high school athletes.

One important thing for families to understand is that HeadStrong is a financial resource, not a concussion treatment program. Your athlete still needs appropriate evaluation and treatment from qualified healthcare providers.

When Should You Use HeadStrong?

If an eligible Iowa high school athlete sustains a concussion during an IHSAA/IGHSAU-sanctioned activity, it is worth asking about HeadStrong and starting the claim process.

And here's the part I especially want families to remember:

Submit the claim even if your athlete seems to be doing well.

You may not know immediately how much care an athlete will need. Some athletes recover quickly, while others may develop persistent dizziness, headaches, exercise intolerance, visual symptoms, or other difficulties that require additional treatment.

The current HeadStrong claim submission guide states that the incident report should be submitted within 30 days of the injury, or as quickly as possible. The report needs to be completed accurately and signed by a representative of the school (preferably someone who was present for the injury).

Submitting the claim early can help prevent a situation where an athlete needs additional care later and the family has not started the claim process.

When in doubt, ask your school's athletic department or athletic trainer about submitting a HeadStrong claim.

How Brekke Rehab Can Help

At Brekke Rehab, concussion care is focused on helping athletes understand what is happening, identify the factors contributing to their symptoms, and progress safely toward the activities that matter to them.

Care may include evaluation and treatment of vestibular, visual, balance, cervical, and exercise-related symptoms, along with individualized progression toward school, daily activities, and sport.

If your athlete has sustained a concussion or you aren't sure what the next step should be, reach out to Brekke Rehab. We can help you understand your options, determine whether physical therapy may be appropriate, and help you navigate the next steps in recovery.

Questions about concussion care or HeadStrong? Contact Brekke Rehab to learn more.

This information is for educational purposes and does not replace an individualized medical evaluation. HeadStrong eligibility and coverage are determined by the program and its current terms. Families should confirm current requirements with their school and the IHSAA/IGHSAU.