By Published: May 29, 2019

The CU Medical Services Concussion Team at Wardenburg brings an interdisciplinary approach to the treatment of concussions

When Dr. Tracy Casault began working at the University of Colorado Boulder in 2013, one thing became quickly apparent: Concussion treatment for students was not where it needed to be.

Despite numerous excellent resources available on campus, there were gaps in concussion management into which students, already muddled by their traumatic injury, could fall, potentially creating long-term effects like leaving school.

And that’s when it occurred to her: Why not just bring these resources together as partners?

The Wardenburg Concussion Team, made up of practitioners and researchers from across the campus, is unique among university health clinics for its inclusive approach—and is only looking to grow and improve the care it provides students, who tend to be young and at higher risk for concussions than older adults.

“We are trying to promote and increase collaboration across campus because there seem to be a lot of silos despite a lot of phenomenal resources that simply need to communicate,” says Casault, a sports medicine physician who works for CU Boulder Medical Services. “I think this could hopefully be a model for how we can all communicate better and provide improved care.”

It’s often not a quantum jump where ‘I have symptoms and then I’m a 100 percent.’ It’s like, let’s transition you safely to the right activities. So, together we partner in doing that.

Concussions can manifest in many ways, with the most common symptom being a headache. However, depending on the severity of the injury, students can feel anything from dizziness and nausea to memory difficulties and mood changes. This spectrum means that a one-size-fits-all treatment model doesn’t always work.

“It’s often not a quantum jump where ‘I have symptoms and then I’m a 100 percent.’ It’s like, let’s transition you safely to the right activities. So, together we partner in doing that,” says Annie Sirotniak, a physical therapist at CU Medical Services and a member of the team.

Concussions are often thought of as an athletic injury. However, concussions can happen any number of ways, which is why this team focuses specifically on CU Boulder students instead of varsity athletes (who are managed by their own team of physicians).

And there is no shortage of those students. Each month during the academic year, Medical Services Concussion Team sees an average of 60 patients diagnosed with a concussion. While these injuries can still be sports-related, they also can be from incidents like every day falls, motor-vehicle accidents or getting hit in some way.

This variety means its critical to include units from across campus to meet the individual needs of the student. Currently, the team comprises seven units including medical services, physical therapy, speech therapy, counseling and psychiatric services or behavioral health, student support and case management, disability services, the Office of Victim Assistance and the College of Arts and Sciences.

Compilation Photograph of Researchers

Dr. Tracy Casault, Annie Sirotniak and Theresa D. Hernández are all part of the CU Medical Concussion Team and will be presenting at the American College Health Association's conference this week on their work.


“The partnership between the Concussion Team and academics addresses our goal of helping students after concussions by providing integrated, interdisciplinary education, research, treatment and resourcing across the student’s time at CU. Together these may reduce the risk of concussion, reduce recovery time after concussion and optimize outcome and life-course trajectory," says Theresa D. Hernández, the associate dean of research for the College of Arts and Sciences and a part of the Concussion Team.

This interdisciplinary, streamlined approach allows practitioners not only to diagnosis concussions, but also to provide the most current, evidence-based care right away, according to Sirotniak.

“It’s just really wonderful to have some leadership that can help make the referrals and coordinate the care with shared vision."

While treatment is an important focus of the team, it also places a high priority on public education, collaboration and outreach. This team has done this by training Resident Academic Programs (RAP) advisors and the CU Student Government, collaborating with club and intramural sports and presenting to other experts, like this week’s American College Health Association’s annual conference.

At the conference this week, the team will give two different presentations. The first, delivered by Dr. John Breck and Stephanie Pascoe, will give a concussion overview, including frequency, diagnosis and treatment.

The second, given by Casault, Sirotniak and Hernández, is about building an interdisciplinary concussion team and discusses how to partner student services and academics so that the student is in the foreground. This talk also covers Hernández’s research on cortisol levels during concussion recovery.

The Medical Services Concussion Team hopes others can use this research not only to inform their own care, but also to inspire other colleges and universities around the country to create their own team or clinic for coordinated care, while still maintaining a level of care that students have come to expect.

“This team provides a service to students that may be unmatched at other institutions, and that hopefully improves their retention and supports their academics. We can help support them through their recovery too, to attain their academic goals,” remarks Casault.

“That’s the bottom line,” agrees Sirotniak. “That’s so important for us. That’s why people are here. Let’s hope we can make their experience successful and that we’ve done our job with what we can control.”