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Concussion Baseline Testing
October 9, 2018
Jenny White


Concussion Baseline Testing

October 15, 2018 and November 12, 2018
Sacajawea Middle School
4:30-5:15 pm & 5:15-6:00 pm

BSF Introduces Cutting-Edge Postural Sway Test This Year

A new partnership with 4c Sports will give parents, athletes, coaches and healthcare providers a more complete data set in the event of an injury.

While we do our best to prevent injuries, they do occur. BSF strongly recommends concussion baseline testing for all athletes ages 12 and older who participate in a BSF Alpine, Freestyle, Freeskiing, Snowboarding or Nordic program (although not the Intro programs). The testing is not required, but it’s strongly recommended. In the unfortunate scenario of a head injury (be it while skiing or in another sport), already having a baseline established gives everyone more data to keep athletes safe and allow them the proper time to heal.

BSF athletes completing the ImPACT test.

In 2012, BSF adopted a proactive Concussion Policy and Protocol, which is consistent with Montana State Law and the United States Ski and Snowboard Association's policies for the management of concussive head injuries. As part of this proactive approach, BSF invested in a software program called ImPACT to help families and healthcare providers better manage concussions in sport. (It’s now also used in the Bozeman High School athletics.) Athletes take a short computer test to establish a baseline. In the event of a concussion, an athlete can retake the computer test, which will then be evaluated by a healthcare provider to determine if an athlete can safely return to activity. Once an athlete has had an ImPACT baseline test, it is good for two years.  

This year, BSF has partnered with Bozeman-based 4c Sports to add another component of testing that we think will be beneficial. During our baseline testing at Sacajawea, 4c Sports will offer an additional 10-minute, non-invasive test called a Postural Sway test, which measures body movement. 4c Sports is donating this baseline test to BSF athletes. 4c Sports is striving to become Bozeman's most comprehensive concussion evaluator with analysis from physicians, therapists, cognitive data, and physiological data.  (Read more on the test below.) In the event of an injury, 4c Sports can conduct a Postural Sway test and compare it to the athlete’s established baseline.

Montana State’s ski team has also been using this new method, and BSF added this as an option because we believe it can help keep our athletes safer in the long run.



Test dates: October 15, 2018 or November 12, 2018

Choose from two sessions available on each date: 4:30 p.m. – 5:15 p.m. and 5:15 p.m. – 6:00 p.m.

Location: Sacajawea Middle School, 3525 South 3rdSt., Computer Lab (Rooms 103 & 105)

*If you are current with your ImPACT (test every 2 years), you are welcome to take the Postural Sway test at any time during the 4:30 - 6:00 pm testing period. There will be multiple testing stations so wait times should be minimal.

1. Signup for your spot at

2. Download and sign the following document, which must be returned to BSF at or before testing. 

BSF Concussion Informed Consent

3. Complete the 4c Sports concussion knowledge survey/informed consent HERE!    



Milicia McDowell of 4c Sports conducting a pre-test interview with an athlete.

4c Sports provided the following Q&A that delves into concussions, skiing injuries, and the Postural Sway test. 


 4c Sports is a Bozeman-based tech company founded in 2012 with the mission of stopping preventable injuries from ending athletic participation at all levels of sport. 4c Sports provides baseline and post-injury biomechanical and postural sway assessments along with corrective exercise programming in order to help prevent orthopedic injuries before they happen and aid in return-to-play decision making when injuries do occur. 4cSports assessments are non-invasive, using measurements made from motion capture systems and force plates to provide detailed models of athletic movement.



 The processes the body uses to maintain balance is called postural control. While the goal of postural control is usually to keep the body in a stable, upright position, this does not mean the body is motionless. It is normal for the body to move back and forth and side to side about different joints of the body, for example about the ankles and hips. This movement is termed postural sway.

While a little bit of postural sway is normal, sometimes a person can show too little or too much movement or the pattern of postural sway can be atypical. This is common in individuals suffering from mild traumatic brain injury, intoxication, weak ankle or knee musculature, or severe back pain. For this reason, postural sway is a good measurement to use when evaluating an athlete’s recovery after suffering a concussion. Working with researchers from Cincinnati Children’s Hospital, leaders in this field of research, 4c Sports has created a hardware and software service-based solution for measuring and evaluating sway.

Concussion is a type of mild traumatic brain injury caused by damage to the head directly, or a blow to the body that causes the brain inside the head to move back and forth. This type of trauma causes the brain to bounce around inside the skull which may mechanically damage brain cells or cause chemical changes in brain tissue. Though concussion is often characterized as a mild traumatic brain injury, the effects of a concussion can be quite serious. (Adapted from the CDC.)


 When considering prevalence, concussions represent roughly 9% of all high school sports-related injuries and approximately 6% of college sports-related injuries. Between 1.5-3.0 million concussions occur each year and over 20% of them occur in high school athletes.  

When investigating specific concussion incidence data in skiing, few studies have been conducted, and it seems, fewer have been published. World Cup and FIS ski racers experience an injury rate similar to that of team sport athletes. It was reported that freestyle athletes suffer 1.8 injuries/1000 runs, higher than in alpine skiing, whose rate is 0.9 injuries/1000 runs and also higher than in snowboarding where athletes are at risk for 1 injury/1000 runs. In high-level ski racing, women have a higher injury incidence, 5.8 injuries/1000 runs, versus men, 3.9 injuries/1000 runs, throughout the season (per 100 athletes).  In comparison, common high school team sports have an overall injury incidence rate of 2.5 injuries per 1000 exposures.


An athlete stands on a platform with embedded sensors that measure forces acting on the surface from the feet. From those force measurements, an overall measurement of body movement is calculated. When these measurements are taken from a healthy athlete, they are recorded as baseline values. If an athlete becomes injured those values change. A post-injury measurement can be used to compare the athlete’s current level of sway to their baseline values in order to see whether the injury is affecting their sense of postural control. Depending on how far from their baseline the athlete is, a decision can be made about whether to return them to play or practice.



 Our evaluations of postural control results in minimal cognitive stress on an athlete and can be used repeatedly in the time period following an injury to help judge progress in the return to health and ultimately return to play. We provide scoring relative to baseline values so it’s easy to see when an athlete is back within a normal range of their pre-concussion postural sway results. Our data, along with ImPact testing, helps doctors and coaches keep the athlete protected until return to play is truly safe.



4c Sports can assess athletes as young as 12 years old. To be a valid baseline, the athlete should come into the assessment fresh, non-fatigued, and healthy.



We ask the athlete to perform a variety of balance-related tasks on a force plate while making measurements of postural control.