What is a concussion?

A concussion, or mild traumatic brain injury, is a brain injury that occurs when the brain moves quickly within the skull.This sudden movement interferes with brain function, which causes a disruption and affects how parts of the brain communicate.

Concussions are serious. Medical providers refer to a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious. 

What are the symptoms of a concussion?

The most common concussion symptoms are listed below. If you experience 1 or more of these symptoms following a hard hit, you may have a concussion and need to be evaluated by a licensed health professional.

Difficult concentrating or focusing
Feeling slowed down
Dizziness or balance problems
Fatigue / lack of energy
Feeling like you are in a fog
Forgetting things (before or after the injury)
Sensitivity to light and/or noise
Blurred vision

The following symptoms can indicate that a more serious brain injury has occurred. If you experience any of the following symptoms following a hard hit, seek medical attention immediately. 

One pupil larger than the other.
Drowsiness or inability to wake up.
A headache that gets worse and does not go away.
Slurred speech, weakness, numbness, or decreased coordination.
Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
Unusual behavior, increased confusion, restlessness, or agitation.
Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.

How can you suffer a concussion?

Concussive injuries are not unique to athletic events. Any time there is a bump, blow, or jolt to the head or a hit to the body that causes the head and brain to move rapidly back and forth a concussion can occur. This can include car accidents, collisions in sporting events, or even a fall during recreational activity. It is important to remember that concussive injuries DO NOT require a direct hit to the head.

How long does it take for symptoms to appear?

Concussions vary by person and incident. Individuals who show or report one of the above symptoms, or report "not feeling right" after a bump, blow, or jolt to the head or body, may have a concussion or more serious brain injury. Although signs and symptoms generally show up soon after the injury, the signs and symptoms of a concussion can take minutes, hours or even days to appear. It is important to continuously check for signs of a concussion right after the injury and a few days after the injury. If symptoms worsen you should seek medical attention.

5 Things to know about Concussion and Contact Sports

What should I do if myself or my child/athlete suffers a concussion?

If you think an athlete has a concussion, remove the athlete from play immediately. The athlete should sit out of play the day of the injury and should not return to play until a licensed medical professional says he or she is symptom-free and safe to return. Children or teens who return to play too soon -while the brain is still healing - are at greater chance for having a repeat concussion. Repeat concussions can be very serious.

Are there specific tests to diagnose a concussion?

There is no specific test to diagnose a concussion and a concussion can not be seen on CT or MRI scans. However the above mentioned symptoms can indicate a head injury has occurred, notifying medical professionals to complete neurological testing.

Licensed health professionals can perform an Acute Concussion Evaluation (ACE) on any individual whom they suspect has suffered a concussion, allowing for early diagnosis, management, and appropriate referral. This evaluation generally consists of a symptom questionnaire, neurological exam, balance testing, and sometimes neuropsychological testing. These tests work best if there is a pre-injury baseline for comparison.

I have a concussion. What should I do to help my brain heal?

Like most sports injuries, rest is the best treatment for concussion. This includes both physical and mental rest. Physical rest means no physical activity that will raise your heart rate until you are 100% symptom-free. Mental rest means no activities that stimulate your brain and require concentration, such as screen time (TV, computer, phone), reading, and schoolwork. Doctors commonly prescribe periods of reduced schoolwork and tests after a concussion to aid the healing process. There is no medication that can help your brain heal.

How long does it take for symptoms to resolve?

Most people with concussions recover in 7-14 days. However, recovery time strongly varies depending on the individual and the seriousness of the injury. Symptoms may last for a short period of time, such as a few plays or minutes of a game, or can persist for weeks or months.

How do I know if I can return to playing my sport?

A previously concussed athlete should only return to sports with the approval of a licensed health professional. The Center for Disease Control and Injury Prevention (CDC) and American College of Sports Medicine (ACSM) recommend a 5-step return to play progression. This is a gradual process that should be completed over days, weeks, or months. If at any point in the progression the athlete experiences concussion symptoms, he or she is pushing too hard and should stop the activity and return to rest.

Baseline: No Symptoms
Athletes should not have any concussion symptoms. Athletes should only move to the next step if they do not have any symptoms at the current step.

Step 1: Light aerobic activity
Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weight lifting at this point.

Step 2: Moderate activity
Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (less time and/or less weight from their typical routine).

Step 3: Heavy, non-contact activity
Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).

Step 4: Practice & full contact
Athlete may return to practice and full contact (if appropriate for the sport) in controlled practice.

Step 5: Competition
Young athlete may return to competition.

Are there any long-term effects of sustaining a concussion?