What is a concussion?
A concussion is a mild traumatic brain injury (mTBI) caused by biomechanical force transmitted to the brain from a direct blow to the head, neck, or body. This trauma can lead to rapid onset of symptoms that typically resolve spontaneously within a few weeks. However, some individuals may experience persistent symptoms lasting several months.
How is a concussion diagnosed?
Concussions are diagnosed through clinical evaluation by a licensed healthcare provider trained in
concussion management. The assessment includes a thorough history, symptom checklist, cognitive evaluation (such as orientation, memory, and concentration tests), balance assessments , and a neurological examination. Neuroimaging, such as a CT scan or MRI, is not routinely required unless there is suspicion of a more severe injury such as a brain bleed.
Why is it dangerous to play sports with a concussion?
Continuing to participate in sports while experiencing concussion symptoms increases the risk of sustaining another concussion, which can lead to more severe and prolonged symptoms, delayed recovery, and in rare cases, catastrophic outcomes like second impact syndrome. It is
crucial to allow the brain to heal completely before resuming contact activities.
How long should I rest after a concussion?
Strict rest, often described as sitting in a dark room, until symptoms resolve after a concussion is no longer recommended. Relative rest for the first 24-48 hours is now recommended. Relative rest allows and encourages activities of daily living while not exacerbating symptoms.
What are the recommendations for limiting screen time after a concussion?
The current recommendations are to reduce screen time for the first 48 hours after sustaining a concussion. Activities like watching TV, using computers, or smartphones may increase
cognitive load and should be reduced for 48 hours. A gradual reintroduction of screen time is advised based on individual tolerance.
What is the average return to school after a concussion?
We encourage students to return to school three days after a concussion, if not sooner. A gradual return-to-learn strategy (RTL) is recommended, starting with partial attendance or reduced cognitive load and progressively increasing as tolerated. The average return to learn without academic support is 10 days.
What is the average return to sport after a concussion?
The return-to-sports (RTS) timeline is highly variable and will depend on each individual’s response to treatment. The average return to sport for athletes recovering from a concussion is approximately 20 days. The initial symptom score is the strongest predictor of the duration of symptoms. The return-to-play process involves a stepwise progression that is mandated by the Indiana High School Athletic Association and consistent with international concussion guidelines. Athletes progress through each stage of the return-to-play progression under the guidance of their athletic trainer and/or physical therapist in communication with the treating provider. Returning to team practice will only begin after being symptom free.
How can exercise & physical therapy help with concussion recovery?
Exercise
Under the guidance of a healthcare professional, engaging in light aerobic activities that do not exacerbate symptoms may promote recovery and reduce the risk of prolonged symptoms. Emerging evidence suggests that controlled, light aerobic exercise beginning as early as one day post injury can aid in concussion recovery and reduce the risk of having prolonged symptoms beyond 28 days. We often
recommend to start going on walks and progressively increase the intensity of aerobic exercise as
tolerated.
Physical Therapy
Physical therapy, particularly vestibular and cervical spine therapy, can be beneficial for individuals experiencing persistent symptoms such as dizziness, balance issues or neck pain following a concussion. We will refer you to a physical therapist trained in concussion management to
develop a personalized treatment plan if we believe it will be beneficial for you.
Is it safe to take OTC meds for symptoms?
Over the counter medications such as acetaminophen, naproxen, or ibuprofen can help with symptom management after initial evaluation.
Can protective equipment help prevent concussion?
While helmets, mouth guards and other protective gear can reduce the risk of severe head injuries and orofacial injuries, they have not been shown to consistently reduce the risk of concussions across all sports. Mouth guards have been shown to reduce the risk of concussion in ice hockey but have not
shown consistent results of reducing concussion in other sports. Proper fitting helmets and approved helmets in NFL players have shown trends that may decrease the rate of concussion. Jugular vein compression devices have been studied in ice hockey and football and have not shown to
reduce the head impact severity.
When should I consider disqualification from sport because of concussion?
There are no universal guidelines for disqualifying an athlete from sports due to concussions. Decisions should be individualized, considering factors such as the number of concussions sustained increase concussibility, symptom severity, duration of symptoms and the athlete's medical history.
