Concussion and Sports: Know Your Game!

Center on Brain Injury Research and Training
Concussion and Sports: Know Your Game!

Concussions are highly individual: depending on the person involved, a slight blow can cause serious symptoms while a harder blow may cause mild symptoms.

It is very important that the symptoms of a concussion are resolved before a student returns to regular school or sports activities. People under age 21 are susceptible to Second Impact Syndrome, which can result in sudden death or severe disability if there is a second concussion within 2 weeks of the first concussion.

Younger athletes often exhibit longer recovery times compared to college or pro-athletes. Females tend to have more symptoms and their concussions often take longer to resolve.

Concussion symptoms include: nausea, vomiting, headache, fatigue, irritability, dizziness, difficulty with balance and reduced thinking speed.

Key points:

  • Concussion is an epidemic that is often under-identified and under-managed.
  • Every concussion must be treated individually.
  • It takes about a week to recover from a concussion, longer if symptoms persist.
  • In Predicting Outcomes:
    • Anmesia is a more important symptom than loss of consciousness.
    • Duration of concussion symptoms is more important to a persons outcome than the initial severity of symptoms.

Recommendations for Students with Concussion

  • Get an immediate evaluation and examination after a concussion.
  • Increasing blood flow to the brain may actually slow down recovery! Activity must be restricted while the concussion resolves; in more extreme cases, students should not return to the game or continue practice after a concussion — an early return to play puts students at greater risk for developing post concussion or second impact syndromes. In some cases, students may need to be put on bed rest.
  • Be alert to activities that may cause an increase in symptoms such as listening to music, light sensitivity, playing computer games, watching TV or dancing and parties may need to be eliminated. Wearing sunglasses may offer some relief.
  • Students should not return to the game or continue practice after a concussion — an early return to play puts students at greater risk for developing Post Concussion or Second Impact syndromes.
  • Get an immediate evaluation and examination after a concussion.
  • Increasing blood flow to the brain may actually slow down recovery! Activity must be restricted while the concussion resolves; in more extreme cases, students may need to be put on bed rest.
  • Be alert to activities that may cause an increase in symptoms such as listening to music, light sensitivity, playing computer games, watching TV or dancing and parties may need to be eliminated. Wearing sunglasses may offer some relief.
  • Continuing activities that make symptoms worse can delay a student’s recovery time! Make sure the student stops doing any activity that causes symptoms to increase, and modify school attendance and activities if needed. The student may need to restrict TV watching, reading and homework until their symptoms resolve.
  • As symptoms are reduced, the amount of time spent reading or watching TV or other activities may be increased.
  • Try frequent breaks or attending school for a half day if students have symptoms that worsen throughout the day.
  • Students shouldn’t drive when they are recovering.
  • Reduce workload and homework. Delay or postpone tests or quizzes that require sustained concentration.
  • Athletes should not return to contact or competitive sports until they are symptom free when at rest or when exercising and have normal neurocognitive testing (e.g. IMPACT or similar testing).

Return to play exercise program

(recommended at the Prague Concussion Conference:)

  • Day 1: Walking for 20-30 minutes at a rate of 2-1/2 miles per hour
  • Day 2: Jogging for 20-30 minutes
  • Day 3: Running for 20-30 minutes
  • Day 4: Performing sports specific practice drills
  • Day 5: Return to contact sports if they are symptom free

If headaches or other symptoms occur, during any step, the activity needs to be stopped. The athlete should then wait 24 hours and start at the previous level again.

Posted on BrainLine June 17, 2010

Source: Concussion Management Recommendations by Dr. Michael Lee. Information condensed, retrieved 8/06/08.

Center on Brain Injury Research and Training.  Reprinted with permission. 

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