We’ve all heard of concussions, but how many people fully understand concussions? A concussion occurs when the head moves rapidly back and forth causing the brain to shift and make contact with the inside of the skull. The National Athletic Trainers’ Association (NATA) estimates 1.6 – 3.8 million concussions are reported each year. However, because many people choose not to seek medical attention, either from lack of education about concussions or the belief that one is only minor, many cases go unreported. It is critical that you seek advice from a medical professional if you think you or a loved one has suffered a concussion.3 The majority of concussion cases occur in youth sports, the Jama Network believes 1 in 5 youth athletes will suffer a concussion in their sports career 5 and only 2 out of 5 concussions will be reported and treated.  Every sport carries a risk of concussion from ice skating to soccer to football but concussions aren’t limited to sports. Falls, car accidents, whiplash, and many other daily mishaps can also result in a concussion.6 Even if a concussion only seems minor, leaving it untreated can lead to major problems. It’s important to know what symptoms to look out for and that you consult with a medical professional if you suspect an athlete has a concussion. 

Symptoms 

It is not uncommon for parents, siblings, and loved ones to notice the signs and symptoms of a brain injury when interacting with an athlete that has suffered from a concussion. Many times, the person with the concussion won’t notice, or will simply dismiss, changes in behavior or symptoms resulting from a concussion. If someone with a concussion fails to notice symptoms on their own, it becomes the role of their support system to identify and seek medical intervention on their behalf. 

If there are concerns that an athlete has suffered a concussion, there are four main areas of behavior to evaluate: physical pain, problems sleeping, problems with memory and focus, and changes in mood.  

Immediate signs of a concussion: 

    • Changes in mood or behavior
    • Headache
    • Nausea and vomiting 
    • Trouble with balance 
    • Sensitivity to light and sound 
    • Dizziness 
    • Vision changes, such as blurry vision or double vision
    • Ringing ears 
    • Diminished reaction time

Knowing how to describe what the athlete is experiencing can go a long way in informing the right treatment and appropriately timing a healthy return to sport for your child.

Because the severity of these symptoms can greatly vary, the athlete should seek immediate medical attention if symptoms are severe or persistent. 

Coaches and teammates should pay close attention if a player complains of any of these symptoms or shows signs of these symptoms during games or practice. These symptoms could be easily dismissed as the result of another ailment but they are classic signs of a concussion. It’s always better to have the athlete evaluated by a medical professional than to assume the best.  

Problems with sleep or feeling fatigued. Changes in sleep patterns include trouble falling asleep, trouble staying asleep, sleeping much more or less than usual, and feeling fatigued or drowsy throughout the day. Parents and athletes should pay close attention to sudden changes in sleep patterns as this could be a quiet indicator of a concussion and can have cascading impacts on cognitive performance. 

Memory and focus issues can also arise: 

    • Difficulty concentrating and remembering information 
    • Confusion or feeling mentally foggy 
    • Experiencing mental fatigue 

Teachers and parents are encouraged to note sudden changes in academic performance and even conversational patterns. Someone suffering from a concussion may appear aloof, tired, uninterested, or incoherent.   

Changes in mood can also be signs of a concussion: 

    • Out of character emotional swings 
    • Difficulty rationalizing emotions 
    • Nervousness 
    • Depression 
    • Irritability7 

We can all help when it comes to detecting emotional changes. Friends, family, teachers, and coaches are all in contact with players who could be suffering from a concussion and there is something we can all do about it. Youth sports attract highly driven people, which is a desirable trait, but sometimes it means it’s up to us to be the voice of reason if an athlete is reluctant to seek medical help on their own. It up to us to seek medical advice on their behalf.   

How To Treat A Concussion 

Immediately following a concussion, it is important to remove the player from activity and seek advice from a medical professional who can better evaluate the severity of the concussion and plan the next steps in treatment. Plenty of physical and mental rest is needed to recover from a concussion. Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) as they can mask symptoms and thin the blood, increasing the risk of bleeding. Concussion recovery plans should be individualized based on the person, injury, and functions affected by the concussion. Make sure to work under the advisement of a doctor to help minimize recovery time and ensure a safe return to daily activity.

During recovery, a physician may recommend that the athlete will need help finding a good balance between rest and activity to avoid over–resting, as well as overstimulation. 30 minutes of daily, low-impact cardio may be recommended to help keep blood and oxygen flowing through the body. Mental activities such as reading, playing video games, and solving puzzles should be introduced gradually, as directed, to help the brain repair its neuro pathways. You may be advised to stop this mental stimulation if symptoms of the concussion start getting worse. As recovery progresses, more activities can be gradually added to a daily routine until the athlete reaches full capacity and is cleared by their doctor. When the athlete is ready to return to school or work, it’s recommended that they ease back in, requesting extra time or assistance with assignments as needed. Many schools will have a concussion protocol and will work with injured athletes to ensure they do not get too far behind and that they don’t push too hard too fast. Make arrangements for the athlete to have a quiet, calm place to rest if symptoms of the concussion return. Concussions that are properly treated take about 2 – 3 weeks to heal, but each individual’s response will be different. Concussions that remain untreated can take much longer to heal and have lasting effects.1 2  

How Can Physical Therapy Help Concussion Recovery? 

Physical therapy is an important part of concussion recovery. After the initial rest period immediately following a concussion, light activity can be introduced to help progress the brain’s recovery. During this period, physical therapy can be used to help reintroduce the brain to certain stimuli based on areas of function affected by the concussion. A physical therapist is specially trained to help find the balance between activity and rest during the recovery process taking the guesswork out of concussion treatment. A physical therapist is also your partner in returning to sports. As the concussion heals, your physical therapist will help you build yourself back up to competitive levels without the risk of reinjury. 

What Can Happen If A Concussion Is Left Untreated? 

As we have discussed, symptoms of a concussion can vary in severity from onset and can last for several days or even weeks. What if a concussion goes untreated? Athletes who don’t report their concussions are at high fall and accident risk due to reduced reaction time, reduced balance, dizziness, and drowsiness. This can lead to other injuries and potentially second impact syndrome significantly increasing the likelihood of permanent brain injury. This can ruin much more than a game or a season. While the effects of brain injury from concussions are still being researched, there is strong evidence that suggests unchecked concussions can lead to depression, bipolar disorder, schizophrenia and in extreme cases suicide, amnesia, early–onset dementia, and death.4 6  

As athletes, coaches, and parents we are all responsible for taking as many safety precautions as possible against concussions but the most important thing we can do is look out for each other. We can’t make a helmet to protect the brain, but we can learn to recognize a concussion and work quickly to get treatment started in an effort to minimize long-term repercussions. 

Learn more about Vestibular Rehabilitation at Spooner Physical Therapy. Ready to schedule an appointment? Click here to schedule an appointment or complimentary movement screen with a Spooner physical therapist at one of our locations throughout the valley.

References 

  1. CDC. (2020, July 27). Concussion Awareness. Retrieved from US Lacrosse : https://www.uslacrosse.org/sites/default/files/public/images/safety/HeadsUp-Coaches2014.pdf 
  2. Cleavland Clinic. (2020, June 2). Concussion: Management and Treatment. Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/15038-concussion/management-and-treatment 
  3. National Athletic Trainers’ Association. (2019, July 28). Concussions. Retrieved from nata.org: https://www.nata.org/practice-patient-care/health-issues/concussion 
  4. Office of Public Affairs. (2016). Concussions: How They Can Affect You Now and Later. Salt Lake City: University of Utah. 
  5. Phil Veliz, P., Sean E. McCabe, P., James T. Eckner, M. M., & al, e. (2017). Prevalence of Concussion Among US Adolescents and Correlated Factors. Chicago: Jama Network. 
  6. TeachAids. (2018, September 6). What is CrashCourse? Palo Alto, CA, USA. 
  7. The Children’s Hostpial of Philadelphia . (2020, July 27). Concussion Awareness. Retrieved from Aspen Junior Hockey: https://www.aspenjuniorhockey.com/concussions