Concussion

What is a concussion?

Concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body elsewhere, which causes the head and brain to move quickly back and forth within the skull. This sudden movement of the brain can cause stretching and tearing of brain cells, damaging the cells and creating chemical changes in the brain. It is important to note only 10% of concussions result in loss of consciousness.

What are the signs and symptoms of a concussion?

Most people with a concussion recover quickly and fully. During recovery, it is important to know that many people have a range of symptoms. Some symptoms may appear right away, while others may not be noticed for hours or even days after the injury. The athlete may not realize they have problems until they try to do usual activities again. Typical signs and symptoms are included in the table below.

These symptoms can be part of the normal healing process and are generally not signs of permanent damage or serious health problems. Most symptoms go away over time without any treatment. It is easy to become upset or afraid if you don’t know what to expect or if you are having problems. Keep talking with your doctor and others about how you are feeling. Tell your health care professional if you do not think you are getting better.

 

Danger signs:

Call your doctor or go to your emergency department if you suddenly experience any of the following:

  • Headaches that worsen
  • Seizures
  • Difficulty with you vision
  • Can’t recognize people or places
  • Increasing neck pain
  • Difficulty walking
  • Unusual behavior change
  • Repeated vomiting
  • One pupil larger than the other
  • Loss of consciousness
  • Seizures
  • Increasingly agitated
  • Weakness or numbness in the arms and legs
  • Slurred speech

What not to do:

  • Do not drink alcohol
  • Do not play video games for at least 48 hours.
  • Do not be left alone for at least 48 hours – have family, friends, flat mates or partner present.
  • Avoid prescription or non-prescription drugs without medical supervision. Specifically:
    • Avoid sleeping tablets.
    • Do not use aspirin, anti-inflammatory medication, or stronger pain medications such as narcotics.
  • Limit physical activity as well as activities that require a lot of thinking or concentration. These activities can make symptoms worse. This includes using a cell phone for prolonged periods, homework, job-related activities, reading etc.
  • Do not drive until cleared by a medical professional.

What can I do to feel better?

Rest is the key! Be sure to get enough sleep at night- no late nights. Keep the same bedtime weekdays and weekends. Take daytime naps or rest breaks when you feel tired or fatigued. Do not drink alcohol. Limit physical activity as well as activities that require a lot of thinking or concentration. These activities can make symptoms worse. This includes using a cell phone for prolonged periods, homework, job-related activities, reading etc. Drink lots of fluids and eat carbohydrates or protein to main appropriate blood sugar levels. As symptoms decrease, you may begin to gradually return to your daily activities. If symptoms worsen or return, lessen your activities, and then try again to increase your activities gradually. During recovery, it is normal to feel frustrated and sad when you do not feel right and you can’t be as active as usual.

Returning to Work?

Planning to return to work should be based upon careful attention to symptoms and under the supervision of an appropriate health care professional. Limiting the amount of work you do soon after your injury may help speed your recovery. It is very important to get a lot of rest. Consider scheduling shortened days at work, allow for breaks when symptoms worsen, and reduce task assignments and responsibilities. Safety considerations include not driving, not lifting or working with heavy machinery, and avoiding heights secondary to balance issues. It is important to note return to work and school is more important that return to sport.

Returning to Sport?

You should NEVER return to play if you still have ANY symptoms.

Return to play should occur in gradual steps beginning with aerobic exercise only to increase your heart rate (e.g., stationary cycle); moving to increasing your heart rate with movement (e.g., running); then adding controlled contact if appropriate; and finally return to sports competition. Refer to table below. Pay careful attention to your symptoms and your concentration skills at each stage of activity. Move to the next level of activity under supervision only if you do not experience any symptoms at the each level. If your symptoms return, stop these activities and let your health care professional know. Once you have not experienced symptoms for a minimum of 24 hours and you receive permission from your health care professional, you should start again at the previous step of the return to play plan.

The following requirements must be met for an individual to return to sport-specific training (i.e. stage 5).

The individual:

  1. has returned to and is tolerating full time work or learning.
  2. is symptom free and has completed up to and including Stage 4.
  3. is a minimum of 14 days post-injury (Day 0 = Day of injury). 

The following factors should be satisfied for a return to competitive sport/play (Stage 6):

  1. The individual remains symptom free at Stage 5 of the graduated return to education/work and sport protocol.
  2. The individual is at a minimum of 21 days post-injury.
  3. he individual has received medical clearance from a qualified medical professional (from a general practice or primary care team ).

For more information or to make an appointment contact [email protected]

References: https://www.acc.co.nz/preventing-injury/sport-recreation/concussion-in-sport

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