Here you will find common questions that are asked when it comes to concussions..
Q: What are the signs and symptoms of a concussion?
A: Signs and symptoms fall into four categories: cognitive, somatic (body), psychological, and sleep disturbance. Also see this link
Cognitive: memory and attention problems, mental “fogginess”, cognitive slowing, and fatigue
Psychological: more emotional, sadness, anxiety and irritability
Somatic: headache, nausea/vomiting, balance problems, dizziness, fuzzy/blurry vision, low energy/fatigue, and light & noise sensitivity
Sleep disturbance: difficulty falling asleep and sleeping more or less than usual
Q: Do you have to lose consciousness to get a concussion?
A: No. For decades the notion that a concussion happened was when someone lost consciousness. However, with medical and technological advancements in the 21st century we are discovering that concussions happen without ever losing consciousness. A concussion occurs when the brain moves around in the skull after a direct hit to the head, face, or neck as well as any force to the body resulting in acceleration and deceleration of the brain inside the skull which causes temporary neurological impairments such as “feeling in a fog”, confusion, or just feeling “off.” A disruption in neurological impairment must be present for the diagnosis of a concussion.
Q: What do I do if a concussion occurs?
A: Since signs and symptoms of a concussion can be immediate or delayed onset of minutes to hours following injury. Due to this varied response time, the consensus is to not allow a player to return to practice or competition in the same day as a suspected concussive injury. The majority of repeat concussions occur within 7-10 days following the initial injury and can complicate recovery for the athlete. Seek medical attention immediately following injury from a sports medicine professional who is trained in concussion management. Cognitive rest and physical rest are recommended for short-term recovery and light exercise may be beneficial following a rest period of 14 days IF the athlete still has symptoms. A physician will walk you through a symptom inventory and conduct a concussion screening tool such as the ImPACT or AXON. Following symptom resolve a Return to Play protocol will begin.
Q: What is the Return to Play protocol?
A: Return to Play (RTP) protocol is a stepwise return to full contact competition while carefully assessing symptoms. RTP typically takes 1 week to complete provided each step is completed successfully. After being symptom-free (or asymptomatic) for at least 24 hours, your doctor will start you on the Return to Play protocol – each step must be followed by 24 hours of no symptoms before moving on. If symptoms return, the athlete will remain at the step where symptoms were not worsened.
Step 1: No activity
Step 2: Light aerobic exercise for 5 to 10 minutes – walking, light jogging, or biking to increase heart rate – no resistance training, <70% max heart rate
Step 3: Moderate exercise for a reduced time from typical routine – increase intensity of previous activities, can add moderate-intensity weightlifting – sport specific exercise with no head impact activities
Step 4: Non-contact exercise/training drills: increase intensity of previous activities and can add cognitive component – can start progressive resistance training
Step 5: Reintegrate into full contact practice
Step 6: Return to Play – Normal game play
Q: Does protective headgear prevent a concussion?
A: There is no good clinical evidence currently available that protective equipment prevents a concussion. In fact, a new study shows headgear may increase risk of a concussion. See the study here. Mouth guards have a role in preventing dental and orofacial injury, but not concussion. Helmets for football, cycling, equestrian, skiing and snowboarding may prevent skull fractures but will not prevent a concussion. (4th International Conference of Concussion in Sports) See our review of the Full90 Headgear here. Please click here to visit the forum set up for this topic.
Q: What should I do if I have a concussion?
A: Tell someone! It’s vital that you tell your coach or parent that you are experiencing the symptoms of a concussion. Once you are diagnosed with a concussion the most important thing to do is turn this computer screen off. That’s right, total cognitive rest. That means no computer, no cell phone, no social media or video games. Your brain needs to rest. By allowing your brain proper rest the quicker you can get back on the field or court. The most important thing to do when you have a concussion is be honest with your health care provider about your symptoms- once they are aware of what’s going on then a proper RTP (Return to Play) protocol can be put in place. Remember each concussion is different so being honest with your doctor can allow them to get you back on the field as quickly as possible for your individual injury.
Q: What is Post Concussion Syndrome?
A: “Post-concussion syndrome is a complex disorder in which a variable combination of post-concussion symptoms — such as headaches and dizziness — last for weeks and sometimes months after the injury that caused the concussion. In most people, post-concussion syndrome symptoms occur within the first seven to 10 days and go away within three months, though they can persist for a year or more. Post-concussion syndrome treatments are aimed at easing specific symptoms.” – Mayo Clinic
Q: What is Second Impact Syndrome
A: “Sometimes, experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and typically fatal brain swelling. After a concussion, the levels of brain chemicals are altered. It usually takes about a week for these levels to stabilize again. However, the time it takes to recover from a concussion is variable, and it is important for athletes never to return to sports while they’re still experiencing signs and symptoms of concussion.” – Mayo Clinic
Q: What is CTE?
A: Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head. CTE has been known to affect boxers since the 1920s. However, recent reports have been published of neuropathologically confirmed CTE in retired professional football players and other athletes who have a history of repetitive brain trauma. This trauma triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau. These changes in the brain can begin months, years, or even decades after the last brain trauma or end of active athletic involvement. The brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia. (www.bu.edu/cste)
CTE is one of two theories linking brain injury to degenerative brain disease. At this point there is no conclusive evidence for a cause and effect relationship between repetitive head trauma and the development of CTE. Additionally, CTE is not well-defined and more research is needed on the topic. Another theory about repetitive brain trauma and cognitive decline states the possibility that with each injury there is a decrease in cognitive reserve which leads to early onset of cognitive decline. Read more in the article by Christopher Randolph, Stella Karantzoulis, and Kevin Guskiewicz called “Prevalence and Characterization of Mild Cognitive Impairment in Retired National Football League Players.” There is a lot of research still needed in this area. Please keep yourselves informed and do not rely solely on the media.