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Concussion Recovery

What is a concussion?

A concussion is defined as a disruption of the normal functioning of the brain usually due to a direct or indirect force to the head.

Is Concussion a brain injury?

Yes. In short, it is a functional injury to the brain, rather than a structural injury.

What do you mean by a functional injury to the brain?

The brain controls many functions of the human body. When these functions are disrupted, the “concussed” person may experience problems with thinking, balance, emotion, and sleep. As a result, they may feel mentally “foggy,” dizzy, nauseated, more emotional, restless, or tired.

What are the signs and symptoms of a concussion?

After sustaining a fall or blow to the head, if one or more of these signs are observed, a concussion is suspected:

  • Appears dazed or stunned, forgetful, or confused, An athlete who sustains a concussion may forget an instruction, be confused about an assignment or position, or be unsure of the game, score, or opponent.
  • Can’t recall events prior to or after a hit or fall.
  • *Answers questions slowly
  • *Moves clumsily.
  • *Loses consciousness (even briefly).
  • *Shows mood, behavior, or personality changes.

If one or more of these symptoms are reported, a concussion is suspected:

  • Headache or “pressure” in the head.
  • *Nausea or vomiting.
  • *Balance problems or dizziness.
  • *Double or blurry vision.
  • *Bothered by light or noise.
  • *Feeling sluggish, hazy, foggy, or groggy.
  • *Confusion, or concentration, or memory problems.
  • *Just not “feeling right,” or “feeling down”

Someone must be “knocked out” or lose consciousness to have sustained a concussion, right?

This is a dangerous misconception about concussions. A concussion does not necessarily result in loss of consciousness, nor does the loss of consciousness on its own predict the severity or course of recovery from the concussion.

What should a parent or coach do when they are not sure whether their child or athlete sustained a concussion?

The statement “if in doubt, sit them out” summarizes it best. More specifically, the CDC recommends and California law (AB 2127)* mandates that an athlete suspected of sustaining a concussion or head injury is prohibited from returning to the athletic activity until the athlete is evaluated by a licensed health care provider. This educational sheet published by the CDC is an excellent resource for parents and coaches:

What are the health risks of “playing through” a concussion or suspected concussion?

Due to slowed reaction time and impaired judgment, an individual who has not fully recovered from a concussion is at heightened risk to sustain another blow to the head if he or she continues to participate in an athletic event. A repeat concussion sustained before full recovery has occurred can lead to second impact syndrome, which is a serious and life-threatening condition that involves rapid swelling of the brain. Although serious, second impact syndrome is preventable through recognition and proper management of an initial concussion.

How soon can an athlete return to play after sustaining a concussion?

The good news is 85% of individuals recover within 3 weeks of sustaining a concussion. However, there are many factors involved in an individual’s recovery from a concussion. Prior to returning to play, it must first be determined by a licensed health care provider trained in the management of concussion that he or she has returned to their “baseline” or pre-injury state. In addition, the athlete must complete a graduated return to play protocol under the supervision of a licensed health care provider trained in the management of concussion.

Why see a Physical Therapist for a concussion?

A Physical Therapist, trained in the management of concussion, is able to evaluate and provide treatment and education for symptoms of concussion, including headache and dizziness. In addition, a physical therapist’s expertise in exercise and movement allows them to safely and effectively implement the mandatory graduated return to play protocol. A Physical Therapist with training and experience treating concussions can help screen for cognitive (thinking and memory) problems, or visual problems that are amenable to referral to Speech-Language Pathology or Occupational Therapy, respectively.

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