What is a concussion?
A concussion is a brain injury that alters the way the brain functions. It occurs when the brain is rocked back and forth or twisted inside the skull from a blow to the head or body. A concussion disrupts normal brain function and alters mental status or consciousness. Signs and symptoms of a concussion may include a range of cognitive, physical, emotional, and sleep-related issues.
Causes of concussions
Concussion most commonly occur in contact or collision sports like football, hockey, soccer, rugby, boxing, wrestling, lacrosse, and martial arts or combat sports. However, they can happen in any sport or recreational activity. Most concussions occur due to falls, player-to-player contact or collisions, player-to-equipment contact like getting hit with a ball or hockey puck, and player-to-ground contact during a fall.
Symptoms of concussions
Some common signs and symptoms of a concussion include headaches, dizziness, feeling in a fog, feeling slowed down, difficulty concentrating or remembering, nausea or vomiting, blurred or fuzzy vision, sensitivity to light or noise, feeling uneasy, emotional ups and downs like irritability or sadness, trouble sleeping, fatigue, confusion, and difficulty processing information. Symptoms may last for days, weeks, or even longer in some cases.
Diagnosing concussions
There is no specific test to diagnose a concussion. Doctors rely mainly on the athlete's self-report of symptoms, as well as a physical examination and questions to check memory and cognitive function. Imaging tests like CT scans and MRI scans are usually normal in concussions. They are primarily used to rule out more serious brain injuries. Balance testing, neurological examinations, and cognitive assessment tools may also be used to diagnose concussions and assess their severity.
Treating concussions
The main treatment for concussion is rest and avoiding activities that require concentration and physical exertion until symptoms resolve. This includes restricting screen time, reading, texting, video games, sports, schoolwork, and jobs or tasks requiring mental focus. Overexertion can prolong recovery. As symptoms subside, activities can gradually be added back in increments to avoid exacerbating symptoms. Cool compresses and over-the-counter pain relievers can provide symptom relief. But complete rest at the initial stage is crucial for healing. Medical supervision from a doctor experienced in concussion management is key for proper treatment, guidance and safe return to normal activities.
Return to play guidelines
Returning to play too soon after a concussion increases the risk of prolonged symptoms and further injury including Second Impact Syndrome, a rare condition that can be catastrophic and even fatal. It is crucial not to return to play the same day as a concussion and only to return when fully symptom-free at rest and after undergoing a medically supervised graduated return-to-play protocol once cleared by a healthcare professional. Factors like history of past concussions, symptom severity, age, and certain sports also influence return-to-play timelines. Those with high school age and younger generally require longer recovery times.
Long term impacts of concussions
While most people recover fully from an isolated concussion within a few weeks, some may experience prolonged symptoms that last weeks, months or potentially years in rare cases of post-concussion syndrome. Repeated concussions, especially if they occur before the previous one is fully healed, can increase recovery times and intensify both short and long term symptoms. They have been associated with various long term effects including persistent headaches and migraine, memory deficits, attention and concentration issues, depression, increased irritability and mood changes, sleep disturbances, dizziness and sensitivity to light/noise. In serious cases, repeated head trauma has been linked to permanent brain damage and neurodegenerative diseases like chronic traumatic encephalopathy (CTE). Playing through concussions or not allowing for proper healing also increases risks for long term issues.
Preventing concussions
While concussions cannot always be prevented in higher risk sports, following safety protocols and rules can help minimize risks:
- Wearing certified helmets, face masks and protective equipment fitted properly and appropriately for the sport helps prevent head impacts.
- Learning and practicing proper tackling, hitting and contact techniques to minimize head collisions.
- Strict enforcement of rules against dangerous contact like spearing in football or checking from behind in hockey helps deter high risk behaviors.
- Training athletes to avoid using the head as a primary point of contact and maintaining a heads up stance.
- Regular equipment checks and replacements as needed ensures proper protection.
- Early diagnosis and proper management of concussions helps avoid subsequent injuries by allowing full healing before returning to play.
With a growing awareness of concussions risks across all levels of sports, researchers continue working on helmet designs, diagnostic tools and treatment protocols to help athletes perform at their best while maintaining long term brain health. But prevention through safe behaviors remains a priority for all players and their coaching staff.
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