What is a Concussion?
A concussion is a traumatic brain injury (TBI). It occurs when forces are applied directly or indirectly to the head and/or body which causes rapid, thrashing of the brain within the skull. As a result, the brain swells and undergoes chemical changes which impairs brain function. While concussions are considered a “mild” TBI, the effects can be serious.
Concussion Risk Factors
Unfortunately, the rate of concussions has doubled since 2002. There are now between 1.6 and 3.8 million reported sport-related mild TBIs annually in the United States. Research from American Academy of Neurology has identified the top potential risk factors for sport-related concussion.
- Females tend to have a higher risk of concussion if participating in soccer or basketball.
- Males tend to have higher rates of concussion overall.
- Athletes with a Body Mass Index (BMI) greater than 27 kg/m3 and training time less than 3 hours weekly have an increased risk of concussion.
Type of Sport:
- Football and rugby have a greatest risk of concussion.
- The risk of sport-related mild TBI tend to be lowest in baseball/softball, volleyball, and gymnastics.
- Well fitted and well maintained headgear may reduce concussion rates in rugby. However, there is no evidence to support one design of football helmet gives more protection than another.
- Moderate risk for another concussion if the athlete is within ten days of having a prior concussion.
There is insufficient evidence to determine if age, level of sport, or position played increases an athlete’s risk of sport-related TBI.
If you think an athlete has sustained a concussion, remove them from play right away. The coach or trainer shoulder evaluate the athlete for signs and symptoms of a concussion and share the relevant results with the athlete’s healthcare professional to confirm the diagnosis. Signs and symptoms traditionally develop right away, but the full extent of the injury is often not as obvious. Therefore, continue to closely monitor the athlete for a few days following the injury. If signs and symptoms worsen, then take them to the emergency room immediately.
“Relative rest” is often the initial treatment prescribed for an athlete that has sustained a sport-related concussion. The brain requires full access to energy supplies to properly heal. Therefore, any demanding physical to cognitive tasks (such as school work, exercise, video games, or reading) should be avoided during this time to avoid symptom aggravation. The optimal length of time for healing has not been established in the current research. However, relative rest is typically recommended for a few days with a prompt follow-up by a healthcare professional for clearance to return to school and to begin the Return to Play Protocol.
Return To Play
Similar to relative rest, there is no specific timeline for return to play after a concussion. However, the athlete is not allowed to return to sport unless cleared by their health care professional. He/she needs to be symptom free for at least 24 hours, without medication. Evidence suggests a slow, step-by-step plan, created by a licensed professional, to prepare the athlete for a safe return to sport. Typically there are 5 stages of Return To Play.
Stage 1: Light Aerobic Activity
Stage 2: Moderate Activity
Stage 3: Heavy, non-contact activity
Stage 4: Practice and Full Contact
Stage 5: Competition
If the athlete experiences symptoms at any stage, then additional rest is necessary. The pace with which the athlete works through the stages depends primarily on the severity of the concussion and may several weeks or months to successfully complete all five stages.
Check out HEADS UP to Brain Injury Awareness or more information on sport-related concussions.
Contact BeneFIT Physical Therapy to begin your Return To Play Protocol!
1. Giza, Christopher C., et al. “Summary of evidence-based guideline update: Evaluation and management of concussion in sports Report of the Guideline Development Subcommittee of the American Academy of Neurology.” Neurology 80.24 (2013): 2250-2257.
2. HEADS UP to Brain Injury Awareness. Center for Disease Control and Prevention website. http://www.cdc.gov/HeadsUp/. Updated May 1, 2016. Accessed October 4,2016.