by Chelsea Ortega, DPT, SCS, CSCS
A concussion is a mild traumatic brain injury - a complex injury to the brain caused by a blow to the head or to the body, 3.8 million of which occur per year in the United States. When a concussion occurs, there is a large amount of activity in the brain with high production and uptake of energy and then this energy supply plummets. Concussion may result in neuropathological changes while no structural abnormality can be seen on scans. Symptoms can evolve over a number of minutes, hours or days.
Some of the most frequent symptoms that occur with concussion include headache, feeling slowed down, difficulty concentrating, dizziness, fogginess, fatigue, visual blurring or double vision, light sensitivity, memory dysfunction and balance problems. Symptoms of concussion can be categorized into four domains, shown here:
If someone is reporting these symptoms after direct or indirect contact, you should be suspicious of concussion. While loss of consciousness is scary at the time of concussion, it's not helpful in determining the severity of a concussion. The number and severity of symptoms, however, are more accurate indicators to determine this and therefore, understanding symptoms is extremely important!
Each concussion is different and can last varying amounts of time. The definition of post concussion syndrome (now known as persistent symptoms) is not consistent, but it's most often described as symptoms lasting longer than 14 days after injury. Dizziness at the time of injury is the #1 risk factor for prolonged recovery. Other risk factors for persistent symptoms can include being female, history of previous concussion, history of depression or mental illness before concussion, headaches, sleep disturbances, ADHD, not being removed from play and having a higher number of symptoms.
The only risk factor that we can control is the removal from play at the time of concussion. Immediate removal from the activity is essential to protect athletes from potentially detrimental injury. Athletes are likely to have a longer recovery and miss more competition if they are not removed from play immediately. In a study of collegiate and tactical athletes they found that 63.3% had delayed removal from play. Removal from play decreases the risk of second impact syndrome, which can be fatal.
Concussion is a very complex injury that requires care from a medical team trained specifically in concussion recovery. Please reach out for further guidance or to schedule an appointment with a physical therapist. Check out the other parts of this series on concussion: