How to recognize a concussion and answering the popular question of “when is it safe to return to play”
A concussion is a brain injury that occurs as a result of a blow on the head. Consequently, an individual may lose perception, become temporarily unconscious, confused or develop other symptoms; even though surprisingly to some individuals, are not always a good indicator of the severity of the concussion. It is important to be able to identify a concussion when it occurs and knowing what to do in order to safely return to play.
It is estimated that 300,000 adolescents suffer concussions, or mild traumatic brain injuries (TBI), annually while participating in high school sports. In competitive school sports, concussions often occur by contact with a team player, opponent, the ground, or a piece of equipment or object in the playing field. Surprisingly, females are at higher risk for concussions than their counterparts – particularly when playing soccer. While for males, the leading cause of concussion injuries occurs as a result of football, with a frequency of 200,000 concussions annually in high school football alone. Other school sports with an elevated risk for concussions include: lacrosse, wrestling, basketball, field hockey, and baseball. This does not mean it can’t happen in all the other school sports. Parents and coaches need to be aware!
Since children and young teenagers are more sensitive and have less cognitive reserve (a resistance to brain damage) than adults, a concussion may result in a greater risk for more serious symptoms, including headaches, memory loss, dizziness and confusion, and a prolonged recovery.
Furthermore, concussions are difficult to prevent, due to the fact that they are usually accidental in nature. They are also hard to diagnose due to lack of imaging studies. There is also no current blood work that can make concussions easily diagnosable. So again, being aware of what a concussion is and recognizing situations where one could occur puts you ahead of the game.
One of the most important things is to be aware of a situation where a concussion may have happened. Noticing when someone has taken a hard fall or hit to the head is a vital step in identifying whether or not they have a concussion. Being able to distinguish a concussion can aid an individual with receiving the proper treatment, which can lessen symptoms and avoid significant adverse health outcomes.
If you believe someone may have a concussion, it’s important to stop and get them to a place where there’s no likelihood of further injury. From there, ask them if they feel dizzy or nauseous, if they have a headache and if they remember the fall or collision. Have them take a break and check in about how they are feeling after a few minutes. If they’re not feeling normal, they should stop and seek medical care.
Symptoms of a concussion can be placed into four categories:
- Thinking and remembering
- Not thinking clearly
- Unable to concentrate
- Feeling slowed down
- Unable to remember new information
- Vomiting and Nauseous
- Blurry or Fuzzy Vision
- Noise or Light Sensitivity
- Equilibrium Issues
- Feeling drained or extremely tired
- Moody and Emotional
- Easily frustrated or upset
- More emotional
- Anxious or nervous
- Sleeping more frequently
- Sleeping less frequently
- Having trouble falling asleep
Medical care should always be sought after a concussion. A headache that worsens, drastic behavioral changes, repeated vomiting, or prolonged loss of consciousness are signs that the person should go to the ER or nearest medical facility. These red flag symptoms can mean a much more serious head injury.
Even when there are no red flag symptoms present, it’s still important to be evaluated by a medical professional within 24 hours, if possible. Getting the injury evaluated sooner will help with getting the proper treatment started so that recovery can happen sooner.
Your physician may recommend plenty of rest – sleep is important for the healing process. Eat a healthy diet, stay hydrated and limit light exposure, screen time and other activities that might worsen symptoms. Acetaminophen pain relievers such as Tylenol are safe to take in the first 48 hours. Ibuprofen (i.e. Advil) and aspirin are blood thinners and should be avoided if there’s a chance of a concussion.
An athlete who’s suffered a concussion should be referred for follow up care from a doctor who can assist him or her slowly return to school and to play when fully recovered. Additionally, he or she should not leave an emergency department and resume practice or play the same day nor should a future return to practice or play date be given at the time of an emergency department visit. The return to play progression is best left to the care of a team approach and by a health professional that are familiar with the athlete’s physical abilities and endurance. In some cases, the athlete may be able to resume activity within the next day, while others may require several weeks to months.
Written by Vania Silva. Vania is a part-time freelancer with a legal and pharmaceutical background and an avid sports enthusiast.