Frequently Asked Questions: Concussion Therapy
- What is a concussion?
- What are the symptoms of a concussion?
- What happens to the brain during a concussion?
- Am I more susceptible to another concussion after already having one?
- How can I tell if an individual has a concussion?
- What should I do if I have a concussion?
- When to go to the hospital?
- How long does it take to recover from a concussion?
- After all concussion symptoms have subsided how long does it take to be able to be physically active again?
- Who else is on the healthcare team for concussion management?
A concussion is a result from a traumatic force to the head, neck, or jaw which results in a complex pathophysiological process that affects the brain. A concussion results in the brain not functioning optimally, and may result in the loss of consciousness. However, the loss of consciousness is not a requirement for diagnosing an individual with a concussion.
Individuals who experience a concussion can develop a wide a range of varying symptoms including:
- Neck pain
- Loss of balance/ lack of coordination
- Poor memory
- Nausea/ vomiting
- Fatigue/ drowsiness
- Easily distracted
- Irritability/ emotional fluctuations
- Ringing in ears
- Sensitivity to light / visual stimuli
- Sensitivity to sound
- Not feeling like yourself
A concussion is the result of a traumatic force to the head, neck or jaw that causes the brain to move rapidly within the skull. The motion of the brain can result in a change to the nerve fibres often causing them to stretch which alters their metabolic pathways. The brain does not encounter any structural damage, and on imaging studies (CT/ MRI) nothing appears abnormal. It is common for these studies to be conducted to determine if there is any bleeding in the brain or fractures to the neck or skull.
As a result of the injury, the brain is unable to produce enough energy to retain its normal function and processes. The changes to the nerve fibres can occur within several minutes of the injury, and it is common for them to last several hours to days, or sometimes, weeks.
It is thought that the altering of the metabolic pathways along with other processes contribute to the various symptoms and behaviours in individuals that are experiencing a concussion.
When the brain has sustained a trauma it is thought to be much more vulnerable to subsequent trauma. For instance, if an individual is diagnosed with a concussion and encounters another blow to the head, the combined trauma of these injuries may form a more severe brain injury with a longer recovery period. (Sidney Crosby knows this all too well).
When an individual has a concussion, the brain is vulnerable and less able to endure a succeeding concussion, even if the trauma encountered was mild.
Concussions can be quite difficult to recognize as a result of individuals exhibiting a wide range of symptoms and various responses. After an individual has experienced a trauma, concussion related symptoms may not occur for several minutes to an hour. Symptoms that are commonly associated with concussions include headaches, dizziness, confusion, the feeling of “being in a fog”, temporary loss of consiousness. Other symptoms individuals may exhibit may be less obvious such as having difficulty with memory.
It is important for individuals who have encountered a trauma to the head, neck, or jaw and are experiencing these symptoms to treat it as a concussion. It is also important to remember that even a slight blow to the head can result in a concussion; it does not have to be a very large impact.
- You should immediately notify someone (parent, friend, coach). Someone should be present with you after the trauma so you are not alone should your symptoms worsen. You should also immediately stop rigorous physical activity until you have had the opportunity to be assessed by a qualified health professional.
- Immediately following the injury you should seek a medical consultation. A proper concussion evaluation should be performed. It is also important to make sure that you get enough rest, and to limit the use of electronic devices such as computers, television, and cell phones. This can be difficult for some – but very important. Also avoid activities that require significant concentration such as reading. Your brain has just encountered an injury and it needs time to rest.
- Follow all recommendations provided to you by your medical professional.
- If required, seek a consultation from a qualified healthcare provider, with specialization in concussion assessment and management, such someone from the Shift Concussion healthcare team. Please note that Dr. Carney is a Certified Concussion Management Provider through Shift Concussion.
- Follow up with your Physician; ensure to keep them updated on your symptoms and any changes you are experiencing. It is also common for your Physician to have you take the concussion test again to determine if your symptoms are improving.
Emergency evaluation is warranted in situations of deteriorating mental status, such as confusion, difficulty recognizing people or places. Also, seek immediate attention if there is worsening headache, seizure, nausea/vomiting, drowsiness, or lethargy. Finally – seek medical attention if there is ANY doubt. It’s always better to be cautious, and get the proper medical attention.
Every individual has a different length of recovery. It is unknown why some individuals recover quicker than others. It has been suggested that the majority of symptoms reside after a few days or weeks. Note, however, that obvious symptom resolution does not mean one is fully recovered. At minimum, the recovery process may be between 3-4 weeks. Some symptoms may be present for months after the injury was encountered. Post-concussion syndrome is the term that is used when an individual’s symptoms are still present several weeks or months after the injury occurred.
After all concussion symptoms have subsided how long does it take to be able to be physically active again?
Individuals who play sports of exert themselves in any rigorous physical activity should undergo what is called a graduated form of exercise testing. This means starting off by doing light cycling or jogging to elevate your heart rate. If no symptoms occur within 24-hours after the exercise, you can slowly move to a more difficult workout. However, if your symptoms do return after the more intense workout you should decrease your level of exertion. With the graduated form of exercise testing you will slowly work yourself up to the point you were physically prior to the injury. It is safest to have a qualified health professional guide you through this graduated form of exercise testing.
When a concussion occurs, the visual system is commonly impacted. As a result of the brain trauma it is common for individuals to encounter difficulty reading, headaches, dizziness, eye pain, and double vision. It is important for individuals who experience these symptoms, and who have suffered multiple concussions to see an Optometrist for an assessment to determine if any visual dysfunctions are present. In particular, there are some Optometrists who specialize in concussion testing as it relates to the visual system. Dr. Carney can provide you with a list of qualified Optometrists able to assist you.
Other team members could include: a psychologist, a speech and language pathologist, a strength and conditioning specialist, a sports doctor.