Concussion and Sports: Know Your Game

Key points

• Concussion is an epidemic that is often under-identified and under-managed.  
• Every concussion must be treated individually.
• It takes about a week to recover from a concussion, longer if symptoms persist.
• In predicting outcomes:
  • Amnesia is a more important symptom than loss of consciousness. 
  • Duration of concussion symptoms is more important to a person’s outcome than the initial severity of symptoms.

Recommendations for Students with Concussion

• Get an immediate evaluation and examination after a concussion.
• Increasing blood flow to the brain may actually slow recovery. 
• Activity must be restricted while the concussion resolves; students should not return to the game or continue practice. An early return to play puts students at greater risk for developing Post Concussion or Second Impact syndromes. In more severe cases, students may need to be put on bed rest. 
• Be alert to activities that may cause an increase in symptoms, such as listening to music, playing computer games, watching TV, or dancing. Parties may need to be eliminated.
• Wearing sunglasses may offer some relief from light sensitivity.
• Continuing activities that make symptoms worse can delay a student’s recovery time. Make sure the student stops doing any activity that causes symptoms to increase, and modify school attendance and activities if needed. Students may need to restrict TV watching, reading, and homework until their symptoms resolve.
• As symptoms are reduced, increases in the amount of time spent reading or watching TV or doing other activities may be increased.
• Try frequent breaks or attending school for a half day if students have symptoms that worsen throughout the day.
• Students shouldn’t drive when they are recovering.
• Reduce workload and homework. Delay or postpone tests or quizzes that require sustained concentration.
• Athletes should not return to contact or competitive sports until they are symptom free when at rest or when exercising and have normal neurocognitive testing (e.g., IMPACT or similar testing).

Return to play exercise program, recommended at the Prague Concussion Conference:  

Day 1: Walking for 20–30 minutes at a rate of 2-1/2 miles per hour.

Day 2: Jogging for 20–30 minutes.

Day 3: Running for 20–30 minutes.

Day 4: Performing sport-specific practice drills.

Day 5: Return to contact sports, if athlete is symptom free.

If headaches or other symptoms occur during any step, the activity needs to be stopped. The athlete should then wait 24 hours and start again at the previous level.

Adapted from:

Concussion Management Recommendations by Dr. Michael Lee. (retrieved 9/21/20).  http://dev.impacttest.com/index.php/concussion/management