Concussion Information

How to Identify a Concussion from a Sports Injury and How to Return to Activities

What is a concussion?

A concussion is a type of traumatic brain injury (TBI) in which the brain is injured by an impact or a sudden movement. "Concussion by definition means to shake violently." A concussion can occur from any blow to the head, neck, jaw, face, or body that forcibly moves the brain within the skull.

Second Impact Syndrome (SIS) is defined as experiencing two concussions within a short period of time. SIS can lead to severe and prolonged symptoms, brainstem herniation, and in rare cases death. Accurate symptom assessment, reporting, and excellent clinical monitoring and management is key to prevention of SIS.

Athletes should be aware of the symptoms of concussion, and talk to a doctor if they suspect they may have a concussion.

What are the symptoms of a concussion?

• Headache
• Memory loss
• Nausea
• Dizziness
• Vomiting
• Feeling slow
• Sensitivity to light or noise
• Blurred or double vision
• Heavy head or “mentally foggy”
• Irritability or mood changes
• Difficulty in sleep patterns
• Fatigue or exhaustion
• Sleeping more or less than usual
• Inability to concentrate or focus

When can one return to school or play following a concussion?

Return to Learn (RTL) and Return to Play (RTP), should be gradually introduced based on the tolerance of stimulation in the classroom and with physical activity. This progression should be carefully monitored by a physician and a concussion center. An athlete must be completely asymptomatic (without symptoms) during school with no academic restrictions and cleared to resume physical activity by a physician trained in the evaluation and management of concussions, before the RTP progression begins. Once cleared, the athlete can resume gradual RTP — with careful monitoring, under the supervision of a licensed health care provider

—to gauge the athlete’s readiness for practice and game play. Below is a chart that shows how to gradually return to regular activities.

Stage	Activity	Objective
Clinically supervised progressive active recovery (with monitored symptoms)	48 hours complete cognitive rest (see above) then gradual entry into clinically supervised light activity	Cognitive recovery and progressive active return during acute phase
Day 1 (without symptoms): light aerobic exercise	Walking, swimming or stationary bicycle keeping intensity less than 70% of maximum predicted heart rate	Increase heart rate
Day 2 (without symptoms): Sport-specific exercise	Skating drills in ice hockey, running drills in soccer. No head impact activities	Add movement
Day 3 (without symptoms): Non-contact training drills	Progression to more complex training drills, e.g. passing drills in football and ice hockey	Exercise, coordination and use of brain
Day 4 (without symptoms): Full contact practice	Following medical clearance, participate in normal training activities	Restore confidence and allow coaching staff­ to assess functional skill
Day 5 (without symptoms): Return to play	Normal game play.