Concussion Information

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

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.




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.

Barnabas Health Ambulatory Care Center
200 South Orange Avenue
Livingston, NJ 07039
(973) 322-7000
RWJPE Sports Medicine New Jersey
186 County Road 520
Suite 3
Morganville, NJ 07751
(732) 946-2100
RWJ Sports Physical Therapy at Princeton
743 Alexander Road
Suite 2
Princeton, NJ 08540
(609) 419-0455
Cooperman Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Children's Hospital of New Jersey at Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
RWJ University Hospital Somerset
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200
RWJ Physical Therapy at Carteret
60 Cooke Avenue
Carteret, NJ 07008
(732) 969-8030
RWJ Physical Therapy at Scotch Plains
2120 Lamberts Mill Road
Scotch Plains, NJ 07076
(908) 389-5400
RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood, NJ 08701
(732) 363-1900
RWJ Physical Therapy at New Brunswick
100 Kirkpatrick Street
New Brunswick, NJ 08901
(732) 545-0494
The Matthew J. Morahan III Health Assessment Center for Athletes
200 South Orange Avenue
Suite 002, Lower Level, East Wing
Livingston, NJ 07039
(973) 322-7913
RWJ Rehabilitation Lawrenceville
4152 Quakerbridge Road
Lawrenceville, NJ 08648
(609) 245-7420
Jersey City Medical Center Rehabilitation Services
100 Town Square Place
Suite 208
Jersey City, NJ 07310
(201) 915-2000

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