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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.

Saint Barnabas Medical Center
94 Old Short Hills Road
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(973) 322-5000
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300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
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600 River Avenue
Lakewood, NJ 08701
(732) 363-1900
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1 Clara Maass Drive
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(973) 450-2000
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Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
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Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
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Children's Hospital of New Jersey at Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
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Barnabas Health Ambulatory Care Center
200 South Orange Avenue
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(973) 322-7000
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Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
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Barnabas Health Ambulatory Care Center Laboratory Patient Service Center - Livingston
200 South Orange Avenue
Livingston, NJ 07039
(973) 322-7194
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1440 Lower Ferry Road
Ewing, NJ 08618
(609) 890-4450
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RWJ Physical Therapy & Cardiac Rehab at Monroe
111 Union Valley Road
Suite 201A
Monroe, NJ 08831
(732) 561-8031
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RWJ Physical Therapy at Carteret
60 Cooke Avenue
Carteret, NJ 07008
(732) 969-8030
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1044 US Highway 9
Parlin, NJ 08859
(732) 727-2220
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RWJ Physical Therapy at Scotch Plains
2120 Lamberts Mill Road
Scotch Plains, NJ 07076
(908) 389-5400
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RWJ Rehabilitation Lawrenceville
4152 Quakerbridge Road
Lawrenceville, NJ 08648
(609) 245-7420
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RWJ Sports Physical Therapy at Princeton
743 Alexander Road
Suite 2
Princeton, NJ 08540
(609) 419-0455
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RWJPE Sports Medicine New Jersey
186 County Road 520
Suite 3
Morganville, NJ 07751
(732) 946-2100
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RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
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110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200
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RWJ Physical Therapy and Vestibular Suite at East Brunswick
593 Cranbury Road
East Brunswick, NJ 08816

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RWJ Physical Therapy at New Brunswick
100 Kirkpatrick Street
New Brunswick, NJ 08901
(732) 545-0494
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The Matthew J. Morahan III Health Assessment Center for Athletes
200 South Orange Avenue
Livingston, NJ 07039
(973) 322-7913
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