Many people who have a concussion will experience initial symptoms such as headaches, dizziness, thinking difficulties, and changes in behavior. Most people can expect their symptoms to diminish after 7 – 10 days. If symptoms continue beyond 10 days, it is important to consult with a healthcare professional trained in concussion management.
- After sustaining a concussion, it is very important to avoid any activity that places the individual at risk of sustaining another concussion.
- Assure the individual that he/she will be okay and that symptoms will reduce soon if he/she follows a recovery plan that balances rest and activity.
- Since most individuals will recover completely, accommodations will be temporary.
- Evaluation by healthcare professionals trained in the care of concussion is important.
- It is as important that professionals who diagnose specific symptoms have expertise in managing those symptoms, such as headaches or dizziness.
A good physician is open to referring the student to specialists as needed. Ongoing coordination of those selected services is important while balancing rest and the return to activity. In addition to this, healthcare professionals who are trained in concussion management will also take into consideration the stressors that are present in the student’s life and how those may impact the recovery process. All factors need to be considered and addressed as a part of the recovery plan.
The good news is that research shows that early identification, education and management of symptoms can prevent long-term difficulties and disability. Managing the symptoms through a balance of rest and activity is the key to recovery.
Return to Learn
Cognitive and physical rest are important in the recovery phase following a concussion. This usually lasts for three days or less, and the student athlete must be symptom free for 24 hours before progressing to the next phase of Return to Learn protocols. Activities that should be limited include cell phone use (including texting), computer use, and video games. Light physical activities can include yoga, meditation, stretching activities, and breathing exercises.
Light thinking activities are the second step in the recovery plan. Activities that are appropriate include listening to music that is calm and relaxing and playing familiar, non-violent video games. Activities of yoga, meditation, stretching exercises, and breathing activities can be continued and intensified a little.
Returning to school should be gradual starting with half-days or attending school part time. Academic adaptations may be needed for a short-term basis. If longer time is needed for school adjustments, discuss a 504 plan with accommodations with the teacher and school staff. Identify adaptations that will make the student most successful. Always monitor the student carefully, allow rest breaks, and look for signs that he or she is not doing well. Everyone involved with the student should work together. This includes parents, athletic and school staff. It is key for everyone to keep the lines of communication open while monitoring the recovery plan.
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Return to Play
For an athlete to return to the playing field or court, it is important that he/she is back to normal performing and behaving as they did before the concussion. Questions to consider: Have the concussion symptoms gone away? Is the athlete thinking as clearly as before? Is the athlete behaving as before? Does the athlete have any difficulty with balance when standing or moving? Does the athlete have any difficulty with vision or hearing? All of these areas need to be back to baseline before there is a return to sports.
Important Take Away Points
After sustaining a concussion, it is very important to avoid any activity that places the student at risk of sustaining another concussion. Assure the athlete that he/she will be okay and their symptoms will reduce by following a Return to Play plan, even in practice.
First and foremost, the student athlete must be symptom free for a minimum of 24 hours before returning to play.
Returning to play in sports should be determined after all symptoms have subsided and consider if the concussion symptoms return or worsen during physical exercise by the student athlete. If symptoms return or worsen, the student athlete should wait before returning to play.
Baseline testing is one part of the identification process of a potential concussion. Baseline testing should not be used in isolation to diagnosis a concussion or not.
Baseline testing is intended to be administered at the beginning of the sports season and provides information in a variety of areas such as thinking skills and physical abilities. Should an athlete be suspected of having sustained a concussion during play then the very first rule is to remove the player from all play. The next step is for the student athlete to be evaluated by a healthcare professional trained in concussion management. If it is determined that the athlete has sustained a concussion, then a plan of recovery should be identified. Once the symptoms of concussion have resolved then the baseline testing can be used to determine if the athlete has fully recovered. Use of the pre-season baseline testing information is not effective for use during a sporting event – the player suspected of having a concussion must be removed from play, and subsequently evaluated on the baseline test.
Licensed Athletic Trainers, physicians and other personnel trained in administering and evaluation of baseline testing must have access to both the pre-season baseline test and post-incident baseline test for effective use of baseline testing.
Schools and youth sports teams should consider pros and cons of baseline testing before requiring the testing in sports concussion protocols.
A balance between rest and return to activity is important to recovery. There are well-designed and researched guidelines that will lead the athlete through the recovery process on their way back into sports.
Athletes might feel like they are letting their teammates down by not participating in practice or the games as they did before. There might be a tendency to hide the concussion symptoms from coaches and teammates. This can actually make the situation worse.
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Download CDC Concussion Checklist