What is a concussion?
A brain injury caused by a blow to the head or a violent shaking of the head and body.
This occurs from a mild blow to the head, either with or without loss of consciousness and can lead to temporary cognitive symptoms.
Symptoms may include headache, confusion, lack of coordination, memory loss, nausea, vomiting, dizziness, ringing in the ears, sleepiness, and excessive fatigue.
There’s no specific cure for concussion. Rest and restricting activities allow the brain to recover. This means one should temporarily reduce sports, video games, TV, or too much socializing.
Typically, I prefer that the patient take six weeks off from PE and Sports.
In the human body, it takes about 6 weeks to achieve a 90% recovery in the tissues that have been damaged. When you suffer a concussion, the little fibers that hold the brain in the center of the skull get damaged. This is why you are more likely to suffer another concussion after the first one. Coming back to soon after a concussion is not a good idea.
If there are repeated concussion in a sport, I recommend that the patient find another sport.
I understand though that there is pressure and desire to return to PE and Sports.
The official guidelines to return to sports are more lax than I would like them to be; nevertheless, they are what they are. And there are many protocols out there.
A plan that can accommodate the desires of the student might be this.
- No PE and sports for two weeks.
- If there are no persistent symptoms – headaches, memory loss, nausea, confusion – a graduated return to PE/Sports over a one week period of time.
Return to Sports Progression
- Step 1: Light aerobic activity
Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weight lifting at this point. - Step 2: Moderate activity
Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (less time and/or less weight from their typical routine). - Step 3: Heavy, non-contact activity
Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement). - Step 4: Practice & full contact
Young athlete may return to practice and full contact (if appropriate for the sport) in controlled practice. - Step 5: Competition
Young athlete may return to competition.
If there are any symptoms during these phases, the patient must stop and return to the doctor for an evaluation.