Recognizing and Managing Concussions in Sports

Concussions are a significant concern in sports, especially contact sports like football, soccer, hockey, and basketball. Despite increased awareness of head injuries, concussions are still frequently underreported, and athletes often continue playing despite symptoms. At Emery Physical Therapy, we emphasize the importance of recognizing and managing concussions early to ensure the health and safety of athletes. In this blog, we’ll discuss how to identify concussions, the importance of proper management, and the role of physical therapy in recovery.

What Is a Concussion?

A concussion is a type of mild traumatic brain injury (TBI) that occurs when the brain is jolted or shaken within the skull. This can happen due to a direct blow to the head, neck, or body, causing the brain to move rapidly back and forth. Concussions can disrupt brain function, leading to a range of physical, mental, and emotional symptoms.

While concussions are often considered less severe than other types of head injuries, they should never be taken lightly. Even a mild concussion can have serious long-term effects if not properly managed. Repeated concussions can lead to more severe brain injuries, including chronic traumatic encephalopathy (CTE), a condition that affects the brain over time.

Common Symptoms of a Concussion

Recognizing the symptoms of a concussion is crucial for ensuring proper management and preventing further injury. Symptoms can vary depending on the severity of the concussion and the individual, but some common signs include:

Physical Symptoms:

• Headache or pressure in the head

• Nausea or vomiting

• Dizziness or balance problems

• Blurred vision or sensitivity to light

• Ringing in the ears

• Fatigue or feeling "out of it"

Cognitive Symptoms:

• Difficulty concentrating or remembering

• Confusion or feeling mentally foggy

• Slower reaction times

Emotional and Behavioral Symptoms:

• Irritability or mood swings

• Anxiety or depression

• Nervousness or a feeling of being overwhelmed

How Concussions Are Diagnosed

If a concussion is suspected, it’s crucial to seek medical attention right away. A healthcare provider will conduct a thorough assessment, which may include a neurological exam, questions about symptoms, and possibly imaging tests to rule out more serious brain injuries, such as bleeding or fractures.

Many sports organizations now have protocols in place for concussion evaluation, including sideline concussion assessments during games. However, diagnosing a concussion can be difficult since some symptoms may not be immediately obvious, and they can worsen over time. It’s important to err on the side of caution and avoid returning to play until a healthcare provider has cleared the athlete.

Managing a Concussion: The Importance of Rest and Gradual Return

One of the most important aspects of managing a concussion is allowing the brain sufficient time to heal. This includes both physical and cognitive rest. Immediate rest after a concussion can help minimize symptoms and prevent further damage.

1. Initial Rest Period

After a concussion, athletes should rest both physically and mentally for 24-48 hours. During this time, they should avoid strenuous physical activity, screen time, and any mentally demanding tasks such as studying or reading. Resting helps reduce the risk of worsening symptoms and gives the brain the best chance to recover.

2. Gradual Return to Activity

Once the acute symptoms have subsided, athletes can begin a gradual return-to-play protocol under the supervision of a healthcare provider. This process involves slowly increasing physical activity levels to ensure that the athlete can tolerate exercise without exacerbating symptoms. The return-to-play steps typically follow this order:

1. Light aerobic exercise (e.g., walking or stationary cycling)

2. Sport-specific exercise (e.g., dribbling a basketball, light jogging)

3. Non-contact training drills

4. Full-contact practice (if applicable)

5. Return to competition

It’s important to note that if any symptoms reoccur at any stage, the athlete should stop activity immediately and consult their healthcare provider before progressing further. Returning to play too soon can increase the risk of another concussion or cause a more serious condition known as second-impact syndrome.

The Role of Physical Therapy in Concussion Recovery

Physical therapy plays a critical role in managing concussions and aiding recovery. While most concussions resolve with rest and time, some individuals may experience lingering symptoms, particularly related to balance, vision, or neck pain. Physical therapists can help address these issues and provide targeted exercises to speed up recovery.

Here’s how physical therapy can help in concussion recovery:

1. Vestibular Rehabilitation Therapy (VRT)

One of the most common lingering symptoms of a concussion is dizziness or balance problems. Vestibular rehabilitation therapy (VRT) is a specialized type of physical therapy that focuses on improving balance and reducing dizziness. It involves specific exercises that help retrain the brain to process sensory input more effectively and regain coordination.

2. Neck and Posture Exercises

Many individuals with concussions experience neck pain or stiffness. Physical therapists can assess and address any issues with posture and neck alignment, as well as strengthen the muscles supporting the head and neck. This can reduce discomfort and improve overall recovery.

3. Cognitive and Visual Rehabilitation

Concussions can also affect cognitive functions like concentration and memory, as well as cause visual disturbances. While cognitive rehabilitation typically involves a neuropsychologist, physical therapists can help with visual-motor exercises to improve eye tracking and focus. These exercises can aid in recovering from the cognitive and visual symptoms that may accompany a concussion.

4. Return-to-Sport Protocol

Physical therapists can guide athletes through a return-to-play protocol, helping them progress through exercises and activities safely. They will monitor for symptoms and adjust the recovery plan accordingly.

Preventing Concussions in Sports

While concussions are not always avoidable, there are several steps that can be taken to reduce the risk of head injuries in sports:

• Wear protective gear: Ensure that athletes are using proper headgear and padding, such as helmets and mouthguards, where appropriate.

• Follow proper techniques: Teach athletes proper techniques for tackling, heading a ball, and other high-risk movements to minimize the likelihood of head impacts.

• Educate coaches, athletes, and parents: Raise awareness about the signs and symptoms of concussions, as well as the importance of reporting them and seeking medical attention.

• Enforce concussion protocols: Ensure that sports teams follow strict concussion protocols, including mandatory rest periods and medical evaluations before athletes are cleared to return to play.

Final Thoughts

Concussions in sports are a serious issue that requires careful management. Recognizing the symptoms, getting a proper diagnosis, and following a structured return-to-play protocol are essential to ensure that athletes recover fully and avoid further harm. Physical therapy is an important tool in the recovery process, helping to address symptoms such as dizziness, neck pain, and balance issues.

At Emery Physical Therapy, we are committed to helping athletes recover from concussions safely and effectively. If you or your child has suffered a concussion, don’t hesitate to contact our team for expert guidance and rehabilitation.