The Concussion in Sports Group defines a concussion as “a traumatic brain injury induced by biomechanical forces.”4Concussions are generally caused by a blow to the head or neck and can result in both short and long-term neurologic impairment. While concussions are recoverable, improperly managed concussions can result in serious, long-term consequences. It is important for players, parents and coaches to be able to recognize the signs and symptoms of a concussion and to understand proper concussion management procedure.
The purpose of this guide is to educate players, parents and coaches on the signs and symptoms of concussions, as well as the importance of proper concussion management. All of the information presented in this guide is based on high-quality, peer-reviewed research articles. A complete list of references can be found below.
Concussion Symptoms
Concussions can be difficult to recognize. Many of the signs and symptoms of concussions are subjective. Furthermore, athletes may be unwilling to admit they are experiencing symptoms. Any player who is suspected of sustaining a head injury should immediately be taken out of the game and assessed by a medical professional.1,4
Common symptoms of a concussion include headache, dizziness, nausea and vomiting. Decreased coordination, disorientation and confusion are all signs of a concussion. Increased irritability, depression and anxiety are also common following a concussion.1,3,4
Developed by an international group of sports medicine researchers and clinicians, the Concussion Recognition Tool 5 is a guide for non-medical professionals to recognize the signs and symptoms of concussions. This guide is available for free on the Spark Player Development website. Any athlete suspected of sustaining a concussion should be evaluated by a trained medical professional.
Even after reported symptoms have disappeared, underlying brain function may continue to be impaired following a concussion. Neuropsychological testing is a form of testing that includes assessment of memory, neurological function, processing speed and reaction time. This form of testing is considered the most accurate way of assessing neurological impairment following a concussions and can be used to asses and track recovery.1,3
Concussion Management
In general, concussions are recoverable. However, research shows that the brain is more vulnerable to serious injury during this recovery period. This is known as Secondary Impact Syndrome. It can occur when an athlete sustains a second blow to the head or neck before they have fully recovered from the initial concussion. This secondary injury can result in long-term neurological impairment and even neurodegeneration. This is why proper concussion management is crucial.1,2
Both the Prague Concussion in Sports Group and the US Soccer Federation advocate for a conservative return to play once a concussion is sustained. Both organizations recommend a 6 stage protocol.1,4
Stage 1) Complete rest. No activity that provokes symptoms. Once the player is asymptomatic, move on to stage 2.
Stage 2) Light aerobic activity. Controlled activities of low-to-moderate intensity. This may also include mobility, balance, and flexibility training. Resistance training should be avoided.
Stage 3) Non-contact, sport-specific training. Begin to incorporate moderate-to-high intensity aerobic training and elastic resistance training.
Stage 4) Non-contact training drills. Resistance training can progress to less than 80% 1RM. No weight lifting with head below hips.
Stage 5) Full contact training after medical clearance.
Stage 6) Return to play.
If any symptoms recur during this protocol, players should drop back to the previous stage. A player should never be allowed to return to play until they are asymptomatic and cleared by a trained medical professional.1,4
Conclusion
Concussions are a serious issue in sports. Mild concussions are usually fully recoverable. However, a secondary blow to the head or neck before the first concussion has fully healed can lead to severe, long-term consequences. To ensure player safety, it is vital that players, parents and coaches are educated on concussions, understand common signs and symptoms, and understand proper protocols for returning to play.
This guide is intended as a broad overview of the most recent literature on concussion recognition and prevention. Concussion diagnosis and recovery recommendations should always be made by a trained medical professional.
References
- Adirim, T. A. (2007). Concussions in Sports and Recreation. Clinical Pediatric Emergency Medicine, 8(1), 2–6. https://doi.org/10.1016/j.cpem.2007.02.002
- Giza, C. C., & Kutcher, J. S. (2014). An Introduction to Sports Concussions: CONTINUUM: Lifelong Learning in Neurology, 20, 1545–1551. https://doi.org/10.1212/01.CON.0000458975.78766.11
- McKeever, C. K., & Schatz, P. (2003). Current Issues in the Identification, Assessment, and Management of Concussions in Sports-Related Injuries. Applied Neuropsychology, 10(1), 4–11. https://doi.org/10.1207/S15324826AN1001_2
- USSF Concussion Management.pdf. (n.d.).