What is a Concussion?

Concussions are the most common form of head injury caused by an impact or forceful motion of the head or other part of the body, resulting in rapid movement of the brain within the skull.

Sport Related Concussion (SRC)

A SRC is defined as a traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain that occurs in sports and exercise-related activities. This initiates a neurotransmitter and metabolic cascade, with possible axonal injury, blood flow change and inflammation affecting the brain. Several common features that may be utilized in clinically defining the nature of a concussive head injury as described in the 2016 Berlin Consensus Statement include four main features:

Suspected Concussion - Recognize & Remove

If someone experiences an impact to the head, face, neck, or body, and either shows observable signs or reports symptoms of a potential concussion, it's crucial to consider the possibility of a concussion. In all cases of suspected concussion, the person should stop the activity right away. Continuing increases their risk of more severe, longer-lasting concussion symptoms, as well as increases their risk of other injury. It's essential that anyone suspected of having a concussion receives medical attention from a qualified healthcare professional.

Respond

A person with a suspected concussion should not be left alone initially. The person should NOT BE woken up, but should be monitored throughout the night for anything out of the ordinary. Only wake the person if you have concerns about the person’s breathing, changes in skin colour, or how they are sleeping. Call 911 if the person is slow to wake or shows any of the Red Flag symptoms. If sleeping normally, let them sleep to allow the brain to rest. Sleep is an important part of the recovery process. If no signs or symptoms appear within the first 48 hours, the person can return to normal activities but should be monitored for several days. If no signs or symptoms appear, chances are that no concussion was sustained. If unsure, please see your medical professional for clearance.

Rest

The first and most important step in recovery from a concussion is to rest for a maximum of 2 days. The Amsterdam Consensus Statement recommends relative rest for only the initial 24 to 48 hours following injury, including limited screen time. Prolonged rest may delay recovery and affect mental health.

Exercise

Returning to light physical activity as tolerated (such as walking) in the initial 48 hours is recommended if there’s no risk of injury. Aerobic exercise within 2 to 10 days after concussion has been shown to help with recovery and prevent symptoms from persisting. Thus, progressive increases in exercise intensity are recommended, according to symptom tolerance levels, as long as there’s no risk (that is, head impact, collision or fall). Slight worsening of symptoms with exercise is acceptable as long as the symptoms improve within 1 hour.

Management

Concussion symptoms can be managed by taking breaks and by prioritizing activities to conserve energy. Symptoms can also be managed by supporting quality sleep; naps should be limited to a maximum of 45 minutes per day. Short-term strategies can help manage concussion symptoms. However, these strategies and techniques can slow recovery if used over an extended period of time. A concussion can have a significant impact on physical, cognitive, and emotional functioning. The recovery process involves managing activities in order to not trigger or worsen symptoms—the key is finding the “sweet spot” between doing too much and too little. Caring for a concussion can involve a variety of treatments and a team of health professionals, depending on the symptoms and how a person’s condition improves. Usually, symptoms will go away in 1 to 4 weeks. If you or your child has had a concussion before, or there are other health factors, recovery may take longer. Persistent symptoms should be personalized to the individual and involve a range of licensed health care professionals including occupational therapists, sports therapists, physiotherapists, chiropractors, and psychologists. Prior concussions, a history of headaches, and learning disabilities are all factors which may influence recovery from a concussion and lengthen the recovery period. It is normal to experience symptoms during recovery, and it is normal to feel good one day, and not so good the next. If new or worsening symptoms are experienced at any stage, the person should return to the previous stage until symptoms have improved once again. Wait at least 24 hours before re-attempting the next stage.

The best way to prevent concussions is to prevent the incidents that cause concussions! Although not all concussions can be prevented, there are steps you can take to decrease the risk of sustaining one or reducing the severity of a potential concussion.

• Seatbelts
• Car and Booster seats
• Proper training in contact sports
• Supervision of sport practices and games
• Sport organizations implementing rules and protocols in contact sports
• Properly fitted protective sports gear, such as fitted helmets*

*Helmets can prevent serious head injuries. However, helmets are not proven to prevent concussions.

Second Impact Syndrome

Second Impact Syndrome (SIS) is associated with brain swelling when an individual experiences a second concussion before the complete recovery from the initial concussion. It is believed that athletes who sustain a concussion and return to their sport early are at a particularly higher risk of sustaining SIS. The management of the condition starts with prompt recognition of a sports-related concussion and protecting the athlete until they recover from the initial injury. The consequences of SIS can cause severe neurological impairment or fatality. Although SIS is an extremely rare condition and there have only been a handful of cases.