You & Your Health: Concussion - What do I do now?

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By Dr. Mark Perrett

BSCs DC Chiropractor

A concussion is a mild traumatic brain injury that causes temporary changes in brain function and is most often caused by a blow to the head. It can also be caused by an excessive movement of the head that causes the brain to move rapidly within the skull.

Initial signs of concussion can include loss of consciousness, headache, vomiting, dizziness, changes in sleep, changes in mood, a feeling of brain “fogginess, general fatigue, and sensitivity to light and sound.

What to do

after a concussion

It can take as little as 24 hours or over a year to recover from a concussion. Most people fully recover in 3 weeks. If you feel you have had a concussion, you must stop your sport or activity and seek medical help. Often people are unsure if they have sustained a concussion and ironically make this decision on the field or at the rink with impaired judgement because their brain has been injured. If you have had a head injury, assume you might have a concussion. 

Initially

 The most important thing to do after you have sustained a concussion is to rest. This can be one of the hardest things to do and the most frustrating. The brain has been injured and needs time to heal, so sleep a lot. This is when your brain recovers. Don’t think too much as your brain uses a lot of energy when concentrating. This includes avoiding electronics, reading, problem solving, and learning activities. When you feel a mild headache or “brain fog”, it’s time to stop what you are doing, lay down and do nothing.

Research from the University of California has shown that you can also help your brain repair after concussion or even surgery  by modifying your diet. Increasing Omega-3 Fatty Acids, Vitamin E, Curcumin, moderate Caffeine use, and decreasing large Saturated Fat intake all help with brain repair.

Back to Activities

When you can perform simple activities of daily living and do not have a chronic headache or brain fog, it is time to get back to work or your sport. This must be a graduated process. A consensus statement on Concussion in Sport – 4th International Conference on Concussion in Sport held in Zurich, November 2012 suggests the following back to play rules.

​1. No activity 

Symptom-limited physical and cognitive rest until symptom free is the objective here. This stage allows the acute symptoms to subside and your brain to heal. You must have no

“foggy head” episodes or other symptoms.

2. Light aerobic exercise

Walking, swimming or stationary cycling with no resistance training are examples.  Symptoms must not occur within a short duration of these activities of up to 15 minutes. Gradually increasing light aerobic exercise with no symptoms is the objective.

3. Sport-specific exercise

Examples include, skating drills in ice hockey and running drills in soccer. No impact activities occur here but getting back into your sport or activity with limited to no symptoms is allowed. This step is so the person can increase their aerobic output and cognitive abilities related to their sport. 

4. Non-contact training drills

At this stage you can progress to more complex training drills (eg, passing drills in football and ice hockey).  Then adding weight training type exercises and having no symptoms allows you to go to step 5.

5. Full-contact practice

Following medical clearance, participate in normal training activities. This step helps to restore athlete confidence and assess functional skills by the coaching staff. 

6. Return to normal game play

Children and adolescents should remain at step one until symptom-free for several days (optimally seven to 10 days). One often will regress to a previous stage for short periods as their brain heals. 

Concussion return to play protocol is a very serious set of rules to follow.  Once you have a concussion you are more susceptible to another one and you are much more susceptible if you have not fully recovered from the one you have. 

Prolonged brain injury from concussion due to not fully recovering can have lasting effects on brain tissue leading to symptoms such as chronic headaches, depression, sleep disturbance, and decreased cognitive abilities. 

Take concussions seriously and follow these rules for a safe recovery.

Activity fact: 90% of concussion symptoms tend to go away over the course of a week but it often takes a minimum of three weeks for brain tissue to fully repair

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