Injured, Now What?

Shedding a little light on Concussions

By Catherine Phillips
Published

Concussions are a parent and coach’s worst nightmare. Also known as the “invisible injury,” concussions are caused when a blow to the head or the body jostles the brain, causing a myriad of signs and symptoms. Symptoms can include but are not limited to: headaches, nausea, dizziness, vomiting, fatigue, changes in cognition, amnesia around the injury event, ringing in the ears and coordination or balance issues.

Unfortunately, this injury is all too common—the Centre for Disease Control and Prevention (CDC) estimates that 1.6-3.8 million concussions occur annually in sports and recreational activities. However, since many concussions are left untreated and unreported, the true number could be closer to 5 million incidents each year.

Athletic Therapists know about concussions – from the point of injury to the point of return to sport. Athletic Therapists are trained to understand the signs and symptoms of concussion, the clinical recovery, as well as the on-field progression to ensure a safe return to the sport you love. 

Whether you’re a parent to active children, a coach, or a family physician, knowing how to identify and treat a concussion is key. We spoke to Colin King, an Athletic Therapist and instructor at Acadia University in Halifax, Nova Scotia, about dealing with a concussion.

At one time, rest in a dark room with no stimulus was the only way we knew how to treat concussions. Although rest is still important in treating a concussion, King says it’s far from the only method. The most recent guidelines highlight that early exercise intervention (or active rest) may be more effective. 

“The first step to treating a concussion is 24 to 48 hours with complete physical and mental rest to get symptoms to stabilize,” says King. This means both cognitive and physical rest. King likes to remind his students that listening to music and binging shows on Netflix affects their brain similar to what running a marathon after spraining their ankle does to their body.

Current International guidelines suggest a benefit to earlier mental and physical activity, beginning 48 hours after injury, even if symptoms are still present. These activities, such as going for a walk or light reading are called Subthreshold Activities. According to King, during this stage it is important that whatever activity you’re doing isn’t bringing on new or increasing current signs or symptoms.

“We know that the clear majority of concussions are going to settle down and resolve within a seven to ten-day period, although it can be longer in children” King says. Best practice is one to two days of rest, gradual reintroduction through Subthreshold Activity, and finally a return to learn or return to play protocol, which means slowly getting back into your regular athletics.

For child or adolescent patients, the return to play protocol starts with daily activities at home that do not give the child symptoms. This gradual reintroduction of normal activities evolves to including some school activities such as homework done outside the classroom. The goal being to increase their tolerance to cognitive work. If this goes well, the protocol calls for the child to return to school part-time with a gradual reintroduction of schoolwork. As school activities gradually increase, the goal is for the child to be able tolerate a full day of school activities and catch up on missed work. If you suspect that you, or someone you know, has received a concussion the most important thing is early recognition and assessment. “When someone gets a concussion it’s important to get assessed as soon as possible by a qualified individual,” King says. An Athletic Therapist can be there to help you manage it. From assessment through to returning to sport, an Athletic Therapist can help to make sure sport is safe and fun.  

Contributing Athletic Therapist
Colin King

PhD, CAT(C)

Colin is an Assistant Professor in the School of Kinesiology at Acadia University in Nova Scotia. He is the former president of the Atlantic Provinces Athletic Therapists Association. He is also currently the acting co-Head AT with Acadia Athletics and was the former Head AT with their Varsity Football Program.