Concussion in Sports

If you suspect a concussion, stop playing and seek medical attention right away.

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During physical activity, an athlete could sustain a bump, blow or jolt to the head that results in a concussion – a common and serious type of sports injury. Concussions can disrupt the way the brain normally works, affecting everyday activities, including schoolwork.

Symptoms may include a headache, neck pain, nausea, ringing in your ears, dizziness or tiredness. You may feel dazed or not your normal self for several days or weeks after the injury. You may experience more serious symptoms such as:
  • Confusion
  • Foggy feeling
  • Headaches
  • Repeated vomiting or nausea
  • Seizures
  • Slurred speech
  • Trouble walking or sleeping
  • Weakness, numbness or decreased coordination
Symptoms of a concussion may not start right away; they may start days or weeks after the injury. If you suspect a concussion, stop playing sports or participating in activity and seek medical attention.

Diagnosis

Diagnosis

Doctors determine the diagnosis of concussion based on a clinical history and physical exam. This includes questions regarding the head injury itself and an examination focused on physical, neurological and cognitive function. Imaging tests such as CT scans and MRI are not routinely used to diagnose concussion and are obtained when there is the potential for other significant focal brain injuries.

Concussion diagnosis can be complex. It is assessed via physician observation, an ImPACTTM neurocognitive examination, balance assessment and imaging tests.


ImPACT examines symptoms, conditions and brain functions, including memory, attention and how quickly the patient processes information, reaction time and orientation. It takes approximately 20-30 minutes to complete.

The balance testing assesses somatosensory (ability to determine touch, temperature and your body’s position in space), visual (ability to see movement) and vestibular (ability to balance or maintain equilibrium) systems and takes approximately five minutes.

Treatment

Treatment

Cognitive rest is the first recommended treatment for concussions. This approach to using the brain as little as possible includes limiting homework, schoolwork and any form of digital media, reserving the most amount of energy for the brain to heal itself.

Generally, the younger the athlete, the longer the recovery, with rough guidelines as follows:
  • College: seven to 10 days
  • High school: seven to 14 days
  • Junior high: two to three weeks
  • Under age 12: more than three weeks

Return to Play Progression

Return to Play Progression

Thorough and continuous evaluation and proper treatment are critical. Medical clearance is required before an athlete can return to sport, and that return is based on our assessment of the symptoms. When symptoms are at zero, a decision is made regarding return to sport. If the decision is in favor of athletic resumption, the athlete begins a five-phase monitored process:
  1. Light cardio
  2. Cardio with lifting
  3. More intense cardio with lifting
  4. Integration of sport practice into training
  5. Contact exposure
If no symptoms are present before, during and after activity, the athlete is expected to have recovered from concussion.

In 90 percent of cases, most symptoms of concussion normalize in seven to 10 days. Prolonged or recurring symptoms, or decline in cognitive, memory and emotional function (depression or anxiety) may be a sign of chronic postconcussive syndrome. If so, the person should not return to sport. Returning to sport while symptomatic from a concussion can cause additional injury such as second impact syndrome, which can lead to serious consequences, including permanent brain injury and even death. Thorough and continuous evaluation and proper treatment are critical.

In the state of Ohio, there are very specific legal guidelines regarding return to play. Coaches, referees or officials must remove an athlete from play if the athlete is exhibiting the signs and symptoms of a concussion during practice or a game. Athletes cannot return the same day they are removed and are not permitted to return to play until they've been assessed and receive written clearance by a physician or other licensed healthcare provider approved by the school or organization.

Reducing the Risk

Reducing the Risk

Protective equipment, field surface, your anatomy and a history of prior injuries are all contributing risk factors for concussions. As such, you should always:
  • Play by the rules of your sport and use good technique
  • Know, and listen to, the signs and symptoms
  • Use protective equipment

Why Ohio State?

Why choose The Ohio State University Wexner Medical Center for treatment of sports-related concussion?

Timely care: We offer patients with a suspected concussion convenient and timely access to care within 24-48 hours of injury at a number of locations.

Experience: We are the sideline care providers for more than 5,000 central Ohio competitors and performers, including Ohio State’s athletes and varsity teams.
Our providers who provide sports concussion care

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