Frequently Asked Questions about Concussion.

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What is Concussion?

Q. What is concussion?

Concussion is a traumatic brain injury that alters the way the brain functions. Effects tend to be short-lived. The term “concussion”, while useful, is imprecise and there remains disagreement around the definition of the injury and the process going on within the brain.

 

Q. What causes a concussion?

Although concussions are usually caused by a blow to the head, they can occur when the head and upper body are violently shaken.  Any blow to the head, face or neck, or a blow to the body which causes a sudden jarring of the head may cause a concussion.

 

Q. What does a concussion look like?

If any of the following signs are noted the injured person should be suspected of having sustained a concussion:

•              Dazed, blank or vacant look

•              Lying motionless on ground or slow to get up

•              Unsteady on feet/falling over/incoordination

•              Inappropriate or unusual behaviour

•              Loss of consciousness or not responsive

•              Grabbing / clutching of head

•              Seizure (fits)

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Signs & Symptoms

Q. What does a concussion look like?

If any of the following signs are noted the injured person should be suspected of having sustained a concussion:

•              Dazed, blank or vacant look

•              Lying motionless on ground or slow to get up

•              Unsteady on feet/falling over/incoordination

•              Inappropriate or unusual behaviour

•              Loss of consciousness or not responsive

•              Grabbing / clutching of head

•              Seizure (fits)

 

Q. I wasn’t knocked out, could I still have a concussion?

Yes. The vast majority of concussions do not have a loss of consciousness (being knocked out). It occurs in less than 10% of injuries and is not required to diagnose concussion. However, if a player is knocked unconscious then they are concussed.

 

Q.  What are the symptoms of concussion?

There are many symptoms that may suggest that someone has sustained a concussion.  Sometimes it can be as vague as someone saying that they “just don’t feel right”.  The most common symptoms are:

•              Headache

•              Dizziness

•              Confusion, or feeling “slow”

•              Visual problems

•              Nausea or vomiting

•              Fatigue

•              Drowsiness / feeling like “in a fog“ / difficulty concentrating

•              “Pressure in head”

•              Sensitivity to light or noise

 

Q.  I felt fine after the injury, but the next day I didn’t feel well.  Could this be concussion?

Yes. Sometimes the onset of symptoms is delayed by 24-48hrs.

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Recovery

Q.  How long will it take to recover?

The majority (80-90%) of concussions feel better within 7-10 days. This may be longer in children and adolescents and recent thinking is that a “normal” recovery for them is within 30 days.  Following recovery advice is the best way to feel better as quickly as possible.

 

Q.  What do I need to do to ensure a good recovery?

  1. Rest. Early rest is key to good recovery from concussion.  The injured person should be advised to take it easy for a couple of days and have a day or two off school.  Its sensible to minimise screen time and reading during this stage.
  2. Return to normal life. If symptom free after a day or two rest, the focus can change to returning to activities of normal life.  This should be done gradually, only increasing what you are doing if you feel well.

 

Q.  Can concussion affect academic performance?

Sometimes the only symptom of concussion that persists is difficulty concentrating in the classroom.  Often, children don’t realise this is caused by their concussion and it goes unnoticed, persists and results in poor recovery and poor academic performance.

Academic staff have an important part to play in recognising if a child is underperforming following a concussion and implementing strategies to aid recovery.

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The Guidelines

Q.  Are there rules about returning to sport?

Yes.  In England, all major governing bodies, as well as the education sector, follow the same rules about returning to sport following a concussion. Globally, most sports having similar guidelines. These guidelines state a two week period of rest followed by a period of Graduated Return to Play (GRTP) is required before a return to sport. Further details of these guidelines are found in questions below.

 

Q.  When can a player return to physical activity?

If all the symptoms of concussion have settled, the injured person can look to start returning to sport after 2 weeks.  Return to sport should follow a phased process, gradually increasing the amount and intensity of activity.  Contact activities should be the final stage of a return.

 

Q. What is the Graduated Return to Play (GRTP)?

This is the process that an injured player should go through to reintroduce sport. Children should do one stage every 48hrs, only progressing if they feel well.  Adults can do a stage every 24hrs.  An example GRTP timetable can be seen here:

 

 

Q.  Why do I need to see a doctor?

It is accepted to be good practice to see a doctor before returning to sport in order to ensure that a full recovery has been made and the injured player is not putting themselves at risk.  Most sports will not allow a player to return until medical clearance has been provided.  In players who are not recovering well, seeing a doctor with experience of concussion will enable good advice to be given early.

 

Q. I/my child feels absolutely fine, why do we have to follow this process?

Lots of people feel better very quickly and it is frustrating for them to be kept off sport.  We now know that symptoms going away doesn’t always mean that a full recovery has been made.  In order to avoid the risks of further injury we take a cautious approach.

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The Risks

Q.  Are there risks with concussion?

The vast majority of people recover without any impact on their health.  The serious risks are acknowledged to come from multiple concussions, particularly those sustained while the player has not been given the chance to make a full recovery from a previous injury.  This is why the concussion guidelines exist.

 

Q. What should I do if I have had repeat concussions?

Anyone with a history of 2 or more concussions within a 12-month period are at greater risk of further brain injury and a prolonged recovery.  They should seek the medical attention with doctors with experienced in concussion management before returning to play.

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