Reviewed by: J. Mica Guzman, MD, MS, DABFM, CAQSM
Written by: Lauryn Feil
As many as 3.8 million concussions occur in the U.S. every year during competitive sports and recreational activities alone. However, nearly 50% of these concussions go unreported because players often don’t believe their symptoms are severe enough to indicate a serious injury. This statistic is quite jarring, especially considering a concussion, despite the severity of the hit sustained by the player or the immediate symptoms observed, is a type of traumatic brain injury and should always be assessed and treated by a medical professional to ensure both safe recovery and safe return to play.
If you, a teammate, or someone you know suffers a hit to the head or body while playing sports, it’s important to know how to proceed when dealing with a potential brain injury. Family medicine specialist J. Mica Guzman, MD, who serves as the Primary Care Clinical Director of UT Health Austin’s Sports and Injury Clinic, provides insight on concussion symptoms, treatment, and prevention for athletes and recreational sports enthusiasts who may be at risk during play.
What is a concussion?
A concussion is a type of traumatic brain injury (TBI) that affects how your brain functions. The changes in brain function are usually temporary and most concussions do not result in loss of consciousness. Oftentimes, physicians may refer to a concussion as a “mild” traumatic brain injury, because they typically are not life-threatening injuries and the impact that causes a concussion isn’t necessarily from substantial trauma. However, even the mildest concussions can result in serious effects.
“A concussion is caused by force that gets transmitted to the brain. This can be a direct blow to the head or face, but also can be a force transmitted from anywhere on the body that radiates up into the brain. This includes a fall or direct hit to the body,” explains Dr. Guzman.
Injury to the brain occurs when the head and brain are rapidly jolted back and forth due to a sustained impact. The sudden force causes the brain to bounce and twist around inside the skull, stretching and damaging the cells and structures inside your brain. This damage can cause physical and chemical changes in your brain affecting how your brain functions.
What are concussion symptoms?
No matter how they happen, concussions, even the mildest ones, can have short-term and long-term effects, and require ample time to heal. These symptoms can be obvious or subtle and can change over time. Symptoms can last for days, weeks, or even longer.
Not all symptoms of concussion are immediately apparent and some can develop over time. However, if someone has just been injured, the more immediate symptoms of a concussion to look for include:
- Loss of balance or dizziness
- Loss of memory
- Temporary loss of consciousness
- Delayed response to questions
- Ringing in the ears
- Nausea and vomiting
- Blurred vision
- Sensitivity to light and sound
Certain concussion symptoms may develop hours or days after the traumatic brain injury has occurred. These symptoms may include:
- Trouble concentrating
- Memory problems
- Irritability and other personality changes
- Sensitivity to light and noise
- Changes in appetite
- Sleep disturbances
- Anxiety, depression, or other psychological problems
How is a concussion treated?
A medical professional will evaluate your signs and symptoms, review your medical history, and conduct a neurological examination to assess your vision, hearing, strength and sensation, balance, coordination, and reflexes. This information is used to help your physician build a treatment plan specific to what your brain needs to properly heal. Concussions are a clinical diagnosis and are not diagnosed with imaging. For symptoms and findings on clinical exam that may need further assessment, imaging tests may also be necessary to produce detailed images of your brain.
In the first few days after a concussion your doctor will likely recommend that you rest, both physically and mentally. You should avoid physical activities and any vigorous movements that could aggravate your symptoms or worsen your injury. You may also be asked to refrain from doing anything that requires a high level of mental concentration, such as playing video games, watching tv, or reading, until these activities no longer provoke your symptoms.
Depending on your symptoms, your doctor may also recommend additional therapies, such as rehabilitation for vision, balance, cognitive thinking, or memory problems, that you could be experiencing due to your concussion.
After a period of relative rest and steady symptom improvement, your doctor may clear you to gradually increase your daily activities as long as you can tolerate them without triggering symptoms. You should continue avoiding any activities that put you at high risk of another head injury. Eventually, once all signs and symptoms have resolved, you and your doctor can discuss the steps you’ll need to take to resume your sport or recreational activities.
“The recovery time for a concussion in adolescents and adults is typically two weeks, which is rather quick. In younger adolescents and children, the recovery time is approximately four weeks,” says Dr. Guzman. “However, healing time can be prolonged and additional complications can occur if patients are doing activities that can aggravate their symptoms.”
How can you avoid future concussions?
“Athletes in contact-heavy sports, such as boxing or martial arts, are the most at risk for receiving a concussion. Collision sports, such as rugby, field hockey, soccer, football, lacrosse, and ice hockey, as well as any other activity where you could take a fall, such as gymnastics, are also high-risk activities,” says Dr. Guzman.
“My advice to athletes is to avoid concussions by playing fair, sticking to the rules, and wearing properly fitting protective equipment, such as helmets, mouth guards, and other recommended gear, as these items are designed to minimize the magnitude of other potential injuries,” explains Dr. Guzman. “Yes, the intention is to win, but not at the cost of injuring yourself or someone else. Have good sportsmanship, so you can stay in the game.”
Anyone who suspects they have a concussion should immediately stop participating in the activity that caused the injury and be evaluated by a medical professional within 48 hours of the injury to ensure the best possible outcome. While accidents do happen and we can’t always prevent injuries, we can raise awareness around the importance of recognizing the signs and symptoms of a concussion. With proper knowledge and treatment, we can help ensure athletes are safely recovering from concussions and reduce the chances of additional concussions occurring in the future.
To learn more about UT Health Austin’s Sports and Injury Clinic or to make an appointment, visit here. If you or someone you know is potentially suffering from a sports or recreational related concussion, please call 1-833-UT-CARES (1-833-882-2737) to make an appointment with a healthcare provider.