Keep Moving . . . Managing concussions

Mike Woods
Mike Woods

By Mike Woods

The NFL season is well underway and multiple players (including some on my fantasy team!) are sidelined with head injuries. It seems timely to review some strategies for managing concussion.

What is it?
The CDC defines a concussion as “a type of traumatic brain injury… caused by a bump, blow, or jolt to the head.” It can be a hit to the body that causes the head and brain to move rapidly back and forth. This impact or acceleration/deceleration of the brain causes ‘neuronal shearing’ and chemical changes within the brain. These cellular level changes are not detectible on imaging such as CT or MRI.

An athlete does not have to experience loss of consciousness to be diagnosed with a concussion.

Common symptoms of a concussion include headaches, dizziness, vomiting, sensitivity to light or noise, mood changes, and difficulty concentrating.

What to do?
The first step is to get appropriate medical attention. If the athlete is on the field, he or she should be evaluated by a qualified health professional.

If the athlete is suspected to have a concussion, he or she should not return to the game.

Rest is crucial for the first 24 to 72 hours. The cellular level changes that take place with a concussion require a lot of energy from the brain in order to reset back to its normal resting state. This creates a short-term energy crisis, which typically presents as significant mental exhaustion.

A physical assessment following a concussion can identify any additional injuries associated with the impact. Cervical spine sprain/strain injuries are commonly found and can contribute to headaches. Additionally, an athlete may experience visual or vestibular disturbances. If not addressed, these impairments may contribute to continued headaches or dizziness even after the brain has healed.

It’s estimated that 80 to 90% of concussions resolve in seven to 10 days. The prognosis is good, so long as the brain is given a chance to rest. Just like a sprained ankle requires time to heal, injured brain tissues need time to recover. This typically means limiting any strain for the first two to three days. Similar to a sprained ankle, however, we may begin to introduce some level of activity before the injury has fully recovered, so long as this return to activity is 1) gradual, and 2) not associated with worsening of symptoms.

A physical therapist, sports medicine professional, or pediatrician familiar with concussion management protocols can assist in setting appropriate goals and expectations.

It is important to note that many high schools are now using cognitive tests such as ImPACT to determine if an athlete is ready to return. While these tests can be important tools and do provide some insight into recovery, they do not take the place of a proper comprehensive assessment, and should not be the sole factor for return-to-play decisions.

See our blog at for much more information on concussion management, including research and more specific management strategies—and be safe!

Mike Woods is a sports physical therapist at VASTA Performance Training and Physical Therapy. Mike and his wife live in Huntington.