Recovering From a Sports Related Concussion: 6 Guidelines for Returning to Play

Headaches, feeling mentally foggy or confused, sensitivity to light or sound, and nausea are just a few of the common symptoms that are reported within 24-hours of suffering a head injury that’s caused  a concussion. Over the next few days, other symptoms can appear. These may include trouble sleeping, becoming irritable, and developing anxiety or nervousness. It’s important to know that concussions do not need to involve loss of consciousness to be serious. In fact, only about 10% of concussions result from being knocked unconscious. 

The majority of concussions are caused by sports related injuries and football reports the greatest number. Other sports with significantly high concussion rates are boxing, soccer, ice skating and cheerleading. Interestingly, baseball players, particularly catchers, has seen a rise in concussion reports.

It used to be acceptable — and common — to return to playing the same day a concussion occurs. However, some symptoms are delayed and may not appear right away and  rest is important. Many athletes will downplay their symptoms in order to get back into the game, not knowing that they could suffer negative or secondary effects later on. 

What does rest actually mean? The definition hasn’t  always been clear. Rest should be directed toward limiting the symptoms while at the same time preventing social isolation and slowed progress in school. There is no set time frame for how long someone should rest as it varies with the severity of the concussion. Should a player wait several days or several weeks? There is insufficient evidence that shows prolonged periods of rest improve outcomes. In fact, prolonged periods can have a negative effect leading to physiological deconditioning, depression, and anxiety related to falling behind in school. 

Returning to play should occur in stages as to avoid further injury. Zollman (2016) described the following stages that a player should follow before returning to game play. 

Stage 1: No activity: The goal is physical and cognitive rest. 

Stage 2: Light aerobic exercise such as walking or stationary cycling. No resistance training: The goal is to increase heart rates. 

Stage 3: Sport-specific exercises: For example, running in football and soccer, skating in hockey. The goal is to add movement

Stage 4: Non contact training drills: For example, passing drills and add in light resistance training. The goal is to begin to add physical and cognitive stress. 

Stage 5: Full contact practice after receiving medical clearance: The goal is to restore confidence and assess skills. 

Stage 6: Game play- being able to play with no restrictions

References: 

Zollman, F. S. (2016). Manual of Traumatic Brain Injury: Assessment and Management. New York, NY: Demos Medical Publishing.