Concussion: Strategies for Treatment and Prevention

Concussion: Strategies for Treatment and Prevention

A concussion is a temporary, treatable injury that people should expect to fully recover from with proper management. This traumatic brain injury occurs after a significant impact to the head or body resulting in brain movement. It commonly happens while playing contact sports such as hockey, soccer, or football.  


Concussion management expert and Summit Health pediatric sports neurologist Dr. Matthew McCarthy, along with physical therapist Tim Dunne, offer their concussion expertise, outlining signs and symptoms, diagnosis process, treatment, and recovery. 


What Are the Signs and Symptoms of a Concussion? 

"Signs and symptoms of concussion typically start immediately or soon after the impact and will evolve over hours to days," Dr. McCarthy explains. Common signs and symptoms of a concussion include: 


- Headache or head pressure 


- Amnesia, confusion, or delayed responses 


- Sensitivity to light and/or sound 


- Nausea and/or vomiting 


- Feeling tired or fatigued 


- Balance problems or dizziness 


- Mood changes 


- Loss of consciousness 


- Dazed or stunned look 


How is a Concussion Diagnosed?  

Diagnosing a concussion can be difficult because there is no single test that can definitively identify it. Dr. McCarthy recommends seeing a health care provider with experience in the treatment of all neurological conditions and specialization in concussion management, ideally within 24-48 hours of a suspected injury.  


Most people with a concussion do not need to be seen in the emergency room or urgent care. Following a suspected injury, they should be observed for the next few hours for signs of a more significant injury. Individuals who are stable or show improvement within 4-6 hours after an injury can be managed at home until an expedited appointment with a physician specializing in concussions can be made. 


But if you notice the following symptoms, call 911 or visit an emergency room: 


- Prolonged loss of or declining consciousness 


- Increasing confusion or irritability 


- Seizures 


- Repeated vomiting 


- Weakness or numbness 


- Extreme or unusual behavior changes 


- Slurred speech 


- Significant facial or posterior head bruising 


- Obvious skull fracture or deformity 


What is the Best Treatment for a Concussion? 

The treatment of a concussion should involve an active and individualized approach to symptomatic treatment and early rehabilitation to ensure a safe and efficient return to sports and other activities. Dunne says that once a patient is evaluated by a doctor, they should commence physical therapy soon after. Each patient receives a comprehensive cervical and vestibular examination looking at range of motion and tension in neck muscles, balance, coordination, and eye movements. The physical therapist will then implement specific exercises and manual techniques based on the results of the examination. Other recommended management strategies include a supervised exercise and return-to-play program, stress reduction techniques, and an optimized pain management plan. 


Do Athletes Need to Have Concussion Baseline Testing? 

Dr. McCarthy notes that a comprehensive neurological baseline evaluation is the best way to prepare an athlete for an upcoming sports season. This will allow for a more accurate diagnosis and a more efficient return-to-play process in the event of a concussion. Kids participating in collision or contact sports should have a baseline evaluation every 1-2 years while playing competitively. 


How Can a Concussion Be Prevented?   

Like all sports-related injuries, there is no absolute way to avoid a concussion, but several things can minimize the overall risk. Properly fitted equipment worn correctly and in good condition is essential for protecting athletes from injury. While no piece of equipment has been shown to prevent concussion, wearing helmets, face masks/shields, and mouthguards can prevent serious cranial, facial, and dental trauma. 


Dunne also notes that ensuring proper training and preparation for sports can help prevent injury. Optimizing cervical mobility and stability, balance, coordination, flexibility, and core strength as well as learning proper form and technique can help reduce overall injury risk.