Concussions

A concussion is a brain injury caused by a sudden hit, bump or jolt to the head, face, neck or somewhere else on the body. The impact can prevent the brain from working normally. Concussions can happen while playing a sport, from being involved in a motor vehicle collision, from slipping and falling, or other activities. A concussion cannot be seen on X-rays, CT scans or MRI’s.

What to do: Concussion management

A person with a concussion may not know if they are ready to return to activity.

Call 911 or go to the Emergency Department if any of these ‘Red Flag’ symptoms are present:

  • Loss of consciousness (do not move the person)
  • Seizure or convulsions
  • Uncontrollable vomiting
  • Worsening mental status
  • Neck pain
  • Severe or increasing headache
  • Trouble with vision
  • Slurred speech
  • Very tired or lethargic
  • Weakness or tingling in arms or legs/unsteady/paralysis

Even if a person is not showing symptoms above:

  • Immediately remove the person from the activity
  • Do not return to the activity for the rest of the day
  • Monitor for signs and symptoms of a concussion
  • Ensure they are assessed by a medical doctor or a nurse practitioner
  • You do not need to lose consciousness (knocked or blacked out) to have a concussion
Signs and Symptoms

Concussion symptoms can last for 10 to 14 days in adults and four weeks in children and youth. For some people, they can last weeks or even months. Some symptoms include:

Physical Symptoms

  • Headache
  • Nausea
  • Dizziness
  • Visual disturbances
  • Light sensitivity
  • Noise sensitivity
  • Loss of consciousness
  • Memory loss
  • Vomiting
  • Loss of balance/poor coordination
  • Seizure or convulsion

Emotional and Behavioural Changes

  • Irritability
  • Personality changes
  • Strange or inappropriate emotions
  • Sadness
  • Anxiety
  • Depression

Thinking Impairment

  • Slow reaction times
  • Difficulty concentrating
  • Difficulty remembering
  • Confusion
  • Feeling in a fog
  • Feeling dazed

Sleep Problems

  • Drowsiness
  • Trouble falling asleep
  • Sleeping more than usual
  • Sleeping less than usual
Recovering from a Concussion

Physical and mental rest is important for the first 24 to 48 hours after a concussion. Mental rest means no driving, watching T.V., playing video games, reading or working on a computer. After 24 to 48 hours you can gradually become more active.

Returning to activities too quickly and too soon may cause symptoms to get worse or take longer to go away. A person may need to stay home from school or work because regular activities could make their symptoms worse. Talk to your medical doctor to decide when you can drive a car or ride a bike (Your ability to react may be slower after a concussion) and when you can return to normal activities (work or school).

Return to School/Work and Return to Play/Sport

In the following tables:

  1. Move forward to the next stage only when symptom-free for 24 hours
  2. If symptoms reappear, go back to previous stages and only participate in activities that you can tolerate.
  3. Contact your medical doctor if symptoms worsen.

Return to school or work

At home:
StageAimActivityGoal of each step

1

Cognitive and physical rest for first 24 to 48 hoursTypical activities at home that do not increase symptoms. No TV, computer, cellphone, reading or physical strainRest with gradual return to typical activities

2

Light cognitive and physical activityGradually build up typical activities – easy reading, limited TV, peer contact, school-type work at home. Still no computer, school or work or physical strainTolerate up to one hour of cognitive activity in two to three chunks
At school or work:
StageAimActivityGoal of each step

3

Part time school or work – light loadGradual introduction of academic or work activities. Up to 120 minutes of cognitive activity, in intervals. Half days of school or work, one to two times per weekAdd movement

4

Part time school or work – moderate loadSchool or work in four to five hours per day, three to five days per week; homework up to 30 minutes per day. No gym, organized sports or examsIncrease academic or work activity
5Nearly normal workloadNearly normal cognitive activities; routine academic or work as tolerated (homework up to 60 minutes per day, minimal learning accommodation). No gym, exams or organized sportsIncrease academic or work activity

6

Full timeNormal cognitive and school or work activities; full curriculum load with no learning accommodation. No full participation in sports until medically cleared after Return to Play or Sport protocolReturn to full academic/work activities and catch up on missed work – Can begin to follow Return to Play or Sport protocol

Return to play or sport:

StageAimActivityGoal of each step

1

Symptom-limited activityDaily activities that do not provoke symptomsGradual reintroduction of work or school activities

2

Light aerobic exerciseWalking or stationary cycling at slow to medium pace - no resistance trainingIncrease heart rate

3

Sport-specific exerciseRunning or skating drills - no head impact activitiesAdd movement

4

Non-contact training drillsHarder training drills (such as passing drills) - may start progressive resistance trainingExercise, coordination and increased thinking

5

Full contact practiceFollowing medical clearance, participate in normal training activitiesRestore confidence and assess functional skills by coaching staff

6

Return to sportNormal game play 
Resources

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Related Resources

External Resources