Would You Recognize the Signs of a Concussion?

The brain is the most intricate part of your body, controlling everything from behavior and movement to memories and intelligence. Simply put, the brain is powerful.

In the same vein, the impact of a concussion is just as significant. As a type of mild traumatic brain injury, a concussion is the result of an intense force on the brain. In fact, according to The American Journal of Medicine, "concussion" comes from "concussus," the Latin term for "to shake violently."

But contrary to popular belief, concussions aren't limited to just contact sports. It's possible to get a concussion after falling off a bike or hitting your head on a weight rack. It can also happen during non-exercise activities, such as slipping on ice while shoveling snow or getting out of the car.

Essentially, any direct blow to the head or neck can cause a concussion, says Mark DeFord, M.D., a sports medicine physician in Indianapolis, Indiana. And while every head injury won't cause a concussion, it's vital to know how to recognize one. Without proper identification, physical activity will only worsen symptoms and the brain won't be able to heal. Moreover, without appropriate treatment, you may be left with long-lasting damage.

What Happens During a Concussion?

First, let's look at how a concussion affects the brain.

The neurons—or nerve cells—are first to take a hit. Specifically, the axon—responsible for the transmitting of signals between cells—on each neuron is injured. Next, blood flow to the brain slows down, says Naomi Albertson, M.D., a sports medicine and family doctor at Reno Orthopedic Clinic. The neuronal function also changes. Eventually, these alterations manifest as signs and symptoms of a concussion.

Every person and every concussion are different. In turn, the signs, symptoms and the resolution of these signs and symptoms can vary greatly.

Plus, the side effects of a concussion may take time to show up. "For most patients, new symptoms don't generally present days or weeks after a concussion, but different symptoms may become more noticeable as others begin to improve," explains Dr. DeFord. "For example, someone may have such a severe headache that they don't notice dizziness or difficulty concentrating until the headache begins to improve."

According to the Centers for Disease Control (CDC), concussion signs and symptoms can be split up into four categories:

  • Slow, foggy thinking
  • Poor concentration
  • Mental fatigue
  • Memory difficulties
  • Headache
  • Nausea or vomiting
  • Dizziness
  • Sensitivity to light and noise
  • Blurry vision
  • Poor balance
  • Physical fatigue
  • Brief loss of consciousness
  • "Glassy" eyes 
  • Irritability
  • Sadness
  • Anxiety
  • Emotional changes
  • Acting differently  
  • Sleeping more or less
  • Sleep troubles

Keep in mind that there are many possible side effects, and a person may experience any combination of these symptoms at different times.<pagebreak>

How Is a Concussion Diagnosed?

Recognizing a concussion doesn't stop at noticing symptoms. As with all injuries, your doctor is the only person who can accurately determine the severity of your concussion. A concussion requires prompt medical attention. At your appointment, your doctor can determine the level of damage, explain treatment and refer you to specialists.

"If someone thinks they have a concussion, they can first go see their athletic trainer, a sports medicine doctor, neurologist or physiatrist," explains Dr. DeFord. "They may need to see a physical therapist or other specialists in the future if symptoms are prolonged."  

Dr. Albertson also mentions that a doctor diagnosis is based on several factors: history of injuries, symptom patterns and signs observed at your appointment. "Imaging with x-ray, CT scan or MRI is rarely needed. However, if symptoms worsen over time, a CT scan may be recommended," she says.

Can I Stay Active After a Concussion?  

Yes—eventually. But it isn't as simple as jumping back into your old routine.

Because every concussion is different, recovery won't look the same for everyone. Yet, general concussion treatment revolves around physical and cognitive rest, as any activity that works your brain will only aggravate symptoms and delay recovery. This often entails avoiding or minimizing mental activities, like reading books. It also includes limited use of computer devices, cell phones and other screens, according to Dr. Albertson.

And how long do you have to wait to get back to your beloved screens or boot camp routine? As you can probably guess, it differs on a case-by-case basis. Concussions have so many varied factors that there is no one-size-fits-all template for recovery—the smartest method is to take it slow and steady and work with your doctor to ease your body and brain back to health.

"Once symptoms resolve—or when directed by the physician—[you] can slowly progress back [to cognitive activities] as tolerated," says Dr. DeFord. From there, as long as symptoms don't return and you've started activities other than physical activity first, you can look into exercising again.

Concussion aftercare involves adequate rest and gradual increase of exercise. It should also be done under the watchful eye of a specialist.<pagebreak>
Remember, a concussion is an injury. Your doctor can explain how to stay active depending on your specific situation. This may include gentle stretching, light workouts or completely avoiding exercise.
Your best bet is to follow your doctor's orders. They are the only ones who can decide when (and how) you can safely return to exercise after a concussion. 

Return to Activity: Post-Concussion Protocol

After a concussion, it's crucial to gradually increase exercise, no matter how hard you worked out before. Your brain needs time to heal. A concussion, after all, can disrupt cellular processes and neuronal signaling. As such, any return to activity should be gradual to allow the brain to recoup from the damage slowly. 

Your brain also doesn't work alone. It's affected by blood flow, your surroundings and the mere act of thinking. The harder you push these factors, the more your brain can't recover.

"When a patient first returns to activity, they should not start at the same level," explains Dr. DeFord. "[Instead, they should] begin slowly and progress under the supervision of a physician or athletic trainer."

He shares that this is done through the "return to activity" protocol. These guidelines are the backbone of concussion management and recovery. The goal is to provide a slow, steady and safe progression to your old routine. The CDC outlines a general protocol that can be followed for concussion victims as they progress in overall recovering, return to school or return to sports (with your doctor's permission, of course).

If you experience symptoms at any point throughout the protocol, take a step back. "Stop for the day and return to the previous step [on] the next day," says Dr. DeFord. "[Then], continue until the steps are completed without any symptoms."

After a concussion, make it a priority to take it easy. Communicate with your doctor and follow their directions. It can be easy to minimize your concussion and push your recovery if you're anxious to return to your routine, but the most important thing during this time is giving your body and brain time to heal properly. With a professional's guidance and adequate rest, you'll be on the road to recovery in no time.