Concussion Discussion

My kids are kind of accident prone. Maybe no more than the average kid these days but much more than I was as a kid! They have had multiple casts on multiple body parts among other injuries. The most frightening thing we have faced however is concussions – my son has had two in three years.

Luckily, I spent the first ten years of my career working with brain injury so I am familiar with these types of clinical presentations lending a degree of comfort to dealing with a concussed kid. Unfortunately, I spent the first ten years of my career working with brain injury so I am familiar with these types of clinical presentations causing me to become extremely neurotic when dealing with a concussed kid!

In 2013 I began learning a little more about the role that physical therapists can play in concussion diagnosis and treatment. With the fall sports season starting, it behooves me to share some of this information with you.

What is a concussion?

An injury to the brain that disrupts how it normally works, caused by a hit or jolt to the head that causes the brain to move around inside the skull.

How do you get one?

The most common mechanism of injury is colliding with another player or the head hitting the ground no matter what sport or activity in which the child is involved.

In football there is additional risk due to head to head contact when tackling.

What are the signs/symptoms of a concussion?

  • Physical = nausea, vomiting, dizziness, blurred vision.

  • Cognitive = memory, concentration issues

  • Emotional = irritability, excessive crying or laughing, mood swings

  • Sleep disturbances

  • Essentially your chid just seems a little off.

Who is most at risk?

  • Kids are more at risk than adults  – their brains and bodies are still developing and therefore are more sensitive to the neurochemical changes that occur during a concussion

  • Girls are more susceptible than boys – they make less testosterone and therefore the  size and power of their neck muscles will be less than boys.

How can a concussion be prevented?

  • Safe play – sportsmanship and proper technique.

  • Proper conditioning and training – in the off season and participation in more than one sport to develop multiple skill sets.

  • Use the proper protective equipment.

The bigger issue is the risk of Second Impact Syndrome  

This occurs when a concussed athlete returns to play before he or she is completely recovered. Astonishingly, 50% of concussions go unreported because either the incident is not recognized as a concussion or the athlete doesn’t report symptoms because they want to stay in the game.

 What to do if you suspect a concussion?


  • Head to the ER or MD – no imaging can ID a concussion but it can rule out other things

  • Have a plan for symptoms management and monitored return to regular activity – school and sport

  • Follow the 4 Step Return to Academics then the 5 Step Return to Sports Protocols under the supervision of a professional familiar with concussions = MD, PT, ATC

For answers to your specific questions please email me at

Be Well!  Roxi


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