10 Questions To Ask Your Athlete’s Doctor About Concussions

  1. What is a concussion?
    • A concussion is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Common features of concussions include:
    • Caused by either a direct blow to the head or indirect force transmitted to the head.
    • Rapid onset of usually short-lived neurological impairment, which typically resolves spontaneously.
    • Acute clinical symptoms that usually reflect a functional disturbance rather than structural injury, and, as such, no abnormality is seen on standard neuroimaging.
    • A range of clinical symptoms that may or may not involve loss of consciousness. *
    • Our knowledge about concussions is growing. Make sure you get the most up-to-date definition from your doctor and why the athlete has been diagnosed with a concussion.
  2. What is second impact syndrome?It can be a deadly event that happens when an athlete receives a second concussion before the first concussion has resolved. The second impact causes excessive and irreversible brain swelling that can kill the athlete. Second impact syndrome is the reason that athletes are not returned to athletic play until all symptoms have resolved and the athlete has completely recovered from the first concussion. Ask your doctor about the latest medical updates to avoid second impact syndrome.
  3. Do we need to go to an emergency department for a concussion?It is important that a physician examines the athlete and makes the diagnosis of a concussion. It is also important to have the appropriate courses of action and treatment plan for the athlete. Not all athletes have to go to the emergency room for this. However, discuss with the physician taking care of the athlete if a trip to the emergency department evaluation would allow for a more through evaluation of the concussion – particularly to rule out other more life-threatening problems.
  4. Do any special tests need to be performed?Currently, the diagnosis of a concussion is made by the clinical history and physical examination of a physician. No special tests are needed to make the diagnosis. However, there are computerized neuro-psychological tests than can follow the progression of the concussion and help the physician in the management of the athlete. Ask your doctor if they feel such tests may be helpful.
  5. How will the athlete with a concussion behave?Each athlete with a concussion will behave differently and symptoms can vary greatly. However, keep in mind:
    • Typical symptoms include headache, dizziness, ringing in ears, and
    • Even more dramatic symptoms can occur, including loss of
    • Discuss with your doctor about typical concussion behaviors and more importantly, symptoms that might indicate an even more serious injury.
  6. What things will help the athlete recover from a concussion?Currently there are no medications to speed the healing of a concussion and most recommendations are to prevent any further trauma to the head and to “rest” the brain. Ask your doctor about activities to avoid helping prevent any delay in the recovery of an athlete with a concussion.
  7. How long wills a concussion last?Each athlete is different in how long it takes to recover from a concussion, and the definition of “recover” is an evolving area. Although the patient feels like they are back to normal, have no symptoms, and even pass the physical examination of the physician, computerized neuro-psychological tests often show altered brain function and are more sensitive in detecting lingering effects of a concussion. Give your doctor as much information as you can on the athlete’s symptoms and clinical picture to help them give you a better answer on how long the concussion might last.
  8. When can the athlete return back to play?Most physicians wont return an athlete back to play until they feel the athlete has completely resolved their concussion to avoid second impact syndrome and to minimize any long-term effect. This is another evolving area of concussion management with a different answer for each athlete. Once the athlete has cleared the concussion, athletes often follow a graduated program of increasingly intensive practices before full release to play. Ask your physician if they have a return to play protocol and what milestones must be met before the athlete is cleared to play.
  9. What is the long-term effect of a concussion?This is an unknown area at this time. In the past, most doctors felt that a single, isolated concussion that resolved probably had little long-term effect. Although still a popular belief amongst doctors, there now is some debate about if some athletes truly just get a single concussion with their sport. As more research into concussion is done, this will be a changing answer over the next few years. Ask your doctor about any new medical updates on long-term effects of a single concussion.
  10. How many concussions can the athlete tolerate?Like most issues with concussion, there is not a single number for each athlete. Severity of each concussion, how long it takes to recover from each concussion, type of sport, and type of athlete all play a role in this answer. What has been documented is an association between multiple concussions and long-term cognitive impairment in some athletes. Ask your doctor on their current recommendations for an athlete with multiple concussions and consider getting more than one expert opinion.
  11. *Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.

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