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How Do I Know if an Athlete Has Had a Concussion?

Any injury to the head that results in “symptoms” means that a player has had a concussion. The most common symptoms are:

-dizziness, unsteadiness

- feeling “spacey”, light-headed


-blank or vacant stare

-difficulty concentrating, confusion, slow to answer questions or follow instructions

-disorientation and loss of memory (unaware of where he or she is, what the score in the game is, what just happened; keeps repeating questions, cannot memorize)


Sometimes, the player will actually be unconscious for a period of time.

What is the Importance of a Concussion?

There are three main reasons why concussions should be recognized and treated properly:

1) Second Impact Syndrome : This can occur when a player suffers a second head injury while she is still having symptoms from a previous concussion. Although it is not common, Second Impact Syndrome is very serious because it usually causes death within 10 or 15 minutes because the brain suddenly swells. The key point is that a player who has had a concussion can never return to play while he or she is still having any symptoms . Also, a player that has had a concussion is more likely to sustain another one because of the unsteadiness, difficulty concentrating, dizziness, etc.

2) Post-Concussion Syndrome : This occurs when a player has symptoms from a concussion that last for a long time (days to months). Along with the regular concussion symptoms, the player may be easily fatigued, irritable, depressed, difficulty concentrating, sleep disturbance and have a persistent low-grade headache. These symptoms can be so troublesome that a player's school, work and social relationships are affected. Under no circumstances should a player return to play if he or she is still having symptoms.

3) Concussions are additive : The more concussions that a player has had, the more severe they tend to become in the future, especially if they did not have enough time to recover. Also, there can be permanent brain damage with repeated head injury.


What Should I Do when an Athlete Suffers a Concussion?

If a player has symptoms that last less than 15 minutes and you, as an experienced coach or trainer, are absolutely certain the player is completely free of symptoms both at rest and on exertion (and you know that he or she has no previous history of head injury), then player is probably OK to return to play.

If a player has symptoms lasting longer than 15 minutes then he or she should be seen by a medical doctor that same day. It helps if the doctor knows about sports injuries and how to treat concussions.

If a player is unconscious then an ambulance should be called and the player has to be assessed in the emergency department.

If there is any question about whether a player is having concussion symptoms , if symptoms are worsening , or if you are just unsure about what to do, then do not take any chances and have the player see a medical doctor.

What Will the Doctor Do?

The medical doctor will conduct a detailed neurologic and mental status examination to ensure that there is nothing else happening other than a concussion. These tests will also include exertional tests (i.e., making sure symptoms do not happen when the player physically exerts himself). The doctor will then grade the concussion and give the player specific advice about when it is safe to return to play. If there is anything of concern, then the doctor will arrange special tests such as a CT scan or an MRI.

How Long Will the Athlete be Out of Action?

There are particular guidelines that a doctor must follow when deciding when a player can return to play after a head injury. The player cannot do any activity that risks another head injury (e.g. games, or contact scrimmage) for at least a week after he is free of symptoms. If a player has had two or more concussions in the same season, then he or she may be out longer than one week. Under no circumstance, can a player go back to play while he or she is having symptoms .

What Should an Athlete Do after He or She Has Had a Concussion?

If the player is diagnosed as having a concussion, then for the first 24 hours after the injury, he or she must report back to the doctor if there vomiting more than twice, severe headache, convulsions, problems with vision, trouble using arms or legs, bleeding from nose or ears, pupils of different size, extreme sleepiness or any worsening of concussion symptoms. It is probably OK to take acetaminophen (e.g., plain Tylenol) for a headache but the player should probably check with her doctor first. It is OK to sleep but a responsible person should be present to wake the player up every two hours to make sure that he or she is easy to wake up as he or she normally is (able to recognize this person, tell such things as birth date, age and telephone number). If the player is not easily awakened then your doctor should be called. After a medical assessment, the doctor will arrange follow-up appointments and give the player advice on when he or she can return to play and what activities are safe to do.

This information sheet was prepared by Dr. Trevor L. Hall, MD, CCFP, Dip. Sport Med. and Dr. Robert Lee, MD, Dip. Sport Med. from the Waterloo Sports Medicine Centre. For further information, feel free to contact us at 519 746 2220.