When Should an Athlete Return to Competition After a Concussion?

3D rendering of football player with brain and nervous system visible. Used to illustrate a concussion.

Concussions are a form of traumatic brain injury (TBI). A concussion can be caused by an individual receiving a blow to the head or by the body being struck so hard that the head makes quick back-and-forth movements.

When the brain is moved around rapidly, the fast movement can cause the chemicals in the brain to move around, which can cause changes in the chemical balance. The rapid movement can also cause the brain to stretch or even damage brain cells.

What Are the Symptoms of a Concussion?

The Centers for Disease Control and Prevention (CDC) reports that common concussion symptoms include:

  • Vision changes
  • Nausea or vomiting
  • Headache
  • Fatigue
  • Issues with balance
  • Feeling dizzy
  • Sensitivity to noise or light
  • Difficulty thinking clearly
  • Issues with short- or long-term memory
  • Feeling foggy
  • Issues concentrating
  • Feeling sad, irritable or anxious
  • Changes in sleep habits

How Long Does It Take to Recover from a Concussion?

Concussion symptoms can take hours or days to appear. Fortunately, symptoms can often be managed with the right therapy or medications.

On average, concussion symptoms go away within two or three weeks. However, according to the journal Sports Medicine, youth athletes may take longer than adults to recover.

Should I Rest After Being Diagnosed with a Concussion?

It was once thought that rest was the most important thing to do after a concussion. While rest is important, it is important to slowly return to your normal activities after a couple of days of rest. Brains need exercise to recover as much as our bodies do.

How Important is Nutrition After a Concussion?

Eating a well-balanced diet after a concussion can be important in the recovery process. Your diet should include antioxidant-rich fruits and vegetables as well as quality protein which can help with brain recovery.

Supplements such as fish oil that are rich in omega-3 fatty acids have been shown to reduce inflammation and improve brain function. Hydration is also critical during the recovery process and should include a minimum of 60-80 ounces of water a day while avoiding caffeine and sugary drinks.

What Can Happen if an Athlete Returns to Competition Too Soon?

Returning to competition too soon could put you at risk for a second concussion. A repeat concussion that occurs before your brain has recovered from the first one is called second impact syndrome.

Second impact syndrome can:

  • Make your symptoms last longer than they would have if you rested and fully recovered
  • Slow your overall recovery
  • Increase the chances of long-lasting or permanent problems or death

Long-lasting problems may include:

  • Weakness
  • Difficulty walking
  • Bladder or bowel incontinence
  • Continued symptoms, such as difficulty concentrating or remembering things, headaches and difficulty with balance

Return-To-Play Protocol

After a concussion, an athlete should only return to sports practices and activities with the approval and supervision of a health care provider. Return-to-play protocols are a set of procedures and steps for safely returning an athlete to play following a head injury.

Athletes will be guided through the protocol by their physician, and when available, a certified athletic trainer. For student-athletes, considering how the student is performing within the classroom is also necessary.

concussion management and recovery chart

What Can I Do to Help Prevent a Concussion?

There are many ways to help reduce the risk of a concussion or a TBI, according to the CDC and the Journal of Exercise Rehabilitation:

  • Wear a properly fitted helmet if your sport or activity calls for it. Athletes should have properly fitted equipment in good condition to reduce the risk of a serious brain injury or skull fracture. You should wear a helmet if you:
    • Snowboard or ski
    • Ride a horse
    • Play softball or baseball
    • Roller skate or skateboard
    • Are a boxer
    • Play ice hockey or football
    • Ride an all-terrain vehicle, scooter, snowmobile, motorcycle or bicycle

Of note, there is no such thing as a “concussion-proof” helmet.

  • Strengthen your muscles. It is important to do balance and strength exercises to improve balance and make your legs stronger. Also, according to the Journal of Exercise Rehabilitation, it may help to strengthen your neck muscles. This is particularly important for athletes, as a stronger neck may be able to absorb some of the shocks of the blow to the head.
  • Improve your reaction time and vision. Work on having a faster reaction time so you can anticipate hits and protect yourself from severe impacts to the head. Have your eyes checked by an eye care provider. If necessary, wear glasses or contact lenses.
  • Promote a culture of safety. Educate the people you know about the risks of concussions, protocols and the importance of reporting symptoms.

UofL Health is Here for You

UofL Health now offers two locations for better patient convenience at its specialized after-hours Sports Medicine Urgent Care clinics:

No appointment is necessary at these walk-in clinics specializing in after-hours care of sports and orthopedic injuries. Our board-certified sports medicine physicians and advanced practice clinicians are on standby to treat a wide variety of injuries and illnesses.

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Article by: Alex Carrasquer, M.D.

Alex Carrasquer, M.D., is a sports medicine physician with UofL Physicians – Orthopedics and UofL Physicians – Physical Medicine & Rehabilitation, part of the UofL Health – Brain & Spine Institute. His areas of interest include general orthopedics and orthopedic sports medicine. Dr. Carrasquer received his medical degree from University of Louisville. He completed both his residency in physical medicine and rehabilitation and his fellowship in primary care sports medicine at University of Louisville.

All posts by Alex Carrasquer, M.D.
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