Concussion 101: Definition, Types And Recovery Time
By Jessica Poole, Certified Athletic Trainer
If anyone has spent any time around sports, football, or ESPN, you have heard a significant amount of chatter regarding head trauma. With football in full swing, now is a great opportunity to talk about a topic that causes lots of headaches for players, parents, coaches and ATCs.
In this three part series (scheduled to run September 8, 15 and 22) I will touch on what a concussion is, who is susceptible, what the symptoms are, management of a concussion and follow-up issues/concerns.
There will be lots of information, so hang on.
First, what is a concussion?
Also known as a mild traumatic brain injury (MTBI), a concussion is essentially a bruise on the brain. Just like you receive bruises on your body, your brain can bruise. It will swell and bleed just like your skin and muscles swell and bleed when a traumatic force is applied. The difference is that when the brain swells and bleeds, it can impair the control center of our bodies.
How does a concussion happen?
Concussions can occur in several ways.
1. Blunt force trauma to one side of the head, such as being hit by an object, such as a foul ball. This is known as a coup injury.
2. Force applied to one side causing the brain to shift and injury to occur on the opposite side from the force application. For example, an individual is hit on the right side of the head and the injury appears on the left side of the brain, as the brain shifts inside skull. This is also known as a contracoup injury
3. Force causes the brain to be injured on the side of impact and on the opposite side of impact as brain shifts in the skull. For example, this can happen with head-to-head contact in football where the athlete is hit in the side of the helmet. The brain absorbs the trauma and is injured both at point of contact and on the opposite side as brain contacts the skull due to the force of the blow. This is known as a coup-contracoup injury.
4. Trauma may be a caused by a combination of compression and shearing (two surfaces sliding across one another causing tearing of tissue). Often any violent force that could cause the brain to “shake violently’ can cause an MBTI, not just an impact at the head. An example of this might be a violent fall that shakes the brain.
How long does it take to overcome a head injury?
There is not a one-size-fits-all time limit for concussion healing. The severity of each head trauma varies by definition and is assessed based on symptoms. Physical attributes and environmental factors play into healing as well.
There are many grading scales and diagnosing protocols for concussions, but it’s difficult to determine when the brain is healed, since it’s not a body part you can readily see. The brain is considered healed when there are no lingering symptoms.
The best medical science can do today is to monitor symptoms and when symptoms are no longer present with exertion, then we clear the athlete for return to play. Some concussions show up on CT or MRI scans. Others do not. I have seen plenty of concussions with marked symptoms that do not show on a scan. Plus, in some cases, symptoms can linger for months or even years. That’s why it’s so important to focus on the symptoms and not on the calendar. It’s also why if you have had a concussion in the past (post concussive syndrome) and not any of the symptoms I’ll be talking about in later posts, be sure you’re evaluated by and cared for by neurologist who is up-to-date in concussion management.
Ok, with the what and how out of the way, next time I will focus on the signs and symptoms and management of concussions.
So stay tuned for more regarding concussions.
It’s a hot topic and one that needs to be discussed within our communities. It is not only an athlete’s issue, because these injuries can occur in routine, daily life, too. As has been said before, knowledge is power. We need to be knowledgeable in regards to brain health.
Stay healthy my friends…
For more info regarding concussions, see gwinnettmedicalcenter.org/concussion, or cdc.gov/concussions
Reference: Broglio, S. P., Cantu, R. C., Gioia, G. A., Guskiewicz, K. M., Kutcher, J., Palm, M., & McLeod, T. C. V. (2014). National Athletic Trainers' Association position statement: management of sport concussion. Journal of Athletic Training, 49(2), 245.