Concussion recovery is unique to every case.

In this episode of Ask Concussion Doc – Episode 13 with Dr. Cameron Marshall, we examine concussion recovery. How do we define it? What’s the difference between asymptomatic and full metabolic recovery? When can an athlete return to activity?

We also discuss what to do immediately after a concussion, and when should the initial assessment happen.

Lastly, we look at concussion prevention. Does neck strength help? What about neck stiffness? Also, helmets and mouthguard are NOT proven to fully protect against concussion. So, what can we actually do to prevent them?

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Initial Assessment Following Concussion

Ideally, the initial assessment following a suspected concussion should happen on the sidelines. There are objective signs that someone watching the game should be able to identify. Some of these concussion symptoms are very short in duration, but may include balance impairments, loss of consciousness, fencing position, and blank or vacant stares, among others. If this is the case, always sit the player out until assessed by a trained healthcare practitioner.

Recognize. Remove. When in doubt, sit them out!

Most often, particularly at the amateur level, healthcare practitioners are not present on the sidelines. Therefore, the sooner an athlete can get an initial assessment, the better. Sources suggest that seeing a healthcare practitioner with training and experience in concussion management, that can give an injured athlete appropriate guidance and recommendations in the early stages, can be extremely effective for recovery. Check out these top 5 most effective evidence-based treatment options for concussion.

Dr. Marshall also discusses some of the red flags to look out for following a suspected or confirmed concussion.

Concussion Recovery

Is concussion recovery defined as a complete absence of symptoms? For how long? What if a patient or athlete suffered multiple concussions. How does this impact concussion recovery? Does it prolong recovery? How does this impact return to play? These are some of the many questions we address during this episode.

Importantly, recovery from a clinical standpoint is different from recovery from a physiologic standpoint. This was highlighted in the international consensus statement on concussion in sport. The physiologic time for recovery is when your brain actually recovers. The clinical time for recovery is when your symptoms go away. Unfortunately, those two things do not coincide. That’s what makes concussion extremely difficult to manage – particularly with athletes.

The problem is, symptom resolution may not mean full recovery of the brain. In fact, the brain may still be in a vulnerable state. Any additional impact during this state could cause another concussion with less force, and that second concussion could have an additive effect and prolong recovery.

Recovery from a physiological standpoint is most important. It’s for this reasons why baseline testing can be useful for return to play decisions. Access the full episode below to find out why.

Can you prevent a concussion?

Unfortunately, the only way to completely prevent a concussion is to refrain from sport. But, we are well aware that the benefits of sport outweigh the potential risk for injury. What’s most important is proper management if a concussion occurs.

That said, some of the ways to reduce the incidence of concussion in sport is to reduce contact and improve in-game awareness (i.e., neck strength vs. neck stiffness). However, even non-contact sports like girls soccer can have a higher rate of concussions compared to high-risk, contact sports.

Dr. Marshall explains these research studies as well as why current protective equipment (helmets and mouth guards) do not prevent concussion injuries.

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