Sports Concussion Recovery Guidelines and Long-Term Risks

Jump To Section

• What is a Concussion?
• When to See a Neurological Specialist
• Return to Play Guidelines: The 7-Day Rule
• Why Recovery Takes Time: The Cellular Level
• Dangers of Second Impact Syndrome
• Multiple Concussions and Long-Term Risks
• Parental Guidance and When to Stop Play

What is a Concussion?

A concussion is a traumatic brain injury caused by a blow to the head or body that results in a temporary, transient loss of normal brain function. As Dr. Arthur Day, MD, explains, the brain is temporarily stunned but then typically regains its function. This injury disrupts neural pathways and can cause symptoms like headache, dizziness, confusion, and sensitivity to light or noise.

When to See a Neurological Specialist

Dr. Arthur Day, MD, advises that while most concussions resolve, certain signs necessitate immediate evaluation by a neurologist or neurosurgeon. These include symptoms that linger for too long, the appearance of a neurological deficit beyond a brief stun, or any situation that seems complicated. The specialist will determine if advanced diagnostic imaging, like a head CT scan guided by Canadian CT Head Rules or New Orleans Criteria, is required to rule out a more serious brain injury.

Return to Play Guidelines: The 7-Day Rule

A critical guideline for sports concussion recovery is the mandatory removal from play. Dr. Arthur Day, MD, states the universal clinical rule: an athlete must not return to active sports until they have been completely free of all concussion symptoms for a minimum of one full week. This seven-day, symptom-free period is non-negotiable for both amateur and professional athletes to ensure safe recovery.

Why Recovery Takes Time: The Cellular Level

The need for a week-long recovery is rooted in the brain's physiology. Dr. Arthur Day, MD, clarifies that a concussion triggers a cascade of physical changes at the cellular level. Even after an athlete feels fine, the brain may still have mild swelling or blood vessel irritability. This cellular recovery process, derived from physiological brain injury research, takes between five to seven days to stabilize fully.

Dangers of Second Impact Syndrome

Returning to play before the brain has fully healed is exceptionally dangerous. Dr. Day warns that a second blow to the head during this vulnerable recovery period can lead to a catastrophic reaction known as second impact syndrome. The brain, unable to adjust to the new trauma, can swell dramatically or have adverse vascular reactions, leading to severe permanent damage or even death.

Multiple Concussions and Long-Term Risks

The cumulative effects of multiple concussions pose a significant long-term health risk. Dr. Arthur Day, MD, explains that repeated head trauma is linked to a progressive degenerative neurological condition that can resemble Alzheimer's disease, causing permanent cognitive decline. This underscores that one concussion is a serious event, and more than one is a major cause for concern regarding an athlete's future brain health.

Parental Guidance and When to Stop Play

For parents and coaches, vigilance is key. Dr. Arthur Day, MD, emphasizes that any concussion sustained during sports is a serious issue. However, if an athlete experiences more than one sports-related concussion, especially within a short period, a serious discussion about discontinuing contact sports is imperative. Dr. Arthur Day, MD, concludes that while one concussion might be a fluke, a pattern of injury indicates that the risks of continued play far outweigh the benefits.

Full Transcript

Dr. Anton Titov, MD: Concussion in sports: what you need to know? Eminent neurosurgeon has a special interest in sports-related injury. He discusses key aspects of concussion in sports.

What you need to know about recovery process from concussion in sports? How long athletes should stay away from the game? When to see a neurological specialist after sustaining concussion in sports?

Concussion in sports. One concussion is concussion too many. Answers to high school sports concussion. Athlete must stay out of the games for one full week.

Dr. Arthur Day, MD: Concussion in sports - return to play is only possible after one week. 7 days without any symptoms after concussion is minimal time before student can return to active sports.

You should get medical second opinion after traumatic brain injury. Concussion in youth sports is a very dangerous phenomenon. Cumulative effects of concussions can lead to long-term degenerative neurological cognitive decline.

Any decline in mental faculty requires medical second opinion from neurosurgeon or neurologist.

Dr. Anton Titov, MD: Why are concussions so dangerous?

Dr. Arthur Day, MD: Multiple concussions lead to secondary brain injury and vascular changes. Long term effects of concussions include Alzheimer's like disease.

Video interview with leading expert in cerebrovascular neurosurgery and minimally invasive neurosurgery. Medical second opinion confirms that concussion diagnosis is correct and complete. Medical second opinion also confirms that concussion CT scan and MRI scan is required.

Medical second opinion helps to choose the best treatment for concussion. Get medical second opinion and be confident that your treatment is the best.

Concussion in sports: what you need to know.

Dr. Arthur Day, MD: There are specific criteria for concussion treatment in athletes. Sometimes athlete had a concussion. Often the coach decides to send the athlete back into the sports play.

Also there are clinical guidelines that dictate what to do after concussion. Sometimes additional diagnostic studies are required. Head CT (brain CT) is required.

There are Canadian CT Head rules. There are also New Orleans criteria for head injury. Sometimes somebody with a concussion should have a head CT scan?

Dr. Anton Titov, MD: Does it matter if it's a high school student or a professional athlete?

Dr. Arthur Day, MD: A concussion is by definition a transient phenomenon. The brain in concussion temporarily loses its function but then regains it.

There are situations in when the concussion symptoms persist. There are also concussions when neurological deficit occurs beyond a brief stun (shock). All such head injury situations greatly raise the chances that something is actually being injured in the brain.

This can be potentially very serious or even extremely harmful. Typical concussion should come and go. After the blow to the head the person is okay.

Athletes with concussion have headache, of course. But these symptoms should go away. Sometimes symptoms linger too long.

Or the situation seems too complicated. In all those cases the patient needs to see a neurologic specialist (neurologist or neurosurgeon). The doctor will make a decision whether patient needs head CT scan or another diagnostic test.

Because there is a risk of something more serious. In such cases of head injury and concussion.

Dr. Anton Titov, MD: When can athlete return to active sports after uncomplicated concussion? Maybe there are differences for professional and amateur athletes.

Perhaps there are some guidelines when athlete can return to play?

Dr. Arthur Day, MD: The general clinical guideline is this. The athlete can return to active sport after concussion after one week without any symptoms.

Concussion disrupts the brain function. This injury actually stimulates a cascade of physical changes at the cellular level. These cellular changes after concussion take some time to stabilize.

The athlete after concussion may feel that there is nothing wrong. But if a person had a concussion, it needs to run its course. Its course of recovery from concussion at the cellular level looks to be between 5 and 7 days.

During the time when concussion is running its course, recovery of brain function at the cellular level happens. Athlete should not return to active sports. The athlete might not have any symptoms anymore.

That is great. But the brain may have some mild swelling. Or the blood vessels may have some mild irritability for at least 5 to 7 days after concussion.

Sometimes athlete returns to play before concussion has run its course. There should be no return to sports if athlete still has symptoms from concussion.

The second blow to the head soon after the first concussion can make things much worse. The brain could not adjust to the second consecutive head blow injury.

Suddenly injured athlete might have swelling of the brain. Hockey player may have adverse reaction from the blood vessels of the brain. So we know that this secondary reaction is much more likely to happen if you have not recovered from the first concussion.

That is the reason for a 7 day interval of staying away from active sports. That is an average period of time (7 days) it takes for brain injury processes to recover at the cellular level.

This conclusions were derived from research in physiological model of brain injury.

Dr. Anton Titov, MD: A football player might have several concussions. Sometimes the parents and coaches should become very concerned about that athlete continuing to play the contact sports?

Dr. Arthur Day, MD: Obviously if the concussions are happening during the sports, it's a more serious issue. Sometimes an athlete falls off his bicycle. Then he has a car accident and then falls off a roof.

These injuries are not related to sports. This athlete is in trouble no matter what they do. But on the other hand, if athlete repeatedly has concussions related to sports, that is different.

Sometimes there is more than one concussion. Then you need to be very serious about it. Obviously there are professional athletes.

They are making a lot of money from sports activity. But we know the facts. There is a risk of cumulative damage to their brain over time.

Permanent brain damage happens if athlete continues to play soon after concussion and other head trauma. So any time I hear about more than one concussion, then I am really concerned about stopping athlete's sport activity.

It is true especially if concussion happens within a short period of time.

One concussion is one more than should happen.

That's right. One concussion could happen as a fluke. It is a rare, low probability event.

But if more than one concussion happens, you need to have a serious talk with parents of the athlete. You need to make a decision about whether or not athlete should continue to participate in active contact sports.

Dr. Anton Titov, MD: Concussion in sports what you need to know. What parents should know about concussion? How long to stay away from sports after concussion? Repeat concussions.