Health Services

A concussion is an injury to the brain due to a direct or indirect blow to the head. The force of impact causes a metabolic imbalance within your brain at the cellular level. This imbalance is the cause of the symptoms you are experiencing.

What should I watch for?
Although most concussions do not cause long-term or permanent damage, any concussion can be potentially dangerous because it affects the brain. As an athlete, you should be monitored for 24-48 hours for any signs and symptoms (or increase in symptoms) of a concussion. If serious problems are going to occur, they will generally show up during this time.

Concussion Symptoms you may Experience
Physical Symptoms - headache, dizziness, nausea, fatigue, problems with vision or balance, sensitivity to light/sound, vomiting
Cognitive Symptoms - feeling of fogginess or slowness, difficulty with concentration
Emotional Issues - irritable, more emotional, sadness
Sleep Changes - drowsiness, insomnia, more or less sleep than usual

When to Seek Emergency Medical Care
It is always prudent to contact your physician if injured. Seek immediate medical care if any of the following symptoms develop:

• A headache that worsens
• Confusion that worsens
• Difficulty recognizing people or places
• Slurred speech
• Loss of consciousness
• Inability to be awakened
• Vomiting
• Seizures
• Numbness in the arms and/or legs or neck pain
  

Medications
Do not take medications without the permission of your healthcare provider. Generally, you will be allowed to take acetaminophen (Tylenol). Be sure to avoid aspirin and aspirin containing products such as Excedrin or Midol; ibuprofen (Advil, Motrin), naproxen (Aleve) and any form of alcohol (cough syrups and cold medications included). Avoid medications that cause drowsiness.

Treatment of Concussions
The most effective initial treatment for a concussion is rest. The rest must be both physical and cognitive.

• There should be no physical activity of any sort while you are experiencing concussion    symptoms. Any activity that increases concussion symptoms or elicits new concussion symptoms is indication that those activities are too much for your injured brain.  

• Cognitive activities (such as school work, reading, watching TV/movies, playing video games or texting) that increase existing concussion symptoms or elicit new symptoms indicate that those activities are too much for your injured brain.

Failure to stop activities that increase your symptoms or elicit new symptoms will actually slow your recovery.

Concussion and School
Because cognitive and physical activities may be too much for you while you are suffering from a concussion, you will probably find that your schoolwork is impacted. Your health is your first priority so you must rest as much as needed, despite your concern about “getting behind”. This will allow you to recover as quickly and as uneventfully as possible.

Recent knowledge based on years of research shows that thinking, “exercising the brain,” and most cognitive tasks can prolong concussion symptoms and slow recovery. Exercise, whether physical or mental, will usually increase the symptoms of headache, dizziness, nausea and lightheadedness. Most students will have difficulty with concentration, memory, and the speed in which they process information - which negatively affects their school learning and performance. Symptoms are usually pronounced in the early post-injury phase, rendering the student unable to take tests. Struggling to learn and perform “overuses” the brain at a time when it is working hard to recover, and can negatively affect recovery.

You should initially rest at home and avoid the following activities until headaches or other significant symptoms resolve: homework, tests, papers and projects, reading, watching TV, computer use, video games, text messaging, physical exercise, bright lights, noise, hot tubs, socializing with friends (going to the movies etc.). In other words, REST. Once headache-free, you can begin brief periods of studying or reading. If symptoms return, you should discontinue the activity.

Returning to school is advised for gradual increasing periods of time once you can tolerate a couple of hours of thinking. Sleeping longer in the morning and coming to school later might be an option. Another option is rest time during the day in the nurses’ offices. The school nurse and grade chair should serve as liaisons between the teachers, athletic trainers and coaches to facilitate the above.

Academic Accommodations are generally required when you return to school following a concussion. Your physician will give you a recommended list of accommodations upon your return. Please turn this form in to the MS/HS nurse. She will be in close contact with the guidance counselor to see that the Accommodation Plan is communicated to your teachers.

Each concussion is unique, so it is impossible to predict your symptoms or course of recovery. Some concussed individuals are back to functioning at 100% in a few days; others take weeks or even months to recover. It is truly a day-to-day, week-to-week process.  Your teachers are willing to work with you in making-up your school work and helping you stay on task with your academic studies.

Below are actions that other students with concussions have found helpful in aiding their recovery:

Required Actions

• Let your guidance counselor know about your concussion so he/she can notify your teachers.
• Once you return to school, communicate with each of your teachers to discuss your class work and assignments.
• Do not attend PE classes. Report to the Infirmary so that you may rest during this time.
  

Possible Actions

• Avoid band and chorus if loud noises make you feel worse. Again, report to the Infirmary to rest during this time.
• Rest in the Infirmary any time you don’t feel well but are not ready to go home.
• Come in late and/or go home early if fatigued.
• Stop all after school activities.
• Do not attend sports practice or games. Even sitting on the bench is too much.
• Make an effort to get extra sleep and rest.
  

Please know that if concessions are made in regard to schoolwork, then you also need to make concessions in regard to your activities outside of school. You should not attend practices, games, dances, retreats, movies, etc. if you are receiving academic accommodations. If you choose to do so, then your academic accommodations may be in jeopardy. If you fail to do your part in the recovery process, then a meeting with school officials may be required.

ImPACT Test
The ImPACT test is a 30-minute computerized test that measures cognitive processing, memory, problem solving, and reaction time. Hopefully you took the ImPACT test while in good health and have a baseline on file. You will be asked to retake the ImPACT test a number of times (approx. every 5-7 days) until you are symptom-free and feel like you’re back to normal. If the test results are at your baseline or better, it indicates that your concussion has resolved. Once cleared by your physician, you may slowly begin to return to physical activity.

Return to Physical Activity
It is important to allow the brain to properly heal before participating in any activity that could lead to another blow to the head. With repeated concussions, the severity and duration of symptoms can be much more serious and last far longer.

Once all concussion symptoms have resolved, your ImPACT test has returned to baseline (if you had a baseline test), and your health care provider has approved for you to return to physical activity, you must do so gradually. This will be coordinated by one of the athletic trainers. Typically, there should be a minimum of five days of increasing activity before you are ready to return to full, competition level play. Any activity that elicits concussion symptoms indicates that you are not fully recovered.