Narrator: Hi, there!
We all know that physical activity and exercise are key to healthy living, and sports are a great way to get our bodies moving. But we also need to know about safety and how to respond to injuries. Most of the time, like with scrapes, sprains, and breaks, it’s pretty obvious what happened and what you need to do. It’s different with brain injuries, such as concussions, because the injury is actually in the brain so it doesn’t show on the outside – or even on X-rays, CT scans or MRIs. Still, a person with a concussion feels the effects and needs the proper care to get better.
Concussions are caused by a blow to the head, face, neck or body from a fall, a hit, or anything that knocks someone with enough force that their brain moves around inside their skull. Concussions may affect the way a person thinks, feels and acts. Most people recover within one to four weeks, but for some, the symptoms can be long-lasting and may even result in long-term issues, such as memory problems or depression.
Concussions are serious injuries that need proper care to get better and that’s why it’s important that athletes, students, coaches, team trainers, officials, educators and families all learn how to recognize, respond to, manage and even prevent, concussions.
So, what do you need to know?
Let’s begin with prevention – it’s the best medicine!
Start by educating yourself about concussions, like you’re doing right now.
Make sure you and anyone you’re supervising are wearing the right equipment for the sport, that everything fits properly and it’s in good condition.
Staying safe also means everyone needs to understand and respect the rules of the sport. It’s important that everyone commits to their sport organization or school’s Concussion Code of Conduct.
You should promote an environment where everyone is encouraged to report injuries and feels supported when they do. Ignoring a concussion can lead to further injury and long-term issues, so you should understand the dangers of the all-too-common “tough it out” mentality.
Now..., how do you recognize a concussion? Everyone can help if they know what to look and listen for.
First, consider whether this might be a more serious injury. Certain “red flags” mean this is an emergency and you should call 9-1-1. Don’t leave the person alone.
Red flags include neck pain or tenderness, double vision, weakness or tingling in the arms or legs, severe or increasing headache, seizure or convulsion, loss of consciousness and vomiting more than once. Also watch for any growing confusion or increasing restlessness or agitation, like if the person gets more aggressive or even angry.
It’s helpful to remember that concussions are brain injuries and the brain does a lot of things, from telling your body how to move, to processing what you see, to learning new things, and regulating your emotions. This means a brain injury can have a number of different signs or symptoms. They might start right away or take hours – even days – to show up. Just one sign or symptom is enough to suspect a concussion.
We usually group concussion signs and symptoms into four categories: Physical, Cognitive (or Thinking), Emotional, and Sleep-related.
Let’s start with physical symptoms. The most common is headaches. People often describe feeling pressure in their head as if there’s a power saw running through it. They might also feel dizzy or nauseous – maybe even throw up. They might stumble around or lose their balance. Other symptoms include blurred vision, sensitivity to light or sound, or ringing in the ears. The person might feel tired, drowsy, or like they have no energy. Sometimes people, especially younger children, can’t express how they’re feeling and might just say they “don’t feel right.”
And, despite what many people think, most people with a concussion DON’T lose consciousness.
The second set of symptoms relate to thinking – feeling confused or just not thinking as clearly or quickly as usual. Also having a tough time concentrating and memory problems, like not remembering what happened just before and after the injury.
The third are emotional symptoms, like getting upset or angry easily, feeling sad, or nervous or anxious. Some people experience depression.
Number four are symptoms related to sleep. A person might find that they are having trouble falling and staying asleep, or the opposite: they might want to sleep a lot.
So, now you know what to look for. If you suspect a concussion, here’s what to do.
One, remove yourself or the injured athlete from activity right away: this is a must. Continued participation puts people with concussions at risk of more severe, longer-lasting symptoms.
Two, if you’re supervising the sport or activity, call the parent or guardian if the athlete is under 18, or the emergency contact if the athlete is over 18.
Three, don’t leave individuals with a suspected concussion alone.
And four, anyone removed from sport with a possible concussion needs to get checked by a physician or nurse practitioner as soon as possible. They shouldn’t return to unrestricted participation in training, practice or competition until they have received medical clearance.
Creating a culture of safety means promoting an environment where everyone talks openly about concussions and understands the importance of letting
others know if something doesn’t feel right. That’s why communication is so important, especially since many concussion symptoms are things that someone feels, and not necessarily things that others can easily see.
Anyone with a concussion should let others know, including their sport teams, clubs, schools, coaches, team trainers and educators. Sport teams, clubs and schools can then support an athlete in returning to school, physical activity and sport.
So quick review: If you are hit, stop and sit out. See a physician or nurse practitioner. Then focus on getting better.
And most people with concussions do get better in one to four weeks. But some take longer.
Some people may experience symptoms, such as headaches, neck pain or vision problems, for months, or even years. Others may have lasting changes in their brain that lead to issues such as memory loss, concentration problems or depression. In rare cases, a person who suffers multiple brain injuries without healing in between may develop dangerous swelling in their brain, a condition known as second impact syndrome, that can result in severe disability or death.
Each concussion is unique, so don’t compare one person’s recovery to someone else’s.
Lots of people, especially athletes, have had injuries that required them to rest and recover. If you sprain your ankle you can’t run until it’s healed and strong again or else you risk re-injuring it or making things worse. It’s the same with a concussion. Except, how do you rest and recover the brain?
Since the brain is involved with pretty much everything we do, resting it requires taking a break in a few different ways. For the first two days after the injury, the person should minimize time spent using screens, such as a phone, computer, tablet or TV. A person with a concussion may have to limit certain activities at first and reintroduce them gradually.
This can be easier said than done. It will take some patience, but remember that rushing back to activities can make things worse.
Returning to school and sport is a gradual process.
Students in elementary or secondary school who are diagnosed with a concussion by a physician or nurse practitioner must follow their school board’s return-to-school plan, which supports both a gradual return to learning and return to physical activity. Contact your school for more information.
Other athletes, including those attending college or university, must proceed through their sport organization’s return-to-sport protocol.
All students and athletes should work with their health-care professional, sport organization and school to establish individual plans for returning to school and sport.
An athlete must not resume unrestricted training, practice or competition until they have received medical clearance.
Most return-to-sport protocols have six steps. Each step takes at least 24 hours, but could take several days.
If during steps 1 to 3 their symptoms get worse more than mildly and briefly, the athlete should stop and try again the next day at the same step. "Briefly” means symptoms should settle back down within an hour. After medical clearance by a physician or nurse practitioner the athlete's concussion symptoms should not come back. If they do, the athlete should return to step 3 and visit the physician or nurse practitioner to be reassessed.
If symptoms do not improve or they continue to get worse, the athlete should return to their physician or nurse practitioner.
It’s important to understand that slower recoveries don’t mean failure and aren’t necessarily “worse” – it’s just what that person needed to heal.
On to the steps…
Step 1 is light daily activities and relative rest.
Step 2 is some light then moderate aerobic exercise -such as walking, first slowly and then gradually increasing the pace. The athlete may begin some light resistance training, if appropriate.
Step 3 is specific exercises for your sport - simple drills, such as shooting a basketball. These should be done individually, away from other participants, and have no risk of head or body contact.
It's not until the fourth step that you can return to team practice and participate in harder drills, after medical clearance by a physician or nurse practitioner. There still shouldn't be any physical contact with the injured player - and that's one of the many reasons why it's important the whole team understands and supports your recovery.
Step five is returning to full practice, including contact, where applicable.
The sixth step is where you get back to regular game play or competition.
Don’t forget: you need the OK from a physician or nurse practitioner before you can return to full practice, training or competition. Check with your sports team and school for the specific steps that should be followed.
And remember: returning to school comes first, before returning to unrestricted sport.
It’s essential to work together to prevent, recognize and manage concussions. Athletes, students, parents, health-care professionals, coaches, team trainers, officials and educators all have a part to play. It’s great for friends and peers to also feel part of this team since they’re often the best source of support and encouragement when someone is recovering from a concussion.
Sports, physical activity and exercise can play a big part in our lives, but nothing comes before our long-term health. If a concussion is recognized early and managed properly, the brain can heal just like any other part of the body.
Remember:
One, recognize signs and symptoms of a concussion and remove yourself, or the athlete, from the sport or physical activity, even if you feel OK, or if they insist they are OK.
Two, get yourself/ the athlete checked out by a physician or nurse practitioner.
Three, support gradual return to school and sport.
[Text on screen with a photo of Rowan Stringer] This video is part of a series of Rowan's Law concussion awareness resources.
Rowan's Law was named for Rowan Stringer, a high school rugby player from Ottawa, who died in the spring of 2013 from a condition known as second impact syndrome (swelling of the brain caused by a subsequent injury that occurred before a previous injury healed). Rowan is believed to have experienced three concussions over six days while playing rugby. She had a concussion but didn’t know her brain needed time to heal. Neither did her parents, teachers or coaches.
These resources are not intended to provide medical advice relating to health care. For advice on health care for concussion symptoms, please consult with a physician or nurse practitioner.