Sports Concussions


Andrews Institute strives to provide the latest evidenced-based and consensus-driven care for sports concussion to patients of all ages and abilities. Led by our team of sports medicine physicians, our sports concussion care team utilizes an approach by which an individualized care plan is created for each patient. Depending on the identified needs of the patient, a comprehensive team of subspecialty clinicians are available for collaborative consultation for the benefit of the patient. Clinician specialties, who may be engaged by our sports medicine team in the care of sports concussions, include athletic training, physical therapy, occupational therapy, physical medicine and rehabilitation, neurosurgery, psychology, sports psychology, psychiatry, neuropsychology, neuroradiology, neuro-ophthalmology, neuro-optometry, sports neurology, sleep medicine and ENT (ear, nose and throat). Based upon the philosophies of Dr. James Andrews, education, prevention, and care of athletes are cornerstones of sports medicine care.

Schedule an appointment by calling 850.916.8700, and let us help you maintain the quality life you deserve. Our caring staff and expert physicians will be with you every step of the way.

What is a Concussion?

A concussion is an injury to the brain occurring as the result of a traumatic force. The force that causes the injury can occur from a direct blow to the head. The injury can also occur as a result of an indirect force to the head such as when a player is hit in the chest or back by another player. When an individual has suffered a recent sports concussion injury, there is typically no structural abnormality of the brain that can be seen on standard imaging. Each patient experiences a unique symptom array with a concussion injury. If the same patient experiences more than one concussion, then each concussion can be different in regards to the symptoms experienced.

Underlying Disorder

As previously described, the underlying condition in a sports-related concussion is an injury to the brain. This injury affects the way the cells and nerves of the brain communicate and function. The injury is considered to be at the microscopic level impacting cells, axons and chemical functions of the brain.

Incidence

Athletes in any sport can experience a sports related concussion. Collision and contact sports represent the highest risk. Actual annual rates of sports related concussion are unclear as it is believed that a high number of sports related concussions go unreported.

Modifying Factors

Factors have been identified that increase risk of a sports-related concussion or affect recovery. Currently recognized factors include:

  • Prior history of concussion – increases risk of new concussion or more prolonged post-concussion recovery
  • Gender – females playing a sport with comparable playing rules and style to the male equivalent have demonstrated increased incidence
  • Youth athletes – recovery is more often prolonged and risk of severe complication (eg. bleeding in the brain and brain swelling) is higher
  • Pre-injury conditions that impact diagnosis, management and/or recovery:
    • Mood disorders, particularly anxiety and depression
    • Learning disorders
    • Attention deficit disorders (ADD, ADHD)
    • Migraine headache history

SIGNS AND SYMPTOMS

After a concussion injury, signs and symptoms vary from patient to patient. Examples of some typical signs and symptoms that may occur after a concussion injury follow.

PHYSICAL

  • Headache
  • Nausea
  • Vomiting
  • Balance (dizzy/vertigo)
  • Fatigue
  • Light sensitivity
  • Sound sensitivity
  • Dazed feeling
  • Stunned feeling
  • Numbness/tingling

COGNITIVE

  • Foggy
  • Slowed down
  • Concentration difficulties
  • Memory issues
  • Forgetfulness
  • Confusion
  • Slowness of response

EMOTIONAL

  • Irritability
  • Sadness
  • More emotional
  • Nervousness

SLEEP

  • Drowsiness
  • Insomnia

DIAGNOSIS

There is no gold standard test for the diagnosis of concussion. The diagnosis is made clinically based on how the injury occurred and the symptoms associated with the injury.

In the evaluation of the patient with a potential concussion, the health care provider’s most important responsibility is in assessing for symptoms that would suggest a fracture or other injury to skull or neck or an underlying structural injury of the brain, such as bleeding in the brain. These conditions may warrant immediate or emergent evaluation.

MANAGEMENT

Once an athlete is diagnosed with a concussion, the initial treatment consists of relative physical and cognitive rest. The athlete diagnosed with a concussion is not allowed to return to sports participation while still symptomatic or in the first days after injury. In particular, activities with a risk of contact or collision to the head should be avoided.

In the first few days after injury, the goal is to allow initial brain healing and recovery. Part of this healing is the avoidance of activities that exacerbate symptomatology. As the days progress, the patient is typically educated that she/he may reengage in some cognitive and physical activities. These steps in treatment and progression are monitored and individualized for each patient.

Most concussions resolve in an uneventful manner over days to weeks. In less frequent instances, the patient may have a delayed recovery or protracted symptoms. These patients will often benefit from consultation from a collaborative treatment team approach.

Returning to sports participation is only considered once the patient is determined to be fully recovered from the injury. Progression of sports reintegration must not only take into account any applicable state or organizational laws, but also the athlete’s unique needs.