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February 23, 2024

Understanding and Managing Concussions in Sports: A Comprehensive Guide with Rock Vomer, DO, DPT

by Rock Vomer, DO, DPT, CAQSM

Concussions are a common injury in the world of sports, yet they are often misunderstood. In this blog post, we aim to shed light on what concussions are, their symptoms, and most importantly, how to manage them effectively. Whether you’re an athlete, a parent, or a sports enthusiast, understanding concussions is crucial for both prevention and recovery.

What is a Concussion and How Does it Happen?

A concussion is a type of traumatic brain injury (TBI) caused by a blow to the head or a forceful jolt to the body, leading to rapid movement of the brain within the skull. This sudden movement can result from various activities, such as a tackle in football, a collision in soccer, or even a fall during a game. It’s important to note that concussions symptoms widely vary from person to person, making them particularly tricky to diagnose.

Recognizing the Symptoms

The symptoms of a concussion can vary from person to person and may not always be immediately apparent. The Sport Concussion Assessment Tool (SCAT6) is a valuable resource for recognizing these symptoms. Common concussion symptoms include:



Nausea or vomiting


Memory problems

Sensitivity to light and noise

Balance issues

Changes in mood or behavior

If you or someone you know experiences any of these symptoms after a head injury or a strong blow to the body, it’s essential to take them seriously and seek medical attention promptly.

The First 48 Hours: What to Do and What Not to Do

The initial 48 hours after a concussion are crucial for recovery. Here’s a guide on what to do and what to avoid during this period:

What to Do:

Relative Rest: Rest is vital for healing. This means taking time off from school or work and avoiding activities that stress the brain, such as excessive screen time, reading, or heavy workloads.

Sleep Optimization: Ensure you get adequate sleep at night, and it’s okay to use melatonin if needed to help regulate your sleep patterns.

Manage Symptoms: Over-the-counter pain relievers like Tylenol can be taken to alleviate severe headaches. Wearing sunglasses and a cap can help reduce sensitivity to light for the first few days.

What Not to Do:

Return to Activities That Worsen Symptoms: Avoid any activities that exacerbate your symptoms, as this can hinder your recovery.

Return to Sports with Risk: It’s crucial to avoid returning to sports at this time, as the risks associated with sustaining another concussion are far too high.

Expect Normal Work or School Levels: Don’t put pressure on yourself to perform at the same level you did before your injury. You need time to heal.

Isolation in a Dark Room: You don’t need to sit in complete darkness for days. It’s essential to strike a balance between rest and gentle activity.

Overuse of Medications: Avoid using headache medications daily unless you’re experiencing significant symptoms. Overuse can lead to medication-induced headaches.

Avoid Alcohol, Junk Food, and Caffeine: These substances can affect your recovery and should be minimized during the initial phase.

After the First 48 Hours

It’s time to gradually reintroduce normal activities and light cardio exercises. However, it’s crucial to let your symptoms be your guide – if they worsen during any activity, stop and rest. It’s also okay to continue Tylenol, but try not to use it for more than two days per week.

For children, returning to school is a priority at this stage. Athletes can receive guidance on exercise from their athletic trainers.

Returning to Sports

Before returning to contact sports activities, it’s imperative to see a physician for clearance. They will assess your condition and ensure that it’s safe for you to resume sports participation. This is a crucial step in the recovery process.

How a Sports Medicine Physician Can Help

A sports medicine physician plays a vital role in managing concussions effectively. They offer various services to support your recovery:

Exercise Guidance: Using protocols like the Buffalo Treadmill Protocol, they can create tailored exercise plans to help accelerate your recovery and help you safely return to sports activities with a guided plan that is unique to you.

Symptom Tracking: Utilizing tools like the Sports Concussion Ongoing Assessment Tool (SCOAT6), they monitor your symptoms over time to ensure you’re on the right path to recovery.

Neurocognitive Testing: This type of testing helps assess your cognitive function and provides insights into your brain’s health during the recovery process.

Medication Guidance: For individuals with persistent symptoms, sports medicine physicians can provide guidance on appropriate medications to manage these symptoms.

Referral Management: For prolonged symptoms, they can facilitate referrals for vestibular therapy to address balance and coordination issues.

Legal Requirements for Return to Sport

In North Carolina, there is a law known as the Gfeller-Waller Concussion Awareness Act that requires athletes to be evaluated by a trained individual or physician for concussion clearance before returning to sports activities. This law prioritizes the safety and well-being of athletes, ensuring that they are adequately recovered before resuming their athletic pursuits.

Concussions are a serious matter in sports, and they demand attention, care, and caution. Understanding what a concussion is, recognizing its symptoms, and knowing how to manage it is vital for everyone involved in sports, from athletes to parents, coaches, and healthcare professionals. The guidance of a sports medicine physician can make a world of difference in ensuring a safe and successful recovery from a concussion. If you or a loved one experiences a concussion, seek professional guidance, and adhere to the recommended protocols for a safer and faster return to the sports you love.

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