A young man wearing a grey jumper clutching at his hand with both hands. Looks distressed or in pain.

What is a concussion?

A sports-related concussion can be defined as a traumatic brain injury induced by biomechanical forces (Berlin Consensus Guidelines, 2016). It is caused by either a direct blow to the head, face or neck. It’s important to note a blow to anywhere on the body, transmits an ‘impulsive’ force to the head and can cause a concussion.

Only 6% of concussion results in loss of consciousness. Just because someone didn’t lose consciousness doesn’t mean they won’t have a concussion.

40% of concussions show up at the time of injury, however, 30% evolve over time showing the importance of monitoring patients or people with a suspected concussion.

Some symptoms to look for with a concussion include:

• Headache
• Fogginess (cognition)
• Rapid and exaggerated changes in mood
• Irritability
• Loss of consciousness
• Memory loss
• Unsteady, unbalanced
• Slowed reaction time
• Drowsiness

Concussion should not be taken lightly in any case but taken to the emergency department if people are presenting with:

• Neck pain
• Increasing confusion and irritability
• Repeated vomiting
• Seizure or convulsion
• Weakness or tingling/burning in arms or legs
• Deteriorating conscious state
• Severe or increasing headache
• Unusual behaviour change
• Double vision

If in doubt sit them out

We don’t want anyone having a second impact (second impact syndrome) where they suffer a second concussion before the symptoms of the earlier one have subsided.
A second impact can cause the brain to swell rapidly and catastrophically which will then lead to further neurometabolic changes and cell death

Most people are unaware that there is treatment available to help reduce symptoms and return to sport faster.
Initial rest from cognitive, physical and environmental factors as needed is indicated for the first 48 hours. Then as tolerated start a graduate return to cognitive and physical activity – need to treat the individual.
Limit: screen time, physical activity, school, socializing, stressful activities
Allow: Increased sleep, hydration and nutrition
Integrate: 5minutes every hour of symptom-free activities (no headaches, dizziness, fatigue)
Alternate between types of activity = cognitive/physical/visual. Integrate screen time sooner on a structured basis.

All activities should be introduced slowly and gradually whilst monitoring symptoms. Some types of activities you could alternate between are listed below:


• Listening tasks- audiobooks, quiet music
• Meditation or relaxation (sooner rather than later)
• Colouring
• Short walk indoors or out
• Brushing the pet


• Reading
• Computer
• Memory tasks
• Problem-solving
• Cooking
• Planning activities


• Increased HR – walking, cycling, jogging
• Household tasks – cleaning, dishes
• Yoga


• Light exposure
• Noise exposure
• Busier places/events
• Talking in a group

General rule:

The athlete needs to be symptoms free for the same amount of time they have had symptoms prior to returning to contact sport.
Successful return to school/work must come before return to sport (game). Especially, in youth and adolescents

The average length of the return to sport/play :

• 14 days for girls
• 15 days for girls
• 2 days earlier if received treatment right away/report it right away.
Non-sport-related concussions take longer than sport-related = whiplash, falls.
It is worth noting most sports will have specific return to play guidelines and protocols. Generally, you will need to be signed off by a qualified GP before getting back to your sport.

Here at Sports & Spinal, we are able to assist you and in getting back to your regular activities, we can provide physiotherapy that includes:

  • Neurological, Vestibular (balance/dizziness) and Musculoskeletal assessment

  • Neck and headache treatment

  • Safe implementation of a graded rehabilitation program to prepare for returning to sport/work

  • Providing specific exercises for reducing some symptoms

  • Assessing for return to school/work and return to sport

Recovering from a concussion can be a frustrating process. Each patient will require individualized care during their concussion management process. Some may recover quite quickly, while some may have a difficult time progressing.  If you need advice on concussion or you have symptoms lasting longer than one month contact our team and they will be happy to book you an appointment with our wonderful team of Physiotherapists!


Find a Sports & Spinal physiotherapist that can help you today