sports neurology at MUSC

sports neurology

Sports concussion information for the athlete

As an athlete, we know that your health is your first priority and returning to play is a close second. Ultimately, the choice of returning to play must be done through a properly trained physician in order to ensure that you are safe and healthy first. We know of athletes that returned to play too early and that choice ended their career and in some rare cases their life. That being the case, below we have provided you with both the short- and long-term consequences of concussion as well as strategies to return to play.

Sports concussion questions frequently asked by athletes?:

Q: I sustained a concussion last night and feel fine today. Can’t I just return to play tonight?

A: Research suggests that returning to play too early may at minimum end your career sooner and in some rare cases end your life. It is essential to utilize the Return to Play protocol and return to play stepwise in a safe and controlled manner.

Q: I sustained a concussion last night and still have a headache. Can I take Ibuprofen or Tylenol?

A: You cannot initiate the return to play protocol until you are off all new medications started since your concussion. Research suggests at least in mice that taking ibuprofen can actually make concussion worse.

Q: What type of physician should I see?

A: Concussion should be at minimum evaluated by a neurologist or a physician trained in evaluating sports concussion. The ideal scenario would be an evaluation from a neurologist with training and experience in sports neurology and concussion.

Q: I sustained a concussion two weeks ago and I still have daily headaches and fatigue. Is this normal?

A: Most adult patients (80-90%) experience resolution of their concussion symptoms within about 7-10 days; however, there is some evidence to suggest that the recovery time frame may be longer in teenagers. Some patients have more persistent symptoms, lasting weeks to month.

Q: My coach said that I might have post-concussive syndrome. What is this?

A: Post-concussive syndrome refers to a constellation of physical and psychological symptoms that can be seen in the aftermath of a concussive head injury. Commonly reported symptoms include headache that worsens with exertion, dizziness, fatigue, insomnia, feeling slowed down, difficulty concentrating, difficulty remembering, sadness, nervousness, and irritability. It is unclear why, with the same type of injury, some patients develop these symptoms while others do not.

Q: Since sustaining my concussion, I have been falling asleep in class and at work and it has been taking me far longer than usual to do the things that I used to do. Why is this happening?

A: Many people require some modifications to their schedule as they recover from a head injury. Initially, they may benefit from a shortened day, shortened classes, or rest breaks. Other modifications include allowing extra time for assignments and decreasing total work-load.

Q: Since my concussion I have been feeling down and depressed. Can that be connected?
A: Post-concussive depression is a real consequence of concussion and should be taken seriously. The World Health Organization states that depression is the 4th leading cause of disability on the planet.

Q: Are there long-term health consequences associated with repeated sports concussions?

A: Epidemiological studies have suggested an association between repeated sports concussions and late life cognitive impairment, but the real answer to this question remains unclear.

Q: I have had three concussions. How many is too many?

A: Great question but the answer remains unclear. Many physicians feel that it is time to permanently retire from contact sports when:

  • The athlete has sustained a low-threshold concussions (i.e. experiencing concussion symptoms after a mild impact)
  • The athlete has sustained multiple concussions and has had increasingly severe and/or increasingly prolonged symptoms after each episode
  • The athlete is exhibiting changes from their baseline between concussive injuries

Q: Is there anything in my medical history that makes me more or less likely to have long-term consequences of concussion?

A: Another great question, but that answer also remains unclear. The MUSC Sports Neurology program is currently looking at whether a personal or family history of headaches or depression makes an athlete more likely to develop these symptoms or a worsening of these symptoms. We are also exploring the possibility of a strong family history of dementia might predispose an athlete sustaining concussion to also develop dementia.


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