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Each year, there are as many as 3.8 million concussions in the USA during sports and recreational activities. It is believed that up to 50% of concussions go unreported. With new research and evidence of long term effects of concussions, these are no longer a “shake it off” injury and should be treated with care.

Here at Elite, we see many student-athletes for training and physical therapy and based on a recent report from the CDC, as many as 20% of student-athletes will experience a concussion each year. While we cannot always prevent a concussion, there are steps to minimize the risk of re-injury and long term complications that can be associated with concussion.

A concussion, also known as a mild traumatic brain injury, is when the head sustains a blow that results in damage to the soft tissue of the brain and surrounding area. There are many symptoms associated with concussion including loss of consciousness, dizziness, headache, vertigo, sleep disorder, mood changes, depression, light sensitivity, difficulty with balance and concentration. Concussions can occur during contact and non-contact sport with the greatest frequency in football, hockey, rugby, soccer, and basketball. Females have also been shown to have a higher risk of concussion than male counterparts.

Once an athlete sustains substantial impact on the head it is critical that they seek medical attention immediately. High School students in MA are required to take baseline testing via the ImPACT test prior to the school year. Once a concussion is suspected, the ImPACT test should be re-administered to compare the athlete’s current cognitive ability to their baseline. An athlete should never return to play the same day a concussion is suspected due to high risk for second impact syndrome (SIS). SIS is a subsequent brain injury, often more severe than the first, that occurs when an athlete sustains a blow to the head when they are already in an injured state. This can be extremely dangerous.

After an athlete is diagnosed with a concussion a period of rest is recommended to help decrease inflammation and restore blood flow to the area. After 24-48 hours, if symptoms persist, a physical therapist can then help guide appropriate recovery.

A recent systematic review published in the British Journal of Sports Medicine reports that an appropriately designed program to re-introduce activity so the athlete can help facilitate recovery and minimize the risk of re-injury. At Elite, we encourage a graded return to activity protocol that includes balance training and cardiovascular exercise as well as cervical and vestibular rehab. This multi-faceted approach helps return the athlete to their prior state of function and minimize long-term complications of concussions.

While it is not an injury you can see, like a cut or bruise, a concussion should be always taken seriously. Medical attention should be sought once the hit occurs to help the athlete get started on the appropriate recovery program. Please ask your Physical Therapist for more information on concussion testing and ways we can help get your athlete back to the field safely!


Patricios JS, Ardern CL, Hislop MD, et al. Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organizations. Br J Sports MedPublished Online First: 02 March 2018. doi: 10.1136/bjsports-2018-099079

Schneider KJ, Leddy JJ, Guskiewicz KM, et al. Rest and treatment/rehabilitation following sport-related concussion: a systematic review Br J Sports Med 2017;51:930-934.