Currently, it is impossible to accurately predict how long concussions will last. There must be full recovery before someone is allowed to return to participation. Connecticut Law now requires that no athlete may resume participation until they have received written medical clearance from a licensed health care professional (Physician, Physician Assistant, Advanced Practice Registered Nurse, Athletic Trainer) trained in the evaluation and management of concussions.
*If at any time signs or symptoms should return during the RTP progression, the athlete should stop activity that day. If the athlete’s symptoms are gone the next day, s/he may resume the RTP progression at the last step completed in which no symptoms were present. If symptoms return and don’t resolve, the athlete should be referred back to their medical provider.
Part III – HEAD INJURIES
Injuries to the head include:
Concussions: (See above information) There are several head injuries associated with concussions which can be severe in nature including:
a) Second Impact Syndrome – Athletes who sustain a concussion and return to play prior to being recovered from the concussion are also at risk for Second Impact Syndrome (SIS), a rare but life-altering condition that can result in rapid brain swelling, permanent brain damage or death.
b) Post-Concussion Syndrome – A group of physical, cognitive and emotional problems that can persist for weeks, months, or indefinitely after a concussion.
Scalp Injury: Most head injuries only damage the scalp (a cut, scrape, bruise or swelling). Big lumps (bruises) can occur with minor injuries because there is a large blood supply to the scalp. For the same reason, small cuts on the head may bleed a lot. Bruises on the forehead sometimes cause black eyes 1 to 3 days later because the blood spreads downward by gravity.
Skull Fracture: Only 1% to 2% of children with head injuries will get a skull fracture. Usually there are no other symptoms except for a headache at the site where the head was hit. Most skull fractures occur without any injury to the brain and they heal easily.
Brain Injuries: These injuries are rare but are recognized by the presence of the following symptoms:
a) Difficult to awaken or keep awake
b) Confused thinking and talking
c) Slurred speech
d) Weakness of arms or legs
e) Unsteady walking
1. NFHS. Concussions. 2008 NFHS Sports Medicine Handbook (Third Edition). 2008: 77-82. http://www.nfhs.org
2. McCrory, Paul MBBS, PhD; Meeuwisse, Willem MD, PhD; Johnston, Karen MD, PhD; Dvorak, Jiri MD; Aubry, Mark MD; Molloy, Mick MB; Cantu, Robert MA, MD. Consensus Statement on Concussion in Sport, 3rd International Conference on Concussion in Sport Held in Zurich,
November 2008. Clinical Journal of Sport Medicine: May 2009 – Volume 19 – Issue 3 – pp 185-200.
3. Centers for Disease Control and Prevention. Heads Up: Concussion in High School Sports. http://www.cdc.gov/NCIPC/tbi/Coaches_Tool_Kit.htm.
4. U.S. Department of Health and Human Services Centers for Disease Control and Prevention. A Fact Sheet for Coaches (2009). Retrieved on June 16, 2010. http://www.cdc.gov/concussion/pdf/coaches_Engl.pdf
5. American Academy of Pediatrics – Healthychildren. Symptom Check: Head Injury. Retrieved on June 16, 2010.
Centers for Disease Control and Prevention. Injury Prevention & Control: Traumatic Brain Injury. Retrieved on June 16, 2010.
Centers for Disease Control and Prevention. Heads Up: Concussion in High School Sports Guide for Coaches. Retrieved on June 16, 2010.