Sports-Related Concussion

Overview

what it is and why it matters

A sports concussion is a brain injury caused by force, either a direct hit to the head, face, or neck, or a hard jolt elsewhere in the body that whips the head. The brain takes a hit but the injury is to how it works, not necessarily to its structure. That's why a CT or MRI can look completely normal in someone who clearly has a concussion. Roughly 1.6 to 3.8 million sports concussions happen in the U.S. every year.

The classic symptom mix: headache or pressure in the head, nausea, dizziness, balance trouble, blurry or double vision, mental fogginess, trouble concentrating, and mood changes. Most athletes recover over the first few weeks with the symptoms gradually peeling away. Your provider tracks your milestones at follow-up visits.

Return to play

No athlete should return to play the same day they sustain a suspected concussion. A graduated return-to-sport protocol, medically supervised, is required before full participation.

Symptoms

what you may notice
  • Headache or a feeling of pressure in the head, the most common symptom
  • Dizziness, balance problems, or a sensation that the room is spinning
  • Nausea or vomiting shortly after the impact
  • Blurry or double vision, sensitivity to light and noise
  • Mental fogginess, feeling "not right," slowed thinking, trouble concentrating or remembering
  • Mood changes: irritability, sadness, or anxiety that wasn't there before
  • Fatigue, drowsiness, or trouble falling or staying asleep

Diagnosis

exam first, imaging second

On the sideline, athletic trainers and team physicians use standardized checklists and computer-based tests, some of which compare your results after the injury with your own baseline if one is on file. A CT scan is not needed for a typical concussion. We order one only if there are red flags, such as a severe headache, repeated vomiting, weakness on one side of the body, a seizure, or a worsening level of awareness. Advanced MRI techniques exist but are research tools, not standard clinical care.

How We Treat It

what we do, in order

The single most important thing to know: most athletes recover over the first few weeks. Care moves through a few stages, an early window of rest, then symptom management, then targeted rehabilitation if symptoms linger, and finally a staged return to sport. Each stage builds on the one before it, and your provider tracks your milestones at follow-up visits.

1

Cognitive and Physical Rest

A short window of physical and mental rest in the first day or two, then a gradual return to light activity. The old advice of weeks of dark-room rest is out: prolonged rest actually slows recovery. The brain heals better with measured re-engagement.

2

Symptom Management

Acetaminophen (Tylenol) for headache in the first few days. We hold off on ibuprofen and other anti-inflammatories early because they thin the blood slightly and we want to be safe about any bleeding inside the head. Melatonin can help with the sleep disruption that often comes with concussion.

3

Multidisciplinary Rehabilitation

If symptoms persist past the typical recovery window (post-concussion syndrome), we layer in targeted therapy: balance therapy for dizziness, vision therapy for visual symptoms, cognitive behavioral therapy for the mood and concentration changes, and supervised aerobic exercise to gradually build tolerance back up.

  1. Return-to-Sport Protocol

    Returning to sport happens in stages, not in one step. The standard pattern: complete rest → light aerobic activity (stationary bike, easy walking) → sport-specific exercise (running, agility) → non-contact drills → full-contact practice → competition. You spend at least a day at each level, and you only move to the next stage after you've been completely symptom-free for that interval. Any return of symptoms drops you back to the previous step.

Providers Who Treat Sports-Related Concussion

sports-medicine team

Frequently Asked

questions we hear in clinic
Can I go back to play the same day?

No. No athlete should return to play the same day they sustain a suspected concussion. A graduated return-to-sport protocol, medically supervised, is required before full participation.

How long does recovery take?

Most athletes recover over the first few weeks, with the symptoms gradually peeling away. Your provider tracks your milestones at follow-up visits.

Do I need a CT scan or MRI?

A CT scan isn’t needed for a typical concussion. We order one only if there are red flags: a severe headache, repeated vomiting, weakness on one side of the body, a seizure, or a worsening level of awareness. The injury is to how the brain works, not necessarily to its structure, which is why a CT or MRI can look completely normal in someone who clearly has a concussion. Advanced MRI techniques exist but are research tools, not standard clinical care.

Should I rest in a dark room until I feel better?

No. A short window of physical and mental rest in the first day or two is helpful, then a gradual return to light activity. The old advice of weeks of dark-room rest is out: prolonged rest actually slows recovery. The brain heals better with measured re-engagement.

What can I take for the headache?

Acetaminophen (Tylenol) for headache in the first few days. We hold off on ibuprofen and other anti-inflammatories early because they thin the blood slightly and we want to be safe about any bleeding inside the head. Melatonin can help with the sleep disruption that often comes with concussion.

What happens if my symptoms don’t go away?

If symptoms persist past the typical recovery window (post-concussion syndrome), we layer in targeted therapy: balance therapy for dizziness, vision therapy for visual symptoms, cognitive behavioral therapy for the mood and concentration changes, and supervised aerobic exercise to gradually build tolerance back up.

How does the return-to-sport protocol work?

Returning to sport happens in stages, not in one step. The standard pattern: complete rest, then light aerobic activity (stationary bike, easy walking), then sport-specific exercise (running, agility), then non-contact drills, then full-contact practice, then competition. You spend at least a day at each level, and you only move to the next stage after you’ve been completely symptom-free for that interval. Any return of symptoms drops you back to the previous step.

Further Reading

authoritative sources

External patient-education references and related OSI pages for additional background: