If you watch football, you’ve seen it. An individual running across the middle for a ball when out of nowhere, a missile in the shape of a man pummels the unsuspecting individual. You see the player lying on the ground writhing in pain and then getting to his feet visibly shaken.
Yet somehow, in a couple plays up to a few weeks, they’re right back at it again. Despite the way concussions may be downplayed in professional sports, it is a serious condition that requires immediate attention and sports rehabilitation.
But how do I know I have a concussion?
It doesn’t require bone-jarring hits for an individual to sustain a concussion. In fact, it’s possible to sustain a concussion without hitting your head. For example, imagine an unsecured purse or bag placed in the passenger seat. When you suddenly slam on the brakes, you stop — but what does the bag do? It continues to fly forward and smashes into your dashboard or flops onto the floor. A concussion occurs when your brain suddenly and rapidly hits the inside of your skull. Similar to the illustration, when your head suddenly changes in direction, your brain can fly into the inside of your skull when enough force is applied.
What do I do if I think I may have a concussion?
It is our professional recommendation that you contact your doctor immediately if you suspect that you may have suffered a concussion. Unlike the professional world, most of us don’t have immediate access to a doctor, nor have we taken a baseline test for our balance and cognitive functioning that is commonly used for the 1-minute and 2-minute concussion tests.
So how can we test it ourselves?
| Test | Procedure | Positive indicator |
| Memory | Give the individual 3 random words to memorize before you begin testing | – Failure to recall after 5 minutes |
| Vision | Have an individual track the eraser or cap of a pen/pencil while you move it up/down/side-to-side | – Eyes begin to skip – Difficulty following your movements – Dizziness or nausea |
| Sensitivity | Monitor the individual and ask them if they feel sensitive to loud noises or light | – Sensitive to loud noises – Sensitive to light |
| Reflex | Use a light to check the pupil’s reflex responses | – Poor pupil response to light changes |
| Balance | Have the individual balance on a single leg while performing a cognitive task (adding 7s up to 100, listing a category of objects, etc.) | – Consistent loss of balance |
| Cognitive | Have the individual perform moderate cognitive tasks that would be easy for them normally (recite the months backward, multiplication tables, etc.) | – Inability to perform the task correctly |
| Speech | Converse with the individual and ask them many questions about the day, the time, interests, things that they were doing | – Incoherent or incorrect answers due to confusion |
| General signs | You should also look for nausea, vomiting, and loss of consciousness | – Nausea – Vomiting – Loss of consciousness |
Now, by no means is this an exhaustive list of tests but it is a good baseline and can provide valuable information to the doctor when you are able to see them. It is my recommendation to perform these tests multiple times throughout the first 12-24 hours to see if there is a drastic change. It is my strong recommendation to seek emergency care if symptoms continue to worsen or if there is a drastic change in symptoms after, establishing a baseline for the individual.
What exercises can I perform for a concussion?
One of the most important things after a concussion is to get proper care through your MD which will often result in referral to a physical therapy clinic for neurological retraining. This is often done to restore the proper function of the eyes and vestibular system which are major proponents of balance and daily function.
Below is a list of exercises that are great starters to help with visual issues. Please perform them while sitting down as this may increase fall risk. If you don’t feel that you can perform all of these exercises, please only perform as many as you’re comfortable doing. These exercises may cause some discomfort and dizziness. Stop if you become excessively dizzy and nauseated. This is by no means an exhaustive list, as balance and cognitive therapy with a physical therapist are also recommended.
| Eye Movement |
· Keep head still · Move eyes up/down, then side to side. · Repeat 5 times |
| Head Movement |
· Move head up and down, then side to side, then diagonally right to left · Repeat 5 times |
| Eye-Head Movement |
· Hold your thumb directly out in front of you and focus on your thumbnail · Move the thumb up, down, and side to side and follow with your eyes and head · Repeat 5 times |
| Gaze Stabilization |
· Place a sticky note or an object on the wall at eye level. · Write a capital letter on the object and stand about 3_5 feet away from the wall (usually around one large step backward) · While keeping your eyes steady on the target, rotate your body side to side for 1 minute |
| Saccades |
· Place two sticky notes/objects about 12 inches apart on a wall, at about eye level · Take a large step backward from the wall · Start the exercise by looking back and forth between the two objects quickly · Objects can be placed horizontally and vertically |
| Convergence |
· With your thumbs up, fully outstretch one arm and bring one thumb close to your face · Focus your eye on the farthest thumb and hold for 10 seconds · Then switch your focus to the closer thumb and hold for 10 seconds · Repeat 5 times and slowly increase the repetitions as you increase tolerance |
If you think you have a concussion, it’s important to see a health professional. You can safely get back on the field with sports rehabilitation. Find a physical therapy clinic near you.
