Concussion Information

What is a Concussion?

A concussion is a mild traumatic brain injury (mTBI). It is caused by acceleration or deceleration of the brain within the skull following an impact to the head, face, neck, or body that disrupts normal brain functioning.

Recognize

Recognizing the signs and symptoms of a concussion is important because a concussion doesn’t show up on imaging like an X-ray, CT, or MRI scan and there is no objective test, like drawing blood or saliva, that can determine if an individual has a concussion. If someone experiences an impact to the head, face, neck, or body, and either shows observable signs or reports symptoms of a potential concussion, it's crucial to consider the possibility of a concussion.

Respond

It's essential that anyone suspected of having a concussion be removed from the activity immediately and undergo medical assessment as soon as possible. Depending on the suspected severity of the injury and access to medical services, an initial assessment may be completed by emergency medical professionals or by an onsite licensed healthcare professional, where available. In cases where any red flags are present, emergency medical assessment by emergency medical professionals should take place.

Diagnosis

A concussion is diagnosed only by a licensed medical doctor or nurse practitioner. In geographic regions of Canada with limited access to medical doctors and nurse practitioners (i.e., rural, remote or northern communities), a licensed healthcare professional, such as a nurse with pre-arranged access to a medical doctor or nurse practitioner, can facilitate this role.

Medical Assessment Letter

Individuals diagnosed with a concussion should receive a Medical Assessment Letter and follow a gradual return to school, work, and sports. Those without a concussion diagnosis should also receive a Medical Assessment Letter and can resume activities without restriction. Since the letter contains personal health information, the individual or their parent/guardian is responsible for providing it to coaches, teachers, or employers.

Exercise

Returning to light physical activity as tolerated (such as walking) in the initial 48 hours is recommended if there’s no risk of injury. Aerobic exercise within 2 to 10 days after concussion has been shown to help with recovery and prevent symptoms from persisting. Thus, progressive increases in exercise intensity are recommended, according to symptom tolerance levels, as long as there’s no risk (that is, head impact, collision or fall). Slight worsening of symptoms with exercise is acceptable as long as the symptoms improve within 1 hour.

Refer

The most common complication of a concussion is post-concussion syndrome (PCS), characterized by persistent symptoms lasting more than 4 weeks after the initial injury. It is important to follow-up with a medical professional if you are worried that the person is not improving or that symptoms are prolonged. Individuals of all ages who have ongoing (persisting) symptoms should be referred for further evaluation by clinicians that have specialized knowledge in concussion.

Persistent symptoms can affect your daily life and make it difficult for you to perform regular activities. Licensed healthcare practitioners with training in concussion management may include medical doctors, physiotherapists, chiropractors and athletic therapists, among others. Find a Concussion Clinic Near You.

Baseline Testing

Baseline testing refers to the practice of having an athlete complete certain concussion assessment tools prior to sport participation to provide baseline measurements that can be compared to post-injury values in the event of a suspected concussion.

Parachute Canada's Statement on Baseline Testing states, "Baseline testing using any tool or combination of tools is not required to provide post-injury care of those who sustain a suspected or diagnosed concussion and mandatory pre-season testing is not recommended".

For more information you can view Parachute's Statement on Concussion Baseline Testing in Canada or view Parachute's Baseline Testing Fact Sheet

Learning From Tragedy - Rowan's Law

Rowan’s Law was named after Rowan Stringer, a high school rugby player from Ottawa, who died in the spring of 2013 from a condition known as second impact syndrome. Rowan is believed to have experienced three concussions over six days while playing rugby. She had a concussion but didn’t know her brain needed time to heal. Neither did her parents, teachers, or coaches. Rowan’s Law and Rowan’s Law Day were established to honor her memory and bring awareness to concussions and concussion safety. The last Wednesday of each September has been designated as Rowan’s Law Day to help raise awareness about concussion safety.