Is it a Concussion: What To Know


Concussions are on the Rise

Over the past five to ten years, concussion awareness has soared.  From Troy Aikman in the NFL to Johnny on the lacrosse team, there is much more awareness than there was in the past.


When I was an ATC, it was NOT uncommon for me to pull a kid or closely monitor an athlete and have the coach come over and comment, “Eh, he just rung his bell a little.  He’s fine.”

The problem with that is if Johnny “rings his bell” enough times, he might suffer irreversible brain damage or death.

This is not meant to scare parents. It’s just a fact. I used to tell my athletes, “I don’t have X-Ray or CT Scan vision.  Not even MRI vision, which I think would be lovely and helpful from time to time.”  You cannot see what is going on in someone’s head.  You can only monitor and check what you CAN see. 

I read an October 2011 article on citing research done by the CDC in 2009. It stated that in the last 10 years, the ER visit rate for head injuries increased by 60%. There was also this interesting piece of info:

“A 2010 study published in Pediatrics found that the number of 8 to 13 year-olds seen in the ER had doubled over a 10-year period, while visits among 14 to 19 year-olds had tripled in the same time period.”

So, why the increase in ER visits?

Perhaps it’s parental awareness, that is the hope anyway. Perhaps it’s because head injuries over all are being taken more seriously.  Whatever the reason, the article states, and I would agree, that the actual number of concussions sustained by young people is still under reported.  

Please let me reiterate that you cannot see what is going on inside someone’s skull.  As much as you can predict someone’s thoughts or feelings can you predict the health of their meninges or the integrity of their arteries.  The only thing you can do is observe and compare it to the “baseline” or what is already known about the athlete.

Symptons of a Concussion


Here is what I consider to be a pretty comprehensive list of symptoms across the spectrum: (I found it here)

Physical Symptoms

Loss of consciousness immediately following the injury

Headache, nausea, or vomiting

Dizziness, difficulty with balance

Drowsiness or insomnia

Weakness, fatigue

Double or blurred vision, or sensitivity to light

Ringing in the ears or decreased hearing ability

Decreased ability to taste or smell

This is where we usually all stop – the physical.  And we stop looking after the first hour or two.  But even if these physical symptoms present 6-12 hours later, they should be taken seriously.  But the mental and emotional parts can be just as telling and important.

Mental Symptoms

Cognitive (Mental) Symptoms

No memory of events immediately before or after the injury

Difficulty concentrating

Repeatedly asking the same question


Slow thinking

Poor judgment

Poor school performance

These again are often evaluated at the time of injury, but careful observation over the course of the next few days to week or so can be very important clues as to the brain health of the athlete.

Emotional Symptoms

Irritability, anxiety, or restlessness


Mood swings

My experience has been that while anxiety, combativeness, and mood swings are COMMON at initial onset, they are also common, and commonly overlooked over the next week.

What You Need To Know:

Head injuries are very serious.  If you suspect a head injury, do not hesitate to have your child checked by a physician.  Better safe than sorry.

If your child does sustain a head injury, do not give them any medication for at least the first 24 hours. Medication given could mask the symptoms or even make them worse (in the case of a brain bleed). 

If, even after the athlete has been cleared to return home by an Athletic Trainer or other certified Health Practitioner, any of the symptoms above show up or get worse, go to or return to the ER immediately. 

It is normal for adolescents and young adults to have the emotional effects of head injuries.  If you really think something is wrong, do something.  Don’t listen to them when they tell you everything is OK and they are fine.  You know your child, trust you gut and have them checked. 

Mild concussion symptoms can and often do take up to a week (or more) to truly subside.  Kids know that they won’t be able to play if they say they have a headache, feel sick to their stomach or looking at the board in the front of the room hurts their eyes.  Once the brain has been injured, even just a little, it is infinitely more susceptible to repeat injury.  

Translation: if they get a mild concussion, and after 3 days say they are fine and return to play, the same amount of force it took to injure them the first time could injure the brain again, and it will be worse and require a longer rest period.  This is called Second Impact Syndrome – read more about it at

After boxers, the second most effected population is ADOLESCENTS.


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