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High School Football Concussions - Symptoms, Treatment & Returning to the Field

Approximately 140,000 high school athletes suffer from a concussion each year. High School football players are more likely to suffer a concussion than high school athletes in any other sport. In Pennsylvania, student athletes who show signs or symptoms of a concussion must be removed from play and can not return until cleared, in writing, by a medical professional. But, as an athlete recovering from a concussion or as a parent, do you know what to watch for?

Signs and Symptoms

A concussion occurs when the brain collides against the skull from a blow to the head or body. Contrary to what most people believe, only 1 out of 10 athletes actually lose consciousness when a concussion occurs. This makes diagnosing a concussion tricky. The 3 main features of a concussion are: Inability to maintain a coherent stream of thought, disturbance of awareness with heightened distractibility, and an inability to carry out a sequence of goal-directed movements. Below is a chart of symptoms that are most commonly reported. These symptoms cover physical, mental, and emotional disturbances.

The First 24-48 Hours

Immediately following a concussion in high school football, the athlete should be removed from play for the next 24 hours regardless of the severity of symptoms. Rest is the most important treatment for concussions. Not only physical rest, but mental rest as well, which means limiting use of television, computers, and cell phones. An athlete can resume normal daily activities such as driving once the concussion symptoms start decreasing. All exercise should be stopped until cleared by a medical professional and symptoms have resolved for 24 hours.

In the past, it was recommended to wake up your child every 3 to 4 hours to assess their symptoms, but new research shows that your child can sleep through the night as long as symptoms have been decreasing and no new symptoms have surfaced. If your child lost consciousness, had amnesia, or still had significant symptoms before bed you may be instructed to still wake your child up every 3 to 4 hours to check on their symptoms.

The days following a concussion a headache is typically the most reported side effect. It is okay to treat the headache with Over-the-Counter options such as Tylenol or Advil.

Go to a hospital if your child experiences any of the following symptoms: worsening headaches, worsening drowsiness, losing recognition of people, vomiting, unusual behavior, seizures, unexplained numbness, slurred speech, or unsteadiness.

Care Beyond 48 hours

Depending on the severity, concussion symptoms can begin to resolve within the same day or may take weeks to months. On average, symptoms last anywhere from 2 to 3 weeks. As long as symptoms continue, rest is extremely important because it gives the brain time to recover. Activities that require concentration and attention can exacerbate symptoms and extend the recovery time. It is best to limit school-related activities until symptom free. When returning to school, a lightened course load, or shortened day may be needed initially until attention, memory, and concentration are back to baseline.

Post-Concussion Syndrome (PCS)

For 85-90% of student athletes concussion symptoms resolve within 10-14 days, but for the other 10-15% symptoms can last weeks or months beyond that. It is not medically known why this occurs but certain factors can increase the risk of PCS such as: history of concussions, pre-existing depression or anxiety, stress, young age, and not resting adequately. If symptoms last 3 to 4 weeks follow up with a medical professional. There is no single approach to treat PCS. Treatment will be tailored to the specific symptoms (i.e. sleep issues, depression, anxiety, mood changes).

Returning to Play

Symptoms can last from hours to months depending on the severity which makes deciding when to return to play hard to determine. Below is the Sports Concussion Institute's protocol for returning to play. It is a step-wise approach which involves being symptom free for 24 hours before moving on to the next step. This gives coaches, parents, and the player adequate time to assess improvement or the need to rest further. It is important not to rush returning to the football field. Leaving the field when a concussion occurs instead of “playing through it” will actually speed up recovery time

As a high school football athlete or parent of an athlete, it is important to be aware of the signs and symptoms of a concussion. Recovery is a collaborative approach involving doctors, coaches, parents, teachers, and most importantly the athlete. To continue a healthy football career it is important to listen to your body and to take as much time as is needed before returning to the field.


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