My 15-year-old daughter dinged her head in a soccer game about two weeks ago. She had a headache and some dizziness. Our doctor said she likely had a mild concussion. I've kept an eye on her and kept her home from practice. She feels better but I'm still worried about her returning to normal play. When is it safe to return to normal activity after a concussion?
If a concussion is suspected, an athlete should not return to play that day. The athlete should not participate in activities which require physical exertion until they are aysmptomatic at rest. Depending on the symptoms the athlete is experiencing it may be important to limit activities with increased cognitive demands such as school work, sitting in front of a computer screen, or texting on a mobile device. In order to participate in a return to play program the athlete must receive written clearance from their medical doctor. The athlete must successfully complete the five steps of the program in order to return to full competition. The program may take five days to several weeks depending on the athlete. The steps include no activity, light aerobic activity, sport specific exercise, non-contact training drills, full-contact practice, and return to game. The athlete is only able to progress to the next step if no symptoms occur. If symptoms do occur during one of the steps the athlete is to rest for no less than 24 hours or until asymptomatic before returning to the previous step. The program should be monitored by an athletic trainer or other trained healthcare professional.
Jonathan Burke DPT, MTC, CSCS, FMS, CrossFit L1?Therapydia Nola?http://www.therapydianola.com
Great answers by Jonathan and Brian. I want to reinforce that when returning a young athlete from a concussion return to academics should always come before return to game. Also, adolescents do generally heal slower from a concussion as previously stated and most likely due to the young athletes continued brain growth which also makes them highly susceptible to second impact syndrome which can result from a second impact before fully healed from the first. What is extremely important to understand is this second impact can be much less violent than the first but can potentially cause serious neurological deficits such as speech loss, motor control loss, or worse. How concussion are manage today is much different than the old adage of "shake out the cobwebs and get back into the game". What we know about concussions is that they are serious, they need to be taken seriously, and we are learning more everyday with significant research and time committed to understanding this injury.
Average healing time for a 15 year old after Concussion can take anywhere from 3-4 weeks. Studies have shown that females in this age group can take longer than males. However, if your daughter continues to have headache and dizziness symptoms, you need to figure out why these symptoms are occurring. Is it from mental exertion (reading, TV, noise, light, etc)? It is from physical exertion? Have you considered having her checked out by a Concussion Specialist or Neurologist who specializes in Pediatric Athletes? The most honest answer is that every Concussion is unique. Generally speaking, in terms of physical activity, your daughter needs to complete a gradual return to play protocol by a trained medical profession (usually a Physical Therapist or Athletic Trainer) to ensure that Heart Rate response is appropriate for the intensity of physical exertion. If your daughter has any symptoms (headache or dizziness) during any of the activities, she will not pass into the next stage. The last stage of the return to play protocol is to return to practice before full contact in a game setting. If you would like a full copy of the University of Pittsburgh return to play protocol, please let us know.
Brian Blatt, PT, DPT, Cert. MDT
Strive Physical Therapy (Moorestown, NJ)