Return to School and Play After Concussion

By Brian P. Rieger, PhD
Chief Psychologist & Clinical Assistant Professor, Department of Physical Medicine & Rehabilitation, SUNY Upstate Medical University
Director, Upstate Concussion Center

Concussion is a common injury in children, and can cause physical, mental, and emotional symptoms that typically last for about a week.  Sometimes symptoms will last longer, especially if proper steps are not taken to prevent complications.  While a child is still experiencing concussion symptoms, it is important to 1) avoid re-injury, and 2) avoid over-exertion, both physical and mental.

Common Concussion Symptoms

Physical

Mental

Emotional

Headache

Dizziness

Balance problems

Blurred vision

Sensitivity to light & sound

Feeling tired all the time

Dazed or confused

Difficulty concentrating

Memory problems

Disorganized

Trouble reading

Getting irritated easily

Feeling more sad or anxious

Easily overwhelmed

Personality changes

 Sports concussion has received a lot of research and media attention lately, but the basic guidelines for return to play after concussion actually haven’t changed much in the last decade.  After suspected concussion, an athlete should immediately be removed from athletic activity and should undergo medical evaluation.  If a diagnosis of concussion is confirmed, then a period of rest and reduced activity is recommended until the symptoms go away, followed by a gradual increase in physical activity.  If headache, fatigue, or other symptoms return after physical exertion—which is not uncommon—then it signals that the brain may not be fully recovered.   When a child is able to engage in vigorous activity without return of symptoms, then he or she eligible to return to all sports and physical activities.

Return to school after concussion has received much less attention than return-to-play, but is certainly no less important.  Many student-athletes and their parents are unaware of the possible academic effects of concussion, such as trouble focusing in class, increased headaches from reading or doing math problems, or trouble keeping up with schoolwork due to getting tired more easily and needing a lot more rest.  Crowded hallways, bright classrooms, and noisy cafeterias can also worsen symptoms, which in turn will reduce the student’s ability to learn.

To help students recover and keep up with their learning after concussion, a number of academic accommodations can be put in place such as rest breaks during the day, extra time on tests, and reducing the amount of homework.  As with return-to-play, return-to-learn should involve a gradual increase in academic activity that is guided by the student’s symptoms.  If the headache, dizziness, or other symptoms are worsening over the course of the school day, then the student is most likely doing too much.

For more information about the academic consequences of concussion as well as suggested academic accommodations, you can check out our Concussion in the Classroom brochure and video online at:

http://www.upstate.edu/pmr/healthcare/programs/concussion/classroom.php

A concussion occurs when a blow or jolt to the head disrupts the normal functioning of the brain.  The immediate symptoms of concussion can be frightening, especially for parents who observe their children acting confused or having trouble following a conversation.  Thankfully, most children will recover from concussion in a matter of days or weeks, with no long-term consequences.   A gradual return to physical and mental activity is recommended after concussion, as symptoms allow.  If symptoms last longer than 2-3 weeks, or if there is a history of multiple concussions, then specialized care in a comprehensive concussion program should be considered.

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