Story by: David Steen Martin on March 11, 2021
The typical time it takes an athlete to heal from a concussion ranges from two to six weeks and follows an evaluation at each step before the athlete is approved to return to play, according to Tad D. Seifert, M.D., director of the Norton Neuroscience Institute Sports Neurology Center.
The entire process can take as little as six to seven days, although this is somewhat atypical. Steps progress in terms of intensity and duration of physical activity, starting with noncontact activity for the first 72 hours.
Caution is required, as a second injury within a short period of time, from 24 to 48 hours, or possibly as long as 10 to 15 days, significantly increases the risk of catastrophic effects — and a much more prolonged recovery.
“If you can’t wake someone up or have someone alert enough to at least carry on a basic conversation, that’s a worrisome sign.”— Tad D. Seifert, M.D.
“If you can’t wake someone up or have someone alert enough to at least carry on a basic conversation, that’s a worrisome sign.”
“You don’t have to be hit directly on the head to be concussed,” said Dr. Seifert, a neurologist. “You can be hit in the torso or body, or have just simply a sudden whiplash-like movement of the head and neck, and that can induce the injury.”
As the athlete can progress through the steps without concussion symptoms returning, more sports-specific activity is added in. Ultimately, the athlete resumes contact in practice to make sure contact is tolerated. If so, the athlete can be cleared for full game participation.
Understanding changes in the athlete’s mood and behavior also provides information key to gauging recovery, according to Dr. Seifert, an unaffiliated neurotrauma consultant with the NFL and NASCAR, as well as the former chairman of the Kentucky Boxing and Wrestling Commission Medical Advisory Panel.
The athletes, their parents, roommates and coaches can provide valuable information to help guide the recovery.
“That history is just invaluable to being able to diagnose what happened and then help institute a plan going forward,” Dr. Seifert said during a recent episode of the “MedChat” podcast, “Identification and Management of Sports-related Concussions.”
“If you can’t wake someone up or have someone alert enough to at least carry on a basic conversation, that’s a worrisome sign,” Dr. Seifert said.
Contrary to the widely accepted belief 15 to 20 years ago, it’s not necessary to wake up someone who’s had a concussion every hour on the hour all night after the injury, according to Dr. Seifert.
Norton Neuroscience Institute’s board-certified and fellowship-trained neurologists use a collaborative approach to identify, evaluate and treat concussions.
Dr. Seifert recommend waking the individual up over the first four hours to ensure they can be awakened easily, and using the opportunity for a cognitive check. After that, sleep can be beneficial.
“The brain loves sleep after an injury like this, and, in fact, most people will find that they’re sleeping more than they typically do over the first two or three days,” he said.
Post-concussive syndrome is defined by concussion-related symptoms that last more than three months. Post-concussion syndrome is treatable, potentially with psychiatric medications for underlying anxiety, depression or mood instability. Typically, these patients also need ongoing headache treatment. They often also need therapy for lightheadedness, balance issues or eye movement.
“Most people tend to respond really well to a multifaceted approach like that,” Dr. Seifert said.
Chronic traumatic encephalopathy (CTE) can occur in athletes who have careers with a lot of head or brain trauma. As they reach middle age, they can experience difficulty with speech, balance, memory and mood. No test exists to diagnose CTE. The condition can be confirmed in an autopsy.
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