A concussion is a form of a traumatic brain injury that happens when your brain is shaken within your skull. Concussion is also known as mild traumatic brain injury (mTBI), but the term mild does not diminish the serious impacts that concussion can have on your health and daily activities. Playing sports, tobogganing, and recreational vehicle accidents are the most common ways people your age get concussions [1]. But it may have happened through a fall, an accident, or even whiplash.
While the majority of people recover from a concussion within one month, in some cases symptoms may last longer than expected. Prompt medical assessment and management can help diagnose concussions and ensure you are provided with proper education, guidance, and treatment to recover fully.
Let’s talk about:
Signs you have a concussion
If you have suffered any trauma to your head and/or whiplash, and you experience symptoms of concussion, it is important to seek medical help. This includes if you have been in a traumatic accident; assaulted; fallen; or injured playing sports. Possible signs of concussion include [2]:
- Headache/migraine
- Dizziness and balance problems
- Nausea
- Fatigue
- Sleep disturbance
- Vision changes
- Sensitivity to light or noise
- Ringing in the ears
- Seizure
- Problems with smell/taste
- Foggy-feeling
- Difficulty remembering and focusing
- Slower information processing
- Trouble thinking clearly or finding your words
- Difficulty making decisions or plans
- Behavioural changes like depression, anxiety, irritability, aggression, or impulsivity
National concussion guidelines recommend that all those with a suspected concussion undergo prompt medical assessment by a physician or nurse practitioner.
Please note: You may not experience all symptoms – but if you are experiencing any of the following after a physical injury, visit your doctor.
When to seek medical attention
You should see a doctor right away if you or someone you are caring for is experiencing the following symptoms after a traumatic event.
- Significant neck pain or tenderness immediately after the injury
- Double vision
- Seizure or convulsion
- Weakness or tingling/burning in arms and legs
- Severe or increasing headache
- Deteriorating conscious state
- Repeated vomiting
- Increase in restlessness, agitation or combative behaviour
If the person is experiencing these symptoms in extremes, call 911 and use emergency services.
Who can diagnose a concussion?
Unfortunately, there is no formal test to officially diagnose a concussion. They don’t show up on imaging tests like CT and MRI scans. A registered doctor or nurse practitioner will diagnose you based on the symptoms you have.
Please note: In Quebec, nurse practitioners are not able to make a concussion diagnosis and in Manitoba, physician assistants are licensed for medical assessments [3].
How long will it take to recover from a concussion?
If this is your first concussion, you may be fully recovered within a few days to weeks after your injury. However, no two concussions are the same, which means that recovery time is different for everyone. Your doctor will be the person to speak to about your recovery questions.
What can impact my recovery?
There are several factors that are taken into consideration when doctors are mapping out your possible recovery path.
Your medical history
Doctors will look at what medical conditions or injuries you’ve had in the past, including:
- History of previous brain injury
- Previous neurological or psychiatric problems
- Effects of other health issues like medications, bodily injuries, etc.
- Anxiety
- Depression
- Insomnia
- The number of symptoms you are experiencing
Personal or environmental factors that may negatively affect recovery
There may be some factors in your life or environment that impact your concussion recovery, including:
- How you were injured (e.g. motor vehicle accident, assault)
- Significant delays or not returning to school following the injury
- Life stressors
- Lack of social support
- Biological factors
- Lower resilience
- Returning to a contact sport too early
Multiple concussions and second impact syndrome
Getting another concussion while you’re still recovering from a previous one may increase the risk for long-term problems. Second impact syndrome is a rare event where a second concussion happens when you’re still recovering from the initial one, which can lead to uncontrolled brain swelling. Most reported cases have been in teenagers and young adults. In a few cases worldwide, it has even been linked to death [4].
It’s so important to fully heal from your first concussion before returning to any sport or activity that could put you at high risk of getting another. When you do return to a sport or activity, you should speak with your coach or teachers about safety precautions.
All these factors can impact how quickly you recover from your concussion [5].
Tips for your concussion recovery
Your doctor(s) will be the one to give you specific recommendations for concussion recovery. There are some general tips you can use in your recovery as well.
Appropriate rest and activity
Research has found that slowly becoming more active after 24-48 hours of rest will help your recovery, while long periods of rest may do more harm than good [6]. So while you should get more rest than you usually do, you should reintroduce activities gradually. As your symptoms decrease, the more active you may be able to be [7]. You should always talk to your doctor before restarting activities that have a larger risk of injury (like sports).
If your symptoms get worse when you’re active, try easing back. It may take a while to find your balance.
There is also no set timeline for when you’re supposed to be able to return to regular activity. The important thing is that you take your time and talk to your doctor regularly.
Return to school slowly
Like with physical activity, your return to school should be gradual, building up over time. Depending on how severe your concussion is, your return could begin a few days to a few weeks after your injury. You should make sure to talk with your teachers and parents about your concussion, any symptoms you’re still experiencing, and how best to build back up to a full day [8].
Other tips you can follow when you return to school are:
- Keep a journal to record your symptoms at the start and end of your day to figure out how you’re feeling and your progress.
- Take regular breaks to give your brain time to rest.
- Plan for additional time to finish tasks so you don’t feel rushed.
- Find a quiet environment to help you focus.
- Ask for help
If you are having trouble with school assignments, chores, or other parts of your day, ask someone for help. It’s better to do that than push yourself too hard.
Bring someone with you to appointments
When you experience a concussion, symptoms can make it difficult for you to remember information. If they’re not already, make sure you have a parent or caregiver in the room when a doctor or therapist is giving you a diagnosis or recommendations. They can help you by writing notes, remembering details, scheduling appointments, and communicating for you if your symptoms make it hard for you to do it.
What if my symptoms aren’t going away?
If you still have symptoms one month after your initial injury, these are called persistent symptoms (sometimes referred to as prolonged symptoms or post-concussion syndrome). Every person’s recovery is different, so don’t be too worried if you do have some symptoms after the one-month period. But you should talk to your doctor about the symptoms so you can get more information.
Persistent symptoms can include:
- Headaches
- Fatigue or difficulty with sleep
- Unsteadiness or decreased balance
- Memory or concentration problems
Your doctor may want to do more tests and check in with you more often if it turns out you have persistent symptoms. Their tests and medical investigations will tell them how to manage your symptoms.
If you’re experiencing seizures, slurred speech, or numbness you should tell your doctor right away (even if it hasn’t been a month yet).
Private concussion clinics
If you’re doing some research on concussion recovery, you may come across businesses that are called concussion clinics. These are generally private (meaning you have to pay to access them). These private clinics have no federal or provincial oversight or regulations and there are no guarantees with the services they provide. When figuring out whether a private clinic is right for you, ask the following questions [9]:
- Does the clinic have a medical doctor?
- Does the clinic have a team of licensed health care professionals?
- Does the clinic follow the most up-to-date standards of care for managing a concussion?
- What tools, tests and recommendations is the clinic using?
Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:
- The product or service promises a quick fix
- Sound too good to be true
- Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
- Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
- The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
- Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based
Always proceed with caution and with the advice of your medical team.
[2] Ontario Neurotrauma Foundation concussion guidelines
[5] Source: ONF Concussion guidelines
[6] Dawson J, Reed N, Bauman S, Seguin R, Zemek R. Diagnosing and managing paediatric concussion: Key recommendations for general paediatricians and family doctors. Paediatr Child Health. 2021 May 20;26(7):402-407. doi: 10.1093/pch/pxab024. PMID: 34777657; PMCID: PMC8581524.
[7] CATT
[8] Reed, et al., 2019, Returning to Activity After a Concussion
[9] The ABI Network 4 Characteristics of a Good Concussion Clinic
