What is a concussion?
A Concussion (or Minor Traumatic Brain Injury) is a temporary loss of normal brain function caused by quick movements or impacts to the head, neck or face, leading to bruising and missed neuronal connections within the brain. Although I’m speaking more specifically to sports-related injuries, concussions can also result from other sources of trauma including motor vehicle accidents and falls.
Concussions are diagnosed based on the Symptoms that a patient presents with and describes, while brain scans, blood tests and physical examinations are typically normal (although still completed to rule out other serious conditions, such as a severe traumatic brain injury or internal bleeding). Symptoms vary from case to case, sometimes not developing until 24-48 hours post-trauma, which is the reason why you should seek medical attention even for minor and vague symptoms.
Common symptoms include:
· Worsening headache
· Feeling dazed or foggy
· Feeling disoriented
· Nausea or vomiting
· Poor concentration or attention
· Changes in mood or irritability
· Difficulty sleeping
· Sensitivity to light or sound
· Changes to vision or hearing
From my experience working with athletes (particularly football, ice hockey, American football, and rugby), I’ve seen too many players with concussion-like symptoms. It is questionable whether we are better able to identify symptoms, or whether our sports are becoming rougher with more direct hits to the head. Unfortunately, we still know too little about them to know how to fully treat and repair traumatic brain injuries. Based on the current best evidence, we know that the best treatment for traumatic brain injuries is temporary rest, lifestyle modifications, and pharmaceutical therapy when necessary.
Nutrition during recovery:
Diet is a small change that can have a huge impact on the recovery. Here are a few tips:
- Meals should be balanced, including plenty of vegetables and whole grains.
- Maintain a regular eating schedule – try to eat close to the same time, every day.
- Set reminders or an alarm for your meals in case you’re experiencing forgetfulness.
- Eat small meals every 3-4 hours.
- Larger meals may result in you feeling more fatigued than you are already experiencing.
- Keep snacks with you, like fruit, nuts, vegetables and trail mix.
- Keep hydrated! Dehydration can worsen many of the common concussion-like symptoms.
Image credit: Wikipedia
Nutritional Supplements that support recovery:
- EPA/DHA fish oil daily is found to reduce brain inflammation as a result of a concussion injury1. Fish oil can be obtained by increasing fish consumption through meals or by supplementing with an Omega 3 Fish Oil supplement.
- Vitamin D is seen to prevent post-concussive syndromes when used alongside conventional treatments2.
- Magnesium is known to contribute in the recovery of post-traumatic headaches by playing an important part of cellular membrane repair and maintenance3.
- Curcumin is not only found to be an anti-inflammatory post-trauma, but also provides significant neuroprotection4. Curcumin is found in the spice Turmeric for cooking or by supplementation.
Avoid these foods as they can be too stimulating during recovery:
- Excessive salty and sugary foods
Other factors that affect recovery:
Symptoms of a concussion often fully resolve within 6 weeks, however depending on the severity and history of previous concussions, post-concussion syndrome may persist for another several weeks.
There are many factors that can affect the severity and recurrence of a concussion. It is found that once someone has suffered one concussion, they are 4-6 times more likely to sustain a second one throughout their lifetime5. In addition, women are twice as likely to sustain a concussion, with the symptoms often being more severe and longer lasting6.
For student athletes, their involvement in regular coursework should be evaluated. Although not thoroughly studied, cognitive rest is often recommended as symptoms can greatly impact their attention, focus, learning, and mental health. The student’s medical provider and school should be involved in making a decision regarding this issue7.
Avoiding sources of symptom exacerbation may seem simple but it is often overlooked. Depending on the presenting symptoms, avoiding bright lights, loud noises, standing for long periods of time, and limiting the amount of focus required throughout daily life can make the recovery process much more pleasant.
Should you exercise?
It is supported that those diagnosed with a concussion should “rest” by avoiding contact and competition in sport until they have made a successful recovery from symptoms. This does not mean complete bed rest.
A study completed at the University of Buffalo actually found that those who participated in a controlled and individualized exercise program within 7 days of injury reduced their risk of persistent post-concussive symptoms compare to those who did not exercise. They advise for exercise to be maintained below the threshold where symptoms are worsened8.
As a health professional working with athletes, I am pleased to see increased research and awareness about concussions. The movie Concussion (Sony Pictures) with Will Smith provided great promotion to the real life story of Dr. Bennet Omalu who studied American football-related brain trauma. The more that our athletes, coaches and parents know about the consequences of concussions, the more we can do to prevent such trauma and improve the recovery process.
The SCAT3 (Sport Concussion Assessment Tool) is a standardized assessment that guides medical professionals through an accurate evaluation9. Teams that are able to complete pre-season baseline testing allows for a helpful interpretation of post-injury scores.
Coaches, parents and trainers should have access to a Concussion Recognition Tool, which informs non-medical professionals about red flags and signs of a possible concussion9. Both assessment links can be found below for free download.
Sport Concussion Assessment Tool (SCAT3) for Medical Professionals Download: http://bjsm.bmj.com/content/47/5/259.full.pdf
Concussion Recognition Tool Download:
About the author: Tara Hambley @tarahambley
I am a Canadian trained Naturopathic Doctor currently living and gaining international experience in the United Kingdom. I remain involved in education by lecturing at the British College of Nutrition and Health (through the University of Greenwich) in the topics of anatomy, physiology, pathology and nutrition. In addition, I provide nutritional consultations for rugby and football teams throughout Essex. My clinical areas of focus include health promotion, disease prevention, athletic performance and injury rehabilitation. Follow me on Twitter @tarahambley to keep updated with what’s trending in the field of health and wellbeing.
- Wu A, Ying Z, and Gomez-Pinilla F. Omega-3 Fatty Acids Supplementation Restores Mechanisms that Maintain Brain Homeostasis in Traumatic Brain Injury . Journal of Neurotrauma 2007, 24(10): 1587-1595.
- Cekic M and DG Stein. Traumatic brain injury and aging: is a combination of progesterone and vitamin D hormone a simple solution to a complex problem? Neurotherapeutics 2010; 7(1):81-90.
- Packard RC. Chronic post-traumatic headache: Associations with mild traumatic brain injury, concussion, and post-concussive disorder. Current Pain and Headaches Report 2008; 12(1): 67-73.
- Petraglia AL, Winkler EA and JE Bailes. Struck at the bench: Potential natural neuroprotective compounds for concussion. Surgical Neurology International 2011; 2: 146.
- Delaney JS, Lacroix VJ, Leclerc S and KM Johnston. Concussions among university football and soccer players. Clinical Journal of Sports Medicine 2002; 12(6): 331-338.
- Covassin T, Swanik CB, and ML Sachs. Sex differences and the incidence of concussions among collegiate athletes. Journal of Athletic Training; Dallas 2003; 38(3): 238-244.
- Arbogast KB, McGinley AD, Master CL, et al. Cognitive Rest and School-Based Recommendations Following Pediatric Concussion: The Need for Primary Care Support Tools. Clinical Pediatrics 2013; 52(5): 397-402.
- Grool AM, Aglipay M, Momoli F, et al. Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents. The Journal of the American Medical Association 2016;316(23):2504-2514.
- McCrory P, Meeuwisse WH, Aubry M, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine 2013: 47: 250-259.
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