Concussions in Sport: Understanding the Risks & Safe Return to Play by Megan Schneider Senior APA Physiotherapist

Introduction

Sports are a fantastic way to stay active, build teamwork, and develop resilience. However, the fast-paced and physical nature of many sports also brings the risk of injuries, with concussion being one of the most serious.

A concussion is a mild traumatic brain injury (TBI) that requires careful management. Unlike muscle strains or sprains, concussions affect brain function, meaning a gradual and structured return to play (RTP) is essential for safe recovery.

In this article, we’ll explore what a concussion is, the risks associated with it, and evidence-based return to play protocols that apply across all sports, but commonly contact sports.

What is a Concussion?

 A concussion is a mild form of traumatic brain injury resulting from a forceful impact to the head neck or body.

The physical forces that occur at the time of injury are transferred to the brain. These forces cause the nerve cells and blood vessels to stretch and rebound, resulting in damage and a temporary change in normal brain function, affecting coordination, memory and balance.

 Common Symptoms of a Concussion

   •       Headache

   •       Dizziness

   •       Nausea or vomiting

   •       Sensitivity to light and noise

   •       Confusion or difficulty concentrating

   •       Memory problems

   •       Loss of balance or coordination

   •       Fatigue

   •       Blurred vision

Symptoms can appear immediately or develop hours to days later, making it essential to monitor athletes closely after a suspected concussion.

Why Are Concussions a Serious Concern?

 Concussions are common in contact sports like football, rugby, hockey, and combat sports, but they can also occur in non-contact sports due to falls, collisions, or accidental impacts.

Risks Associated with Concussions

Second Impact Syndrome (SIS)

If an athlete sustains a second concussion before fully recovering from the first, it can cause rapid brain swelling, which can be fatal. This is especially dangerous for youth athletes, as their brains are still developing.

Athletes who have experienced a concussion are 4x more likely to experience another concussion. And twice as likely to sustain a lower limb injury due to impaired nerve and muscle control.

Chronic Traumatic Encephalopathy (CTE)

Repeated head injuries over time can lead to long-term brain degeneration, increasing the risk of memory loss, depression, and cognitive decline later in life.

Prolonged Recovery & Mental Health Impact

Concussions can result in extended time away from sport, school, or work, which can cause frustration, anxiety, or depression, particularly in young athletes.

Because of these risks, returning to play too soon is dangerous. A gradual return-to-play (RTP) protocol is crucial for full recovery and future brain health.

Return-to-Play (RTP) Protocol for Athletes

The latest sports medicine guidelines recommend a stepwise approach to ensure athletes return to competition safely and symptom-free.

Key Guidelines:

   •       If symptoms return at any stage, the athlete must rest for 24-48 hours and drop back one step.

   •       Medical clearance is required before returning to contact training or games.

   •       Younger athletes (<19 years old) may require an extended recovery period.

Final Thoughts: Prioritizing Athlete Safety

Concussions are a serious injury that should never be ignored. Rushing back to sport too soon increases the risk of long-term damage, which can affect an athlete’s health, performance, and well-being for years to come. If you experience a concussion you should seek medical guidance immediately and follow an individualised return to play protocol to ensure a safe return to sports.

Key Takeaways:

✅ Know the signs of a concussion.

✅ Follow a structured return-to-play protocol.

✅ Prioritize health over competition.

By taking a responsible approach to concussion management, athletes can ensure a full recovery and continue to perform at their best—both in sport and in life.

If you or someone you know suffers a concussion you can book an appointment with a physio for guided treatment.

References

1) Cantu, R. C., & Voy, R. (1995). Second impact syndrome: A risk in any contact sport. Physician and Sportsmedicine, 23(6), 27-34.

2) Davis, G. A., et al. (2023). Consensus statement on concussion in sport—The 6th International Conference on Concussion in Sport. British Journal of Sports Medicine.

3) Harmon, K. G., et al. (2019). American Medical Society for Sports Medicine position statement: concussion in sport. British Journal of Sports Medicine, 53(4), 213-225.

4) Iverson, G. L., et al. (2021). Cognitive and mental health outcomes following concussion in youth sports. Journal of Head Trauma Rehabilitation, 36(2), 94-105.

5) McCrory, P., et al. (2017). Consensus statement on concussion in sport—The 5th International Conference on Concussion in Sport. British Journal of Sports Medicine, 51(11), 838-847.

6) McKee, A. C., et al. (2013). The neuropathology of CTE. Brain, 136(1), 43-64.

7) Patricios, J., et al. (2023). Updated guidelines for concussion management in sport. Journal of Sports Medicine and Science.

8) Reid, S. A., et al. (2022). Return to strength training after concussion: A systematic review. Sports Medicine, 52(3), 421-436