What is a concussion?
A concussion is a type of brain injury. It can change the way the brain functions. Symptoms can affect your body, thoughts, emotions or behaviours.1 Common signs and symptoms of a concussion2 include:
- poor balance
- nausea and vomiting
- feeling drowsy or having difficulty sleeping
- difficulty thinking clearly and remembering
- being easily upset or angered
If any of the following signs or symptoms are observed, call 911 and get immediate medical attention.
- neck pain or tenderness
- double vision
- weakness or tingling / burning in arms or legs
- severe or increasing headache
- seizure or convulsion
- loss of consciousness
- deteriorating conscious state
- increasingly restless, agitated or combative
How do you get a concussion?
A concussion can be caused by a direct hit to the head, face, or neck, or from a blow to anywhere on the body that causes the brain to move rapidly back and forth inside the skull.1 You can get a concussion by getting body-checked, heading a soccer ball, being rear-ended while in a motor vehicle, or experiencing a fall. You do not have to lose consciousness (be “knocked out”) to have a concussion. Not all head injuries are concussions.
How do you know if you have a concussion?
Any person who has received an impact to the head, face, neck or body should be checked for signs and symptoms of a concussion.1, 2 The Concussion Recognition Tool 5 (CRT5, British Journal of Sports Medicine) can be used by anyone, such as a coach, parent, or bystander, to identify a person with a suspected concussion. Some people will show signs or feel symptoms right away. For others, these can develop over the next 48 hours. All individuals suspected of having a concussion should go see their health care provider for a medical assessment as soon as possible.1 A concussion can’t be seen on an x-ray, MRI or CT scan. Only a medical doctor or nurse practitioner can diagnose a concussion.
When can you return to school, work, or sport if you have a concussion?
Recovery times are different to each individual. The signs and symptoms of a concussion often last for 10-14 days but may last up to four weeks in children and youth.1 It’s important to give your brain the time it needs to heal. Rest for the first 24 to 48 hours. That means no TV, computer, reading, work, school, or physical activities. After that, light mental and physical activity can be started, as long as it doesn’t make your symptoms worse. Returning to your regular activities and sports needs to be done carefully and gradually (in steps), to make sure that your symptoms don’t reappear.1,2 How quickly you can do that depends on the type of symptoms you have and how severe they are.
For school-aged children, Ophea’s (Ontario Physical and Health Education Association) new concussion protocols clearly outline what to do if a concussion is diagnosed and what learning and physical activities are permitted at each stage of recovery.6 These protocols have been identified by the Ministry of Education as the minimum standard when it comes to concussion safety for schools.7 For more information on managing concussions in schools and school-aged children visit Schools and Daycares.
You should always complete your return to learn/work plan before returning to full sport participation.1,2 Returning to sport before you’re ready puts you at a high risk of having another concussion, with symptoms that may be increased and last longer.
Concussion safety in Ontario
In March 2018, Ontario passed concussion safety legislation to help protect amateur athletes in sport and in school settings.4 Rowan’s Law (Concussion Safety), 2018, sets out rules that call for:
- Athletes, coaches, educators and parents to review concussion awareness resources every year to help them prevent, identify and manage concussions.
- Protocols about removing-from and returning-to sport, to make sure athletes are immediately removed from sport if they are suspected of having a concussion and giving them the time they need to heal properly.
- A concussion code of conduct that would set out expectations for behaviour to minimize concussions while playing sport.
Concussions in sport
Concussions can happen in many sport-related settings so it is important that all organizations take steps to protect their participants. The goals are to reduce the total number of concussions that occur in sports and to reduce the negative effects of concussions on individuals. Creating policies and protocols in the event of a sport-related concussion can help reach these goals. Policies should address the following areas: 1,2,4,5
- pre-season concussion education
- concussion code of conduct
- procedures for suspected concussions
- onsite concussion assessment
- removal from sport protocol
- medical assessment
- test period
- multidisciplinary concussion care
- return to sport protocol
Athletes who have a concussion should never return to sport if they still have symptoms. If you return to active play before full recovery from your concussion, you’re placing yourself at risk of having another concussion, with symptoms that may be increased and last longer. It’s important to work with a medical professional to develop your return-to-learn (Parachute) and return-to-sport (Parachute) strategies.
If you are a parent and/or coach of a child in a sport, consider completing the Making Head Way concussion awareness module (Coaching Association of Canada). Check with your local sport association or provincial sport organization for specific training and policy requirements related to concussions.
Information on concussion prevention, identification, management and treatment, can also be found on The Ministry of Health and Long Term Care’s web portal.
The portal contains information for:
- educators and coaches in schools
- coaches, officials and athletes
- children and youth
- health care providers
Concussions outside of a sports setting
The information outlined in The Canadian Guidelines on Concussion in Sport (Parachute Canada, 2017) can be applied to children, adolescents and adults who sustain a concussion outside of a sport environment and are returning to activity (i.e., school, work, etc.).2 Receiving appropriate diagnosis, and care for concussions and following recommendations for a gradual return to activities is key to helping reduce the negative impact concussions can have.
For more information on the prevention, identification, management and treatment of concussions, visit The Ministry of Health and Long Term Care’s concussion web portal.
- McCrory P., et al. (2017) Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838-847.
- Parachute (2017). Canadian Guidelines on Concussion in Sport. Toronto: Parachute.
- Davis, GA et al. (2017). Concussion Recognition Tool 5. British Journal of Sport Medicine. 51:872. Retrieved from http://bjsm.bmj.com/content/bjsports/51/11/872.full.pdf
- Ontario Ministry of Tourism, Culture and Sport (2018). Concussion in sport. Retrieved from http://www.mtc.gov.on.ca/en/sport/concussions.shtml
- OPHEA (n.d.). Ontario Physical Education Safety Guidelines. Retrieved from http://safety.ophea.net/ on April 11, 2018.
- Ontario Physical Education Safety Guidelines. (2018). Concussions. Retrieved September 20, 2018 from http://safety.ophea.net/concussions.
- Ontario Ministry of Education. (2014). Policy/Program Memorandum 158: School Board policies on Concussion. Retrieved September 21, 2018 from http://www.edu.gov.on.ca/extra/eng/ppm/158.pdf.
This item was last modified on February 10, 2020