Red Flags
If any of these signs are present go immediately to the emergency department.
- Severe or worsening headache
- Very drowsy or unable to wake up
- Seizures or convulsions
- Bad nausea or vomiting
- Unusual behaviour, very confused or very irritable
- Weakness or numbness in arms or legs
- Unsteady on feet or slurring of speech
- Loss of consciousness
- Fluid leaking from ears, bruising around eyes or ears
- Inability to remember more than 30 minutes before the injury
A concussed person should be watched by a capable adult for at least 3 hours following a head injury.
It is important to watch out for worsening symptoms during this time and go immediately to your nearest emergency department if any of the above symptoms are present or if you are concerned or unsure.
What is a Concussion?
A concussion is a functional disturbance of the brain, not a structural injury. It affects how the brain functions and is caused by the sudden acceleration and deceleration of the brain within the skull. This can occur from an impact to the head, neck, or other parts of the body that causes abrupt movement of the brain.
When the brain moves suddenly, it stretches and twists the brain tissue, causing tiny channels along the nerve cells to open. This results in chemicals inside the cells rushing out and exchanging with chemicals outside the cells. This exchange triggers an excitation within the cells, leading to the immediate signs and symptoms of concussion, such as imbalance, incoordination, and memory loss. In simpler terms, the brain becomes over-excited and begins misfiring causing concussion symptoms.
Timing is Crucial!
Starting your recovery process as early as possible significantly enhances your chances of a swift recovery. Those who wait or never start treatment following a concussion have a much greater risk of experiencing persistent concussion symptoms.
Research indicates that continuing to play after sustaining a concussion can prolong the brain’s recovery time. Therefore, it is essential to immediately remove a concussed player from the game or activity.
Cooling the head and neck after a concussion can reduce symptom severity and support faster recovery.
The greatest predictor of a successful outcome following a concussion injury is getting the right advice and treatment plan within the first week after injury.
The following cards will walk you through what to do in the first 3 days after injury. If you have persisting symptoms please seek treatment from a healthcare provider trained in concussion management.
Day one: The day of the injury
Red Flag Card
Always have a capable adult supervise you for at least 3 hours after a concussion. Refer to the Red Flag Card for critical symptoms. If any are present, or if you’re unsure, seek medical advice immediately.
Supplements and Dosage
Following a concussion injury take the rapid absorption supplement according to these dosing guidelines:
Adults: 2 sachets.
Child to 12 years: 1 sachet. This expertly formulated rapid absorption supplement has been designed to support your recovery.
Monitoring
For the first three hours after the injury, closely monitor the concussed individual, keeping an eye out for any worsening symptoms. Every 30 minutes, check that they can stand and walk with normal balance. If you observe any signs of their condition deteriorating, take them to the emergency department immediately.
It is safe to allow sleep once the person is stable and behaving normally. Sleep should not be prevented, as adequate rest supports brain recovery. There is no need to wake the person regularly unless advised by a healthcare professional or if they are breathing abnormally.
Medication
Rest vs. Activity
Engage in normal daily activities as long as they do not exacerbate your symptoms. It’s beneficial to keep moving gently. If an activity significantly increases symptoms stop and change activities.
Icing
Lie on your back on the floor or a yoga mat and place an ice pack in the hollow of your neck for 10-15 minutes, without a pillow under your head. This can be repeated several times a day.
Breathing Techniques
While lying on your back, focus on deep, slow breathing. Aim to exhale for 6 and inhale for 4. This technique is useful for reducing feelings of anxiety or being overwhelmed.
Precautions – What Not To Do
Avoid slouching or keeping your head in a forward position.
Do not consume alcohol.
Steer clear of tasks that require intense concentration or cognitive effort.
Avoid going to the gym, engaging in heavy lifting, or any rigorous physical activity.
Do not place yourself in situations where there is a risk of sustaining another concussion.
Do not drive or operate heavy machinery.
Hydration
Maintaining normal hydration is important after a concussion, as dehydration can worsen symptoms such as headache, fatigue, and dizziness. The brain is approximately 73% water, and adequate fluid intake supports normal brain function during recovery. Aim for regular fluid intake throughout the day, guided by thirst and urine colour (pale yellow). For most adults, this is around 2-3 litres per day, with higher needs in warm conditions or with increased activity. Drinking excessive amounts is not recommended, as overhydration may worsen symptoms.
Diet
To optimize your recovery, consider adjusting your diet for the next two weeks. Reducing inflammation can be achieved by eliminating refined sugars and gluten, and incorporating low GI (glycemic index) carbohydrates into your meals.
Day two: Managing Activity
Red Flag Card
Read the red flag card. If you have any of these symptoms please seek urgent medical advice.
Supplements and Dosage
Following a concussion injury take the rapid absorption supplement according to these dosing guidelines:
Adults: 2 sachets.
Child to 12 years: 1 sachet. This expertly formulated rapid absorption supplement has been designed to support your recovery.
Activity
Today’s focus is on managing your activities without significantly worsening your symptoms. Recent research suggests that an early return to activity can promote a quicker recovery. However, this doesn’t mean overexerting yourself!
Begin your daily tasks and monitor how you feel. A useful method is the ‘2-point tolerance rule.’ Rate your symptoms on a scale from 0 (no symptoms) to 10 (unbearable). If an activity increases your symptoms by more than 2 points, you should either stop or modify the activity. For example, if a headache intensifies from $3/10$ to $5/10$ while using your phone, it’s time to put the phone down and switch to a different activity. If you feel like going for a walk or engaging in gentle physical activity, feel free to do so, but continue to use the 2-point rule to guide your actions.
Work and School
Concussion affects people differently. If you feel well enough, a graded, supported return to work or school can be an important part of your recovery. Use the 2-point rule as your guide. If symptoms increase by more than two points, take a break until they settle. Avoid pushing through symptoms, as this can prolong recovery.
A gradual increase in cognitive load, with short periods of activity with rest and breaks, helps ensure a smoother, faster recovery. Schools or workplaces may offer temporary adjustments such as reduced hours, quiet spaces, or modified tasks. Some people may need a structured return-to-learn/work plan (reduced hours, breaks, modified tasks). See your doctor or healthcare professional managing your concussion injury if this is required.
Driving
Return to driving depends on the type and severity of your symptoms. You should not drive if you experience:
Vision changes
Slowed reaction times
Dizziness or motion sensitivity
Concentration difficulties
Delayed decision-making Driving requires rapid processing, coordination, and attention. Wait until these skills have fully returned. If your job involves driving or operating machinery, your employer may require medical clearance before you return to work.
Sleep
Sleep will aid your recovery from a concussion. Establishing a consistent bedtime routine and creating a calm, comfortable sleep environment are key. To help initiate sleep, avoid using screens at least an hour before bedtime. This is a good time to try deep breathing exercises or listening to soft music. These techniques can help relax your body and mind, making it easier to fall asleep.
Icing
Lie on your back and place an ice pack in the hollow of your neck for 10-15 minutes. Repeat as needed.
Breathing Techniques
While lying down: inhale for 4, exhale for 6. Helps reduce anxiety or overwhelm.
Precautions – What Not To Do
Avoid slouching or keeping your head in a forward position.
Do not consume alcohol.
Avoid going to the gym, engaging in heavy lifting, or any rigorous physical activity.
Do not place yourself in situations where there is a risk of sustaining another concussion.
Hydration
Regular fluid intake throughout the day aiming for 2-3 litres of water per day, more if you are in a warm environment. Staying well hydrated supports overall brain health and aids in recovery.
Day three and beyond
Activity
Before starting your day, take a moment to think back on how yesterday went. Consider whether your activities were well-managed, causing only mild or no increase in symptoms, or if you exerted yourself too much, leading to a flare-up of symptoms. Based on this, adjust today’s activity level to avoid exacerbating symptoms. If yesterday was successful, keep up the good work.
If you were less active yesterday due to symptoms, you might try some gentle physical activity today to help increase blood flow to your brain and aid in recovery. Activities like walking or cycling on a stationary bike can be beneficial. Always remember to use the 2-point rule: pause or slow down if your symptoms increase by two points.
Supplements and Dosage
Following a concussion injury take the rapid absorption supplement according to these dosing guidelines:
Adults: 2 sachets.
Child to 12 years: 1 sachet. This expertly formulated rapid absorption supplement has been designed to support your recovery.
Breathing
If you haven’t tried this technique yet, it’s definitely worth giving it a go! After a concussion, it’s common for your body to enter a ‘fight or flight’ state. Practicing slow breathing can help shift you into a more relaxed ‘rest and digest’ state. While lying down is ideal for this exercise, sitting works well too. Start by relaxing your shoulders. Then, slowly breathe out to a count of 6 and inhale to a count of 4; continue for 2 minutes.
Sleep
As discussed yesterday, it’s important to ensure you’re getting adequate rest at night. You may find that you need to go to bed earlier than usual. Feeling more fatigued during the first few days after a concussion injury is not unusual. This increased fatigue is due to your brain using its energy to recover.
Hydration
Aim for 2-3 litres of water per day, more if you are in a warm environment. Staying well hydrated supports overall brain health and aids in recovery.
What’s next…
You’ve made it through your first few days! If you haven’t already, reach out to a healthcare provider who is trained in concussion management, has a great reputation and is up to date with the latest research. Seeking treatment early will reduce your risk of persistent concussion symptoms.
Supplementation
It is highly recommended to support optimal recovery by deeply nourishing your brain and body systems on an ongoing basis. There are several studies that show promising results from specific nutrients that, when used appropriately, can support a thorough recovery process.
Return to Sport
If you have had 3 or more concussions in a season or 5+ concussions in your sporting career it is recommended that you consult with a sport-related physician (such as a sports medicine doctor or neurologist) prior to returning to sport. Do not return to contact sport or activities that risk another head injury until you are symptom free and you have completed the return to sport process, which requires a minimum stand down of 3 weeks.