How Long Does A Concussion Last?
Well it has been a while since I have posted anything on concussions. So in light of the latest concussion symposium I attended I would like to highlight a few things for you. If you are involved in soccer there is some interesting information that I learned about heading as far as guidelines for heading.
It is now debatable in how long the actual concussion itself lasts. If you recall in my article what you need to know about concussions I referenced a study completed in 2011 that concluded that the actual concussion lasts about 10 ten days. Keep in mind that this study used mice to get give us this information.
It was from this study that the “reset“ program was developed along with the article “Stuck in the trench.
Part of the reset program was to shut almost everything down: no texting, no TV, no Xbox etc., minimize the information processed through the eyes.
Now research that implemented human subjects using proton magnetic resonance spectroscopy indicates that it may take 30 days for the actual concussion to subside or be resolved.
In this particular study they were looking for the levels of NAA and creatine responsible for the function of nerve cells.
In the first three days post contact there was a significant difference (lower) in these levels compared to non-concussed. It wasn’t until 30 days after that these levels were within normal levels of the non- concussed group.
So what does that mean to you? Perhaps the rush to return to play needs to be reconsidered as well as the time passed for contact. Next, keep in mind this is only one study and it had a small number of participants- just under 50. Obviously more studies of this nature needs to be undertaken to give you a more definitive answer.
This study coupled by the study by Hutribuse et al indicates that symptoms may be gone between 3-15 days and that it may take a lot longer to fully recover from secondary issues of a concussion.
Of note, part of the Australia Institute of Sport policy for return to contact for children 18 and under states: “No return to contact activities before 14 days from complete resolution of all concussion symptoms”.
Heading Guidelines for Soccer?
Next, the USA developed guidelines for heading in soccer within their youth system. They are as follows:
Age 0-10 no heading
Age 11- 13 heading in practice – no more than 20 contacts
Age 14 and older games.
These guidelines get into the specifics of the size of the ball to be used for each age group and the amount of time allotted for heading during the week.
Is baseline concussion testing a waste of time?
Next, is baseline concussion testing a waste of time? If you recall, one of the first articles I wrote was titled “Why You, Your Team and Club Need Baseline Concussion Testing” and I was quite adamant that you needed it. Many businesses and clinics have jumped on this band wagon (myself included); however, there are many concussion “experts” stating that it is not necessary and apparently there is no scientific basis evidence based studies that suggests it is needed.
Although IMPActTest has received receive U.S. Food and Drug Administration (FDA) de novo clearance, there several people who believe it is the most accurate, reliable or valid testing for concussion.
My own take on the IMPACT is that it has value as part of series of other tests but it in itself is not definitive in either assessing or diagnosing a concussion.
Furthermore, a concussion to this day is still a clinical diagnosis by a Physician and an assessment by other health care professionals (PT, AT, DC, RMT) as far as I know.
I expect that there will be some statement from the International Concussion in Sport group in February on testing tools with a SCAT4 and Child SCAT4.
Finally here are some takeaways for you from this article:
- A concussion is a clinical diagnosis / assessment
- The actual concussion may last up 30 days
- Impact tool alone does not diagnose or assess a concussion
- Symptoms of a concussion may resolve between 3-15 days ; however the concussion itself is not resolved
- It may take up to 18 months to 2 years to fully from secondary issues resulting from a concussion.
Decrease in N-acetylaspartate following concussion may be coupled to decrease in creatine.
J Head Trauma Rehabil. 2013 Jul-Aug;28(4):284-92. doi: 10.1097/HTR.0b013e3182795045.
Vagnozzi R1, Signoretti S, Floris R, Marziali S, Manara M, Amorini AM, Belli A, Di Pietro V, Dʼurso S, Pastore FS, Lazzarino G, Tavazzi B.
The Molecular Pathophysiology of Concussive Brain Injury
Garni Barkhoudarian, MD, David A. Hovda, PhD, Christopher C. Giza, MDe,
Clin Sports Med 30 (2011) 33–48
The effect of concussion history on cognitive-motor integration in elite hockey players
Johanna Hurtubise Diana Gorbet, Yehyah Hamandi, Alison Macpherson & Lauren Sergio
First draft submitted: 19 April 2016; Accepted for publication: 3 June 2016; Published online: 6 September 2016