Many concerned parents approach us about their child's safety in contact sports and the risks of concussions. I would like to answer some these questions here to help provide some clarity on the topic.
Does a concussion cause PHYSICAL damage to the brain?
One previous theory of the mechanism of a concussion was that following a trauma to the head, the brain collides with the skull. This in turn would lead to the brain injury. More recently, the mechanism is believed to be the acceleration-deceleration forces that shear the nerve cells within the areas of the brain. This causes the nerves to develop metabolic and energy imbalances that in turn cause numerous dysfunctions and symptoms.
My child no longer has symptoms, are they cleared to play?
When it comes to concussions, symptoms are a poor indicator of the individual’s recovery. Symptoms will improve anywhere between 3 and 8 days while reaction time, balance, cognitive processing, and energy levels take significantly longer. The recovery of the energy deficits of the brain cells can take up to 30 days after suffering a concussion. Thus it is an important 1st step to be symptom-free but all physical and mental capabilities must be restored prior to returning to competition. This concept is the most challenging for athletes and coaches alike, due to the simple fact that the athlete looks and acts “normally”. A precise return to play protocol will test all necessary functions to ensure a proper recovery.
Should I take my child out of competition due to multiple concussions?
Well with all the media coverage in the last few years, it is easy to understand where all the concern comes from. Concussions are a prevalent injury in our youth today and there has been numerous claims that these injuries may lead to brain dysfunction later in life. However, despite this, risk factors determining initial concussion, recovery periods, recurrence, and long-term outcomes remain poorly understood and warrant further study. Each individual case is different and the most important plan of action is that the concussion is managed appropriately. This will ensure the athlete returns to play at the appropriate time and with minimal risk of further damage.
What is the best way to prevent long term damage following concussions?
The most important aspect of concussion management is ensuring that an athlete does not return to sport too soon, as this puts them at high risk of sustaining added injury. The most effective way to protect against these risks is to get an appropriate baseline assessment. By establishing individual’s normal values, it takes most of the ambiguity away from determining a return to play.
Are online neurocognitive tests enough for a baseline and establish return to play?
These baseline tests have been shown to only be marginally reliable due to the numerous factors that can alter the results of these computer tests. Thus, computerized neurocognitive tests should be used as one aspect of the full baseline assessment and not as the only tool. 
The Optihealth Clinic is a proud affiliate of Complete Concussion Management ™. Find out more information at www.completeconcussions.com
Dr. Mike Rumeo is chiropractor with a passion for improving the health of his community and pain management. He primarily utilizes chiropractic, medical acupuncture and rehabilitation to help his patients. He is the owner of the Oakville Optihealth Clinic, a multidisciplinary clinic located at Fourth Line and South Service Rd W, in Oavkville ON. To contact Dr. Rumeo, please email him at email@example.com or call at 905.465.0202.
 Marshall, C. M. (2012). Sports-related concussion: A narrative review of the literature. The Journal of the Canadian Chiropractic Association, 56(4), 299–310.
 Vagnozzi R, Signoretti S, Cristofori L, Alessandrini F, Floris R, Isgro E, et al. Assessment of metabolic brain damage and recovery following mild traumatic brain injury: a multicentre, proton magnetic resonance spectroscopic study in concussed patients. Brain. 2010;133(11):3232–42.
 Noble, J., & Hesdorffer, D. (2013). Sport-Related Concussions: A Review of Epidemiology, Challenges in Diagnosis, and Potential Risk Factors. Neuropsychol Rev, Neuropsychology Review, 23(4), 273–284. Springer US. doi:10.1007/s11065-013-9239-0
 MacDonald, J., & Duerson, D. (9000). Reliability of a Computerized Neurocognitive Test in Baseline Concussion Testing of High School Athletes. Clinical Journal of Sport Medicine, Publish Ahead of Print.