With the increased temperature and daylight of summer, children and adults are increasingly participating in team sports (soccer, football, baseball) and individual athletic activities (cycling, roller blading, rock climbing, mountain hiking). Although fun and healthy, these activities occasionally result in concussion for the amateur athlete and recreational outdoorsman. Concussion (synonymous with mild traumatic brain injury) is a neurologic event that has a good prognosis for full recovery but, in certain instances, if not properly evaluated and treated, can have serious medical consequences. Concussion entails a blow to the head that then results in a brief loss or alteration of consciousness. If the athlete is not ‘knocked out,by definition there must be an alteration of consciousness which is typically experienced as disorientation (unsure of location/time/date), confusion (repetitive questioning) or amnesia (no memory immediately before or after the event). These symptoms should be distinguished from surprise, shock and anger that do not necessarily constitute concussion. When the athlete remains unconscious, has blood or fluid coming from his/her ears or nose, cannot be aroused from sleep or declines from alertnessto unconsciousness, it is important to seek immediate medical attention for evaluation by a physician that may include brain imaging such as a CAT scan or MRI with instructions for return to normal activities and athletic competition.

There is typically a perfectly normal triad of symptoms experienced in the days and weeks post-concussion that may include: 1) Physical-nausea, dizziness, headache. 2) Cognitive-memory and attention problems, fatigue. 3) Emotionalanxiety, depression. It is important to note, however, that the overwhelming majority of individuals who experience concussion enjoy a full recovery within a brief period of time. Individual characteristics such as prior concussion, psychiatric/developmental conditions such as ADHD and depression or concurrent medical conditions can adversely affect recovery. In the small number of cases with persistent and/or worsening symptoms, evaluation by a sports medicine physician and/or neuropsychologist is recommended to expedite recovery and provide support/reassurance. Community Neuropsychology can provide the latter and make a referral to a Sports Medicine provider. Outside of exercising good judgment, wearing a helmet or some type of protective headgear is the single best step to avoid concussion.Support and guidance from a professional as well as setting positive expectations for a full recovery help insure a good outcome. Finally, concussion does not result in permanent brain damage but is best understood as a temporary alteration in brain chemistry and functioning that, importantly, resets or heals on its’ own. Now go enjoy the wonderful Colorado outdoors, have fun and be safe.


— Paul Richards, Ph.D.