Sports Concussion

A sports concussion can occur following direct contact, such as a head-to-head hit or hitting your head on the ground, or indirect contact, such as a hit to the body that causes your head to move or turn quickly.

Concussions can cause a variety of physical, mental, and emotional symptoms. Physical symptoms may include headaches, dizziness, neck pain, balance impairments, vision issues, noise or light sensitivity, exercise intolerance, and fatigue. Mental symptoms may include concentration difficulties, memory issues, or fogginess. In addition, a concussion can affect your ability to sleep normally.

Our sports concussion specialists perform a thorough evaluation and screening to identify what problems you may be having and recommend appropriate treatment.

Your first appointment will be with a primary care sports medicine doctor or sports neurologist. These are concussion experts who specialize in the evaluation, diagnosis, and management of sports concussions in competitive and recreational athletes. Your evaluation will include the following tests, which may be repeated following treatment to assess your healing progress.

Neurologic Exam

Evaluates your hearing, vision, strength, sensation, coordination, and reflexes.

Cognitive Testing

Screens for problems with memory, word recall, and mental processing that may have resulted from a concussion.

Cervical Spine Screening

A blow to your head or body can cause cervical spine pain, which may be associated with headaches and dizziness. This screen will assess your posture, neck movement, and strength to determine if your neck pain is contributing to your concussion symptoms.

Balance Testing

Concussions can cause you to feel off balance after the injury. Balance is controlled by the proprioceptive, vision, and vestibular systems. We assess these with tests that challenge each of these systems.

Vision Screening

Evaluates how well your eyes move in all directions; whether you’re having problems such as blurry vision, double vision, or light sensitivity; and how well your eyes function while you’re trying to read.

Vestibular Screening

The vestibular system provides sensory input that helps with your balance and your orientation in space. Simple tests, such as having your eye follow a finger or staring at a focused point and moving your head, can cause you to feel dizzy if your vestibular system is impaired.

Depending on your needs, we can refer you promptly to the sports physical therapists, vision specialists, neuropsychologists, headache specialists, speech pathologists, and occupational therapists who are part of our concussion team. Your treatment may include:

Active Rest

The first 2-3 days after a concussion can be the most symptomatic. Active rest means allowing yourself time to rest and limiting activities that increase your symptoms -- such as using devices with screens or being in busy or loud environments. You may sleep more after a concussion, but after a few days experts recommend trying to return to your normal sleep routine and limiting naps. Recovery following a concussion often takes 3-4 weeks but can take longer with more significant concussions. Following your evaluation, your doctor will provide recommendations on when you can return to activities such as school and work.

Physical Therapy

Depending on your symptoms, we may recommend individualized therapy to minimize neck pain, headache, dizziness, balance problems, and exercise intolerance that can be associated with concussion. Our sports physical therapists are specially trained to perform cervical, vestibular, balance, and cardiovascular assessments and incorporate techniques, exercises, aerobic conditioning, and training designed to return you to your daily activities.

Vision Rehabilitation

Our concussion clinic partners with the Duke Vision Rehabilitation and Performance clinic to provide formal assessments and treatment for vision-related symptoms that may result from a concussion. Treatment options may include corrective lenses and filters for light sensitivity and vision problems such as blurred or double vision. Vision rehabilitation can help you improve your ability to focus while reading, to visually track and scan to safely interact with your environment, and to manage your symptoms while completing vision-related tasks.

Neurocognitive Treatment

Therapists may use computerized training, written materials, cognitive behavioral therapy, and other forms of therapy to help you improve memory, enhance reasoning or reduce symptoms such as anxiety or emotional difficulties.

Post-Concussion Headache Treatment

Persistent or severe headaches may be treated by a headache specialist, who may prescribe medical management or other therapies to provide relief.

Speech Pathology

Speech Pathology evaluation and treatment can help you overcome issues related to memory, understanding, attention, problem-solving, and/or communication that can lead to difficulties in school, work, or daily activities.

Occupational Therapy

Occupational therapy evaluation and treatment can help with cognitive retraining strategies to improve concentration, memory, and decision making and avoid mental fatigue. Additionally, our occupational therapists can provide treatment and teach strategies to help you better tolerate environmental and sensory stimuli such as busy or loud environments.

Recognized Concussion Specialists
Our concussion specialists lecture at concussion management meetings around the country and follow the latest international guidelines in concussion management. Our physicians have participated on NFL committees on traumatic brain injury management, in similar groups at high schools and colleges throughout North Carolina, and on subcommittees on concussion with organizations like the American Academy of Neurology.

High School Collaboration
Our high school outreach program allows us to coordinate post-concussion academic modifications with your school and teachers. We complete North Carolina-mandated Gfeller-Waller return-to-play paperwork for high school athletes.

Baseline Testing
This testing is offered pre-season to athletes to obtain baseline values for cognitive function, vision, balance, and the King-Devick test. These values can later be used to compare to any post-injury assessments to help with concussion evaluation. This testing is available for a fee, as it is not covered by insurance.