Sports Concussion

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Seeking prompt care for a concussion is crucial to starting the recovery process, as a concussion can affect your ability to attend school or work and keep you off the playing field. At the Duke Sports Concussion Clinic, we’ll perform a thorough screening and evaluation to assess your concussion injury. Our specialists will personalize your treatment to help you return to health and the activities you enjoy.

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About Sports Concussions

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.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Concussion Evaluation

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 after treatment to assess your healing progress.

Neurologic Exam

We will evaluate your hearing, vision, strength, sensation, coordination, and reflexes.

Cognitive Testing

These tests screen 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 (neck) pain, which may be associated with headaches and dizziness. This screening will assess your posture, neck movement, and strength to determine whether your pain is contributing to your concussion symptoms.

Balance Testing

Concussions can cause you to feel off balance. Balance is controlled by the proprioceptive, vision, and vestibular systems. We assess these systems with the Sway mobile app, which uses the accelerometer in a cell phone to provide an objective measurement of balance in different positions.

Vision Screening

These tests evaluate 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.

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Concussion Treatments

Depending on your needs, we can refer you promptly to specialists in sports physical therapy, vision, neuropsychology, headache disorders, speech pathology, and occupational therapy who are part of our concussion team. Your treatment may include:

Active Rest

The first two to three days after a concussion can be the most symptomatic. You will need to rest and limit 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. Light activity such as walking can also help with recovery during this time period. Full recovery following a concussion often takes three to four 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 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 other daily activities.

Occupational Therapy

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

Related Treatments

Sports Vision Rehabilitation and Training

Why Choose Duke

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 state-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, Sway cognitive and balance testing, and the King-Devick test. Results can be compared with any post-injury assessments to help with concussion evaluation. This testing is available for a fee, as it is not covered by insurance.

Research
The Duke Sports Concussion Clinic is committed to providing evidence-based treatments. Our clinic performs and participates in ongoing concussion research studies to enhance the quality of care and contribute to the growing body of literature around sports-related concussion.

Official Team Doctors

Duke sports medicine specialists are the official team doctors for all Duke sports teams.

Reviewed: 07/02/2020