Stages of concussion aren’t always easy to assess, but they’re essential to understanding pathways to care and treatment.
Concussions are one of the most common forms of mild traumatic brain injury (TBI). They usually result from a direct blow to the head, a jolt to the body or spine, or a violent shaking of the head and upper body.
Concussions are now considered a mild form of TBI and can lead to significant health issues if not properly managed.
Statistically speaking, 80-90% of adults who sustain a concussion will recover.
Unfortunately, this leaves 10-20% of adults with concussions dealing with symptoms for longer than three months in duration, sometimes even longer.
Understanding the different stages of concussion is crucial in identifying symptoms, seeking appropriate treatment, and preventing further damage.
In this article, we’ll examine the specific stages of concussion, including the symptoms at each phase, the underlying mechanisms, and the essential steps for recovery.
What is a Concussion?
Before diving into each of the stages of concussion, it’s essential to understand the fundamentals of concussions.
A concussion occurs when the brain violently twists and shakes inside the skull due to sudden movement or impact. This shaking can stretch and damage brain cells, affecting normal brain function temporarily or even permanently in some cases.
While concussions are often linked to contact sports, the data shows this isn’t the only case. They can also result from falls, car accidents, and other non-sporting incidents.
In fact, the third most common cause of concussions is auto accidents!
The Progressive Stages of a Concussion
Concussions typically follow a progression of stages. The stages of concussion symptoms represent a different phase in the injury and recovery process.
Here’s a detailed look at the essential stages:
1. Immediate Impact (Acute Stages of Concussion)
One of the first stages of a concussion occurs immediately following the impact or injury.
Depending on the mechanism of action, symptoms can range from mild to moderate or even severe.
In this initial stage, individuals may experience an array of symptoms, including the following:
- Confusion or disorientation
- Headache
- Dizziness
- Temporary loss of consciousness (though this doesn’t have to be present)
- Pain in the head, neck, or site of injury
- Lightheadedness
- Loss of vision
Sometimes, a concussion patient may seem fine right after the hit. This period of time is often labeled the “lucid interval” for delayed concussion symptoms.
Unfortunately, symptoms can worsen in the minutes or hours following the injury, which makes early monitoring crucial.
If symptoms continue to get worse and present as crippling pain, loss of consciousness, or lethargy, this warrants a visit to the emergency department for further investigation.
2. Post-Concussion Syndrome (Subacute Stages of Concussion)
The second stage of concussion typically involves the continuation or development of symptoms within the first 24 hours to a few days after the initial injury.
This phase is commonly known as the subacute stage and is relative to each individual.
During this time, people might experience a wide range of symptoms, such as:
- Persistent headaches
- Memory issues or recall
- Sensitivity to light and noise
- Fatigue or drowsiness
- Difficulty concentrating or focusing
- Progressive development of pain
- Dizziness and disorientation
- Excessive feelings of fatigue or sleepiness
The subacute stage is critical because symptoms often escalate or change, where the full extent of the concussion becomes more apparent.
Reducing physical and cognitive activity during this period is essential to prevent exacerbating the condition. Most individuals will require rest, adequate sleep, and proper nutrition for recovery during this phase.
It’s also important to note a significant shift in overall neurological, metabolic, and inflammatory-based mechanisms during this phase. Proper hydration, nutrition, and rest are imperative for recovery in this early stage.
3. Recovery Stage (Subacute to Chronic Stages of Concussion)
The next stage of concussion recovery is precisely what one would think: recovering from a concussion. Depending on the severity of the concussion, the recovery stage can last from days to weeks (and even months or years).
One thing to note is that just because someone feels better doesn’t mean they’re out of the clear. The improvement of symptoms is essential for progress, but during this recovery stage, it’s important to take it slow and steady to win the long game.
This timeframe is one of the most critical stages of concussion, where individuals must exercise caution to avoid further injury. The brain is still vulnerable, and any additional trauma can result in more severe or prolonged symptoms.
Common signs of improvement during this phase include:
- Gradual improvement of cognitive function
- Lessening of headaches
- Return of energy levels, though fatigue may still persist
- Reduction in dizziness and balance issues
- Improvement in light and sound sensitivity
- Changes in appetite and ability to hold down food
In the recovery stage, doctors often recommend rest, limiting screen time, and avoiding stressful activities that could hinder the healing process.
They also usually advise engaging in light activities only after symptoms have significantly diminished.
In this stage, most people will want to sit in a dark room to rest and recover. While that is needed for the first week or so of recovery, doing that long-term could actually hinder long-term healing.
If concussion symptoms haven’t resolved during these first few weeks of recovery, it’s best to start exploring treatment options with qualified medical professionals.
Your best bet is to engage with a highly experienced Functional Neurologist or physical therapist who can create a personalized treatment plan and support you in all aspects of recovery.
4. Full Recovery and Return to Activity
The fourth stage of concussion recovery encompasses the full resolution of symptoms and a return to pre-concussion levels of functioning.
By this time, the brain has likely healed to a point where everyday activities can resume without risk of relapse.
However, it’s vital to follow medical guidelines to ensure that reentry into physical activities, especially contact sports, is done safely.
During this phase, individuals might experience:
- Full cognitive recovery
- No lingering symptoms such as headaches or dizziness
- Resumption of routine physical activity
- Cleared medical evaluations
- Improved emotional stability
- Elimination of neck and head pain
- Back to standard sleep patterns
- Complete return of energy levels
Before returning to high-impact sports or physically demanding activities, it’s crucial to undergo thorough medical evaluations to ensure that there’s no risk of secondary concussions.
The Buffalo Concussion Treadmill Test is the gold standard for return to play activity following a concussion. It’s a clinical guideline for graded aerobic and cardiovascular exercise and measuring HR with symptom changes.
Without going into too much detail, one should work out at the intensity and HR appropriate up to where an individual starts to acquire symptoms.
Once that threshold is established, workouts should center around or below that HR to build endurance and eventually retrain the nervous system back to health.
5. Long-Term Monitoring and Prevention
The final stages of concussion focus less on treatment and more on monitoring and prevention.
While many people recover fully from a concussion, some may experience long-term symptoms, especially if they’ve had multiple concussions or failed to adequately recover from a previous one. These types of second-impact concussions can lead to chronic symptoms that can significantly impact quality of life.
This fifth stage is about long-term management and changing behaviors to avoid other serious neurological conditions associated with repeated brain injuries.
While the research is still very early, a lot of people are worried about increased chances of developing Chronic Traumatic Encephalopathy (CTE), Alzheimer’s, and Dementia as a result of repeated head injuries.
Essential aspects of long-term management include:
- Awareness of symptoms that could indicate complications
- Regular follow-ups with healthcare providers, coaches, and trainers
- Adopting preventive measures in sports or high-risk activities (e.g., wearing helmets)
- Cognitive therapy or rehabilitation if symptoms persist for months or years
Understanding the long-term impact of concussions and preventing future head injuries is crucial, particularly for athletes, soldiers, and other high-risk groups.
Common Symptoms Across All Stages of Concussion
Although each stage of a concussion has its unique characteristics, various symptoms can appear at any point throughout the injury and recovery process. These include:
- Nausea or vomiting
- Blurred vision
- Slurred speech
- Neck pain
- Headaches
- Dizziness
- Memory loss
- Balance and coordination problems
- Sleep disturbances (insomnia or excessive sleep)
- Mood swings, irritability, or depression
In severe cases, symptoms like seizures, inability to wake up, or severe confusion can indicate a more serious condition like a brain hemorrhage, which requires immediate medical attention.
Treatment and Recovery Tips for Concussions
Treating a concussion involves a combination of rest, personalized medical care, and gradual reintroduction of activities.
Here are some of the most effective recovery strategies:
- Immediate Rest: Both physical and mental rest are necessary in the acute stage.
- Medical Evaluation: Always seek professional medical care to assess the severity of the concussion. As previously stated, Functional Neurologists, medical neurologists, and trauma-trained physical therapists should be your preferred avenue of assessment and care.
- Gradual Reintroduction of Physical Activities: Once symptoms improve, the literature supports a gradual return to low-grade physical and aerobic activities before fully resuming routine tasks and sports.
- Cognitive Rest: Limiting screen time and decreasing periods of intense concentration can help the brain recover faster. Over time, these processes should improve a
- Adequate Hydration and Nutrition: Staying hydrated and maintaining a balanced diet support overall healing. Throughout all the stages of concussion, it’s imperative to support the brain and body with high-quality fats, adequate protein, and complex carbohydrates.
- Avoiding Further Injury: Once symptoms have resolved, training the brain and body for activities to prevent and overcome future injuries is essential.
When to Seek Medical Attention
You should seek immediate medical care if any of the following occur after a concussion:
- Prolonged loss of consciousness
- Repeated vomiting
- Worsening headache
- Seizures
- Confusion that gets worse over time
- Unusual behavior or irritability
The following symptoms may suggest a more severe issue like brain swelling or bleeding, which can be life-threatening if left untreated.
Understanding the Stages of Concussion
Understanding the stages of concussion can significantly improve how we approach early assessments, treatment, and rehabilitation.
Early identification, proper management, and a gradual return to activity are all crucial components of recovery. By being aware of the risks and following medical advice, individuals can prevent long-term complications and ensure a complete recovery from concussions.
It’s one of the many reasons why people come to see us at The Neural Connection! Leading the way in concussion rehabilitation and treatment is a core focus, but don’t just take our word for it.
Check out our 88+ 5-Star Google Reviews from patients who have found success at our clinic with our specialized approach to treating concussions.
If you are still struggling with symptoms from a concussion or traumatic brain injury, we would love to speak to you.
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*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.
