A concussion is an injury that affects the function (but not structure) of the brain. The sudden movement of the brain causes stretching and tearing of brain cells, damaging the cells and creating chemical changes in the brain. Once this injury occurs, the brain is vulnerable to further injury and very sensitive to any increased stress until it fully recovers. Common sports injuries such as sprains and fractures are structural injuries that can be seen on MRIs or x-rays, or detected during an exam. A concussion, however, is primarily an injury that interferes with how the brain works. While there is damage to brain cells, the damage is at a microscopic level and cannot be seen on MRI or CT scans. Therefore, the brain looks normal on these tests, even though it has been seriously injured. In fact, an adolescent brain is more vulnerable to concussions, and takes more time to heal.
After suffering a concussion, no athlete should return to play or practice on that same day. Previously, athletes were allowed to return to play if their symptoms resolved within 15 minutes of the injury. Newer studies have shown us that the young brain does not recover quickly enough for an athlete to return to activity in such a short time. An athlete should never be allowed to resume physical activity following a concussion until he or she is symptom-free and is given written clearance to resume physical activity by an appropriate health care professional.
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