I always related concussion to boxing. When I played, I didn't know they even existed in the NFL. If you would have sat me in a room and said "You cannot leave here until you guess the one mystery injury that could end your career," I'd still be in that room. I never thought concussions were part of football" - Former NFL player Merril Hoge

I've never had a concussion. I probably get my "bell rung" or get "dinged" once every game or other game. I've never told a trainer because it doesn't really cause problems, it's just a short little bang. It's pounded in your head that you can play though anyting. I just suck it up most of the time. You just have to suck it up if you want to play." - former college football player

"Nobody in football should be called a genius. A genius is a guy like Norman Einstein." -Football commentator and former player Joe Theismann

Mild TBI (mTBI) is defined as insult to or decelleration of the head resulting in(American COngress of Rehab Medicine, 1993)

Post-Concussion Syndrome (PCS)

Summary and Agreement Statement of the 2nd. International Conference on Concussion in Sport, Prague 2004. (Re-state definition from Vienna Conference) "Sports concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces". Several common features that incorporate clinical, pathological, and biomechanical injury constructs that may be used in defining the nature of a concussive head injury include the following.

  1. Concussion may be caused by a direct blow to the head, face, neck, or elsewhere on the body with an "impulsive" force transmitted to the head.
  2. Concussion typically results in the rapid onset of short lived impairment of neurological function that resolves spontaneously.
  3. Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than structural injury.
  4. Concussion results in a graded set of clinical syndromes that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course.
  5. Concussion is typically associated with grossly normal structural neuroimaging studies.

Issues in Concussion:

Return to Play:
Most injuries will be simple concussions, and such injuries recover spontaneously over several days... it is expected that an athlete will proceed rapidly through the stepwise return to play strategy.

During this period of recovery in the first few days, physical and cognitive rest is required. Activities that require concentration and attention may exacerbate the symptoms and as a result delay recovery.

The return to play after a concussion follows a stepwise process:

  1. No activity, complete rest. Once asymptomatic, proceed to level 2.
  2. Light aerobic exercise such as walking or stationary cycling, no resistance training.
  3. Sport specific exercise—for example, skating in hockey, running in soccer; progressive addition of resistance training at steps 3 or 4.
  4. Non-contact training drills.
  5. Full contact training after medical clearance.
  6. Game play.