Concussion Basics: A Parent’s Guide

sports concussion
Dr. Roseann Capanna-Hodge

Dr. Roseann Capanna-Hodge

In person in our Ridgefield, CT center and virtually with at-home neurofeedback and coaching, we support individuals with a concussion diagnosis and post-concussion symptoms every day.  Commonly, individuals can suffer long-term for months or even years from a single concussion or multiple ones. Parents often come to as a last resort to help restore their child’s cognitive, behavioral, or emotional functioning. Neurofeedback and Biofeedback can be a help to normalize brainwave activity, which the research says can result in improved cognitive, attention, and emotional functioning. This concussion parent guide is designed as a reference tool for both understanding and treating a concussion.

How Do You Define Concussion?


The medical definition of concussion is a complex pathophysiological process affecting the brain, induced by biophysical processes that can occur with or without the loss of consciousness.  A simpler concussion definition is a type of traumatic brain injury (TBI) caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull that can result in prolonged injury and in some cases death.  Motor vehicle accidents, falls, and sports-related injuries are the primary concussion causes.

What is a Concussion?


During an impact, the brain, although protected by fluid and membranes, is pushed against the skull and can be bruised. When the membrane is disrupted in a concussion, this creates dysfunction in the brain cell. Further, damage from a concussion can alter the balance of chemicals in the brain, which impairs nerve cell function and can result in a variety of cognitive issues.

When the membrane is not working, then the glucose transporter system gets disrupted, which results in no energy getting into the cell. This shifts energy and results in a cellular energy crisis and causes a disruption in brain function.

Further, different parts of the brain can move at different speeds, and these shearing forces can produce nerve tissue damage due to stretching and tearing. More serious injuries can result in changes in cerebral blood flow.

What Concussion Diagnosis Criteria Do Doctors Use?


Even though most people think there has to be a loss of consciousness with a concussion, upwards of 90 percent of concussions do not involve the loss of consciousness. Sometimes signs of a concussion are obvious with loss of consciousness, dizziness, and confusion, and sometimes the symptoms can appear later.

Common symptoms include:
Confusion and disorientation
Problems in thinking/Cognitive Processing
Slowed cognitive processing
Memory issues
Nausea and vomiting
Balance Issues
Sleep problems
Emotional Lability
Anger or agitation

If you or your child have suffered a head injury, you need to see a doctor for a concussion test. While it might seem like a good idea to do a concussion test online at home, only a certified professional can appropriately diagnose the injury.

How Long Do Concussion Symptoms Last?


A typical concussion recovery time for adults should occur within two to six weeks. Meanwhile, concussion symptoms in children should resolve in a similar manner.

Delayed concussion symptoms can present days, weeks, months and even years after the initial injury.  Post-concussion symptoms can worsen gradually, which makes diagnosing Post-Concussion Syndrome even more challenging.

Concussion Rates


The CDC says that there are 2.5 million concussions a year. Of those concussions, 8% or over 225,00 concussions a year result in prolonged concussion syndrome. Even though the number one reason for concussion is accidents and falls, youth are the number one age group of individuals who experience a concussion. Sports-related injuries are the prevalent reason for a concussion for youth.  According to the CDC, boys (8.3%) were more likely than girls (5.6%) to have ever had a significant head injury.

What Sports Have the Highest Rates of Concussion?


Football is the number one sport that youth experience a concussion. There is a high level of physical contact with great force and often repeated force contact, which can result in a concussion. There is a theory that football players have a false sense of security of physical safety because of the gear they wear. Soccer and Lacrosse are the second and third most common sports that result in a concussion.

What Should a Parent Do After a Concussion?


Take your child to a neurologist or concussion specialist to be evaluated. Concussions are easily missed and even more so for Post-Concussion Syndrome.

For example, someone is more likely to suffer another concussion in the next seven days after a concussion because of processing difficulties in the brain cause problems with the vestibular system. Coordination issues after a concussion may result in an increased probability of a fall or injury.

Additional concussions can cause secondary injuries or prolonged concussion syndrome so going to a trained specialist is a way to get the right diagnosis and hopefully avoid prolonged issues.

What is Second Impact Syndrome?


Second Impact Syndrome is the sudden swelling of the brain as a result of a second concussion before the first concussion symptoms have subsided. Even a mild concussion can result in Second Impact Syndrome.

Most cases of Second Impact Syndrome have occurred with young athletes. This is a very serious condition that results in a 50 percent mortality rate. It is imperative not to return to play sports before symptoms of the first concussion have resolved.

What Concussion Treatments Are Recommended?

Sleep and Rest


After being medically assessed, the first concussion treatment is sleep. The next most important concussion recovery protocol is rest which encompasses limiting movements and media (if not fully restricting media). During the concussed period, schoolwork should be put on hold, as cognitive processing activities such as reading and visual processing, can exacerbate the brain injury and certainly interfere with healing.

Diet and Supplements


Reducing inflammation in the body and brain also promotes healing. Following an anti-inflammatory diet — reducing or eliminating gluten, dairy and sugar and increasing healthy fats, fruits, vegetables, protein, and water — can help as can supplements that reduce inflammation, such as, curcumin. Neurologist and Concussion Expert, Dr. Harry Kerasidis, reports that specific supplements such as antioxidants, b-complex vitamins, and essential fatty acids also support brain health.

Therapies like Neurofeedback and Biofeedback can help restore brain function through the stimulation of electrical activity.

How Can Neurofeedback help a Concussion?


The neurofeedback and biofeedback process can help the brain recover from a concussion.

QEEG and Concussion


The first step in the neurofeedback process is a QEEG. A QEEG is an EEG brain map. Electroencephalography (EEG) is the measurement of electrical patterns at the surface of the scalp which reflect cortical activity, and are commonly referred to as “brainwaves.” A quantitative EEG is a computer analysis of the EEG data in which we identify dysfunctional patterns. It is a visual way to see brain functioning regarding brain waves and gives us a clear understanding of what areas of the brain are over working or under performing.

When someone has a concussion, there are specific patterns that emerge, which help to identify the specific neurocognitive impact of the concussion. It helps us to understand some of the common challenges a person with concussion faces, such as slowed processing, attention problems, anxiety, and mood and behavioral changes. It can be very useful as a means to not only identify a concussion but measure response to treatment. Neurofeedback can be very helpful for restoring attention and improving processing speed, as well as reducing anxiety.

Neurofeedback and Biofeedback


A concussion often causes the brain waves to get stuck in a repetitive pattern, impairing thinking and processing. Through Neurofeedback training, one can learn to produce healthy brain waves again.

The process of Neurofeedback involves reinforcing a healthy combination of brainwaves. People e with concussion symptoms typically come in two to three times a week. With Biofeedback, one can learn to control their autonomic functions to improve their physical and mental state which helps manage post-concussion pain and physical issues.

When Can an Athlete Return to Play?


How do you know when you need not rest? Well, there simply are no more symptoms. Neurologist and Concussion Expert and author of Concussionology: Redefining Sports Concussion Management For All Levels, Dr. Harry Kerasidis, advises that symptoms be formally tracked to make sure that we are objectively assessing symptoms. Formal testing including, QEEG can also be used to look at how the brain is functioning and whether or not a player can return to play.

School Accommodations for Concussions


Athletes recovering from a concussion may require accommodations to support their educational or physical needs. With physical issues, they may need to use an elevator or avoid the hallway during class period changes.

Cognitive processing or memory issues may require a reduced workload, relief from board copying, eye breaks, frequent breaks, or use of earplugs.

Some youth with concussion or post-concussion syndrome might need a gradual return to school with a modified schedule. Further, some youth are so impaired that they need homebound instruction for an extended period until they have healed enough to return to the classroom.

Healing occurs at different rates and multiple factors promote and interfere with the process. If the brain isn’t healed and that child is displaying symptoms, then we must honor that child and provide the time their brain and body needs. Therapies like neurofeedback and biofeedback, as well as dietary change, can be a way to help restore the brain more quickly.

To make an appointment with Dr. Roseann for a QEEG brain map  or brain check or to discuss how one of our clinically effective and natural therapies for concussion can help your child, teen, or young adult such as neurofeedback, contact us. 

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Dr. Roseann is a Children’s Mental Health Expert and Therapist who has been featured in/on hundreds of  media outlets including, CBS, NBC, FOX News, PIX11 NYC, The New York Times, The Washington Post,, Business Insider, USA Today, CNET, Marth Stewart, and PARENTS. FORBES called her, “A thought leader in children’s mental health.” 

She is the founder and director of The Global Institute of Children’s Mental Health and Dr. Roseann Capanna-Hodge. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Medicine Mental Health Provider (CMHIMP) and an Amen Clinic Certified Brain Health Coach.  She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF) International Society for Neurofeedback and Research (ISNR) and The Association of Applied Psychophysiology and Biofeedback (AAPB).

© Roseann-Capanna-Hodge, LLC 2021

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