As Canadians prepare for warmer temperatures in the months ahead, there are far more opportunities to engage in sports and recreational activities. While there are tremendous social and health benefits associated with these types of outdoor activities for both adults and children, it is extremely common for people to sustain concussions and brain injuries this time of year. In Ontario, an average of 26 per cent of concussions are diagnosed in the summer.[i] Concussions and other traumatic brain injuries (TBIs) can range from mild to severe, with potentially debilitating short and long-term consequences, especially for children and youth.[ii]
The outbreak of COVID-19 has led to the cancellation of many sports and organized outdoor activities, but not all. As cycling, rollerblading, water sports and other summer activities pick up, concussion safety must remain top of mind.
Here are five ways to increase concussion awareness and mitigate the risk of head injuries:
1) Education is key
Before engaging in rigorous or recreational activities that could result in head trauma, it is important to be aware of what a concussion or traumatic brain injury is, as well as the signs and symptoms that may occur.
Concussions are defined as traumatic brain injuries that affect brain functionality. They are typically caused by blows to the head, or violent shaking of the head or upper body. While some concussions may cause a person to lose consciousness, most go unnoticed by those without proper medical training and cannot be detected by X-rays, CT scans or MRIs.[iii] Immediate and informed action is critical following any injury that may have caused a concussion.
There are a number of signs and symptoms associated with concussions, but the time at which these symptoms emerge can vary. While some symptoms show up right away, others may take hours – even days – to appear.
Common signs and symptoms of a concussion are as follows:
Physical: headache, dizziness, nausea or vomiting, blurred vision, sensitivity to light or sound, balance problems, low energy, drowsiness, neck pain or tenderness, seizures, loss of consciousness
Cognitive: not thinking clearly, feeling confused, problems concentrating, memory loss, trouble sleeping
2) Be mindful of concussion prevention protocol
Although concussions or TBIs are bound to occur as we engage in more outdoor sports and activities, there are ways to reduce the likelihood of sustaining a head injury. Following education, it is important to ensure the necessary sports equipment is in working condition and fits properly. Helmets are essential when it comes to head protection and may limit the impact of a blow to the head or a fall, yet they are not the only defence against concussions. Depending on the sport or activity, other important pieces of equipment include: shoulder pads, mouth guard, ear and eye protection, chin straps, face shields, as well as neck, chest and upper extremities protection.
When engaging in water sports or activities, helmets should be worn at all times, as hitting your head against the water surface is just as dangerous as hitting your head on the ground. Additionally, wearing a life jacket for activities like water skiing, boating, tubing, white water rafting and kayaking is crucial because if you sustain a concussion and lose consciousness, a life jacket will keep you afloat.
3) Weather is a factor
Warmer weather creates an added incentive to enjoy outdoor sports and activities, but summer days can reach extremely high temperatures, with humidity levels of 45 degrees and higher. This can result in high UV rays, muscle cramps, heat stroke and a higher chance of losing consciousness. Falling is the number one cause of concussions, accounting for nearly half of all TBI-related emergencies.[iv] These types of incidents can be prevented by staying hydrated, applying sunscreen, or cooling down with towels and ice packs.
Prolonged outdoor activity in hot weather can also lead to a significant reduction in a person’s cerebrospinal fluid, which plays an important role in cushioning the brain from hitting against the inside of the skull upon impact. For athletes, it is extremely important not to overexert yourself outdoors or on the playing field on these hot summer days. While competitiveness is difficult to reign in, it is important to mitigate the risk of head trauma to avoid potentially life-altering injuries.
4) Designate a concussion spotter
If you are engaging in outdoor sports or activities this summer, it is important to designate a concussion spotter to look out for possible injuries or concussions and notify the appropriate people. Concussion spotters are becoming more prevalent amongst professional and amateur sports leagues to monitor for head injuries and conduct baseline testing measures to determine if a concussion has been sustained. For outdoor recreation enthusiasts, this could be a voluntary or rotating position to ensure that everyone involved is educated on concussion management protocol.
While concussion spotters cannot replace the expertise of a medical professional, there are signs and symptoms that they can be made aware of, including: significant impact to head or body, loss of consciousness, lying motionless, clutching head or helmet, stumbling, difficulty with coordination, disorientation, slow movement, blank or vacant stares, inability to communicate, slurred speech or vomiting. There are also digital tools and smartphone apps for concussion screening and management. For more information on these programs, click here.
5) Have a plan
If you suspect that you or someone you know has sustained a concussion, it is important to have a plan in place to ensure access to proper medical care. The first step is to remove the individual from the activity or sport for an onsite assessment. If the person exhibits any of the aforementioned signs or symptoms, seek medical attention as soon as possible. If symptoms do not appear immediately, keep in mind that they may develop in the hours and days following the incident.
Precautions taken within the first few days after a concussion or head trauma is sustained include: rest, avoiding alcohol and caffeine, sleeping at least eight to 10 hours, have someone monitor for worsening symptoms, avoiding screen time, limiting exposure to mentally exhausting activities, avoiding bright lights and loud music, eating healthy and staying hydrated. Check with your doctor if you are experiencing a headache following head trauma, as ibuprofen or aspirin can increase the risk of bleeding.
Approximately 30% of individuals may experience chronic symptoms such as balance impairment as a result of their concussion.[v] For long-term concussion or mild-to-moderate TBI treatment options in relation to balance and gait, please visit the PoNS Treatment™ website for a free consultation.
[i] “Concussion rates are nearly double what we thought – and summer is prime injury time”, University Health Network. July 2019. (Accessed June 10) https://www.uhn.ca/corporate/News/PressReleases/Pages/Concussion_rates_are_nearly_double_what_we_thought_and_summer_is_prime_injury_time.aspx
[ii] “Sport and Recreation-related Concussions and Other Traumatic Brain Injuries Among Canada's Children and Youth”, Government of Canada. October 2018. (Accessed June 4) https://health-infobase.canada.ca/datalab/head-injury-interactive.html
[iii] “Government of Ontario Concussion Awareness Resource e-booklet,” Ministry of Heritage, Sport, Tourism and Culture Industries. March 2020. (Accessed June 4)
[iv] “TBI: Get the Facts,” Centers for Disease Control and Prevention, March 11, 2019. (Accessed June 2) https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
[v] Kleffelgaard I et al. Disabil Rehabil. 2012;34(9):788-794 (Accessed June 10)