How to get back into the game after a concussion


Sidney Crosby is one of the most exciting figures ever to grace the game of hockey. He’s one of the game’s most marketable stars and is frustratingly good. Which is why come playoff season – the man takes a lot of punishment.

During Game 3 between the Pittsburgh Penguins the Washington Capitals, Crosby took a brutal two-hander in front of the net from his counterpart, Alex Ovechkin, wobbled off balance, and was met by an (accidental) crosscheck to the head by Washington Capitals defenseman, Matt Niskanen.

“Anytime you see that with his history of concussions – it raises concerns.” – Bob Cole.

Even though he put it rather mildly – hockey fans held their collective breaths hoping that the best player in the world would get up unscathed.


Image via CBC

The hit Crosby took caused the fourth diagnosed concussion of his career. Seeing him bounce back into his next game can make it seem like concussions aren’t that big of a deal, but taking care of yourself after one is crucial.

So wait – what exactly is a concussion?

A concussion occurs when the brain is shaken inside the head from external forces, like a fall – or in this case, a blow with a hockey stick.

“A concussion is a mild traumatic brain injury,” says Doctor Alun Ackery, an Emergency Physician and Trauma Team Leader at St. Michael’s Hospital and Assistant Professor of Emergency Medicine at University of Toronto.

You can sustain a concussion from different types of impact, it’s doesn’t require a los consciousness, or even a direct hit to the head, and symptoms can take up to 48 hours to appear. Also, a concussion can’t be detected using CT scans or MRIs.

Unlike a knee sprain, there are no external signs. People experience symptoms in a variety of ways that are tough to visualize externally.

What are the symptoms of a concussion? 

The physical symptoms that occur after a concussion include headache, head pressure, neck pain, nausea/vomiting, dizziness, blurred vision, balance problems, sensitivity to light/noise, fatigue/low energy, drowsiness and trouble falling asleep.

Emotional and mental symptoms can include feeling slowed down or in a fog, not feeling right, difficulty concentrating, difficulty remembering, confusion, feeling more emotional, sadness, irritability and nervousness/anxiousness.

People who have experienced multiple concussions and who experience concussions before the brain has had time to heal are at risk for worse symptoms, longer recovery time and possibly permanent damage.

It’s critically important to be honest about how you feel and ease back into sport to prevent permanent or severe damage to the brain.

How to get back on the ice

The way to repair from the damage is through rest. Taking a few days off work or school after a concussion, while tracking symptoms and limiting stimulation, is important.

Easing back into sport can be done through a Return to Activity plan. The process includes 6 steps: rest, some activity, light practice (ex. jogging), yellow shirting (you can participate in a practice but no-one can come into contact with you), full contact practice and return to play. Once no symptoms are experienced at one step the next one can be tried, but if any issues or symptoms arise you must go back a step.

Why it is vital that you don’t rush yourself  

“If you don’t allow for the appropriate time to rest and heal your brain, you are at a much greater risk for re-injury and possible worsening the initial physical insult.” – Doctor Alun Ackery.

Not only are worse or prolonged symptoms a common result of multiple concussions, there can be some more serious consequences from risking a quick return to playing.

“Before concussions were better understood, many athletes, both professional and amateur, would return too quickly and put themselves at risk for re-injury,” says Ackery. “In very rare circumstances, athletes put themselves at risk to have Second Impact Syndrome if they have a subsequent head injury which can cause the brain to swell and cause more permanent severe damage.”

Marc Savard was forced to retire from the NHL after severe concussions that left him with exhaustion, headaches, depression, sensitivity to light and sound, as well as anxiety that he still deals with today.

marc Photo via Boston Globe

“After missing the Buffalo series, I was cleared to play in round two against Philly. The thing is, protocols rely on the player telling the truth about how they are feeling. In my mind, I was telling myself I was all good. Was I all good? No,” wrote Savard in The Players’ Tribune.

The culture of injury in sport

Savard isn’t alone in this. Getting back into the game too early is common among pros and amateurs alike.

Former Toronto Maple Leaf, Scott Thornton is one of 33 retired NHL players who are participating in a study that suggests that 59% percent experience psychiatric disorders including depression, anxiety and substance abuse.

“The decisions can’t be in the players’ hands. We come from a generation where we’re supposed to be tough. There’s a pride in playing injured — that’s how you gain respect,” said Thornton in a CBC article.

The news comes as the NHL faces a lawsuit from ex-players alleging that the league knew about the long term health effects of repeated head injury but failed to protect or educate it’s players. Among them is Grant Ledyard. The lawsuit claims that he experienced roughly eight concussions during his career and now suffers on a daily basis from headaches, mood swings, loss of temper, depression and sensitivity to light.

Taking care of yourself after a concussion is important. For more information about concussions – check this video out.

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