Concussion

Concussion, also called a mild traumatic brain injury (mTBI), may be caused by a direct or indirect impact to the head, neck, or body, causing a rapid movement of the brain inside the skull. The sudden motion causes a neurochemical disturbance resulting in a range of clinical signs and symptoms. It is important to note that not all concussions result in a loss of consciousness (or “blacking out”). Recovery timelines differ for every individual and every concussion. Learn more about concussion and management strategies from the Centers for Disease Control and Prevention (CDC) and U-M Concussion Center.

Signs & Symptoms

It is important to be able to recognize some of the common signs and symptoms associated with concussion. Someone who sustains a concussion may appear dazed or confused, clumsy, or disoriented. In addition, concussion symptoms may not appear immediately following an impact, but typically present within 24-72 hours after injury. Symptoms include, but are not limited, to:

Headache
Nausea or vomiting
Changes in vision
Dizziness or difficulty balancing
Sensitivity to light or noise
Confusion
Difficulty concentrating
Problems remembering
Difficulty falling or staying asleep
Being more emotional

For more information regarding concussion signs and symptoms, please see the U-M Concussion Center e-poster. If you think you have a concussion, you should remove yourself from all activities and set up an appointment with your healthcare provider (When in doubt, sit it out!). If you are participating in sports, you should not return to play until you are cleared by an approved healthcare provider.

Questions to Ask Your Healthcare Provider

What should I do if my symptoms get worse?
How should I manage my symptoms at home?
When will I be able to return to class?
Can you provide documentation so that I can notify my instructors of my concussion?
When will I be able to return to physical activity?
What are my options for treatment?

General Recovery

A majority of concussions resolve within the 2-4 weeks after injury; however, every person recovers at a different rate and every concussion is different. It may take you shorter or longer to fully recover from your concussion. You should resume activities of daily living (e.g., reading, texting, screen time, social interactions) after a brief period of rest (24-48 hours).

Contact your healthcare provider for a follow-up appointment if you are experiencing persistent symptoms (>4 weeks), as this may be indicative of Post-Concussion Syndrome (PCS). Common symptoms of PCS include tension-type headaches, prolonged dizziness, or difficulty with concentration and/or memory.

Returning to Class and Physical Activity

You may begin to gradually reintroduce coursework and physical activities after an initial period (24-48 hours) of cognitive and physical rest. We encourage students to become gradually more active while staying below their symptom thresholds (i.e., activities should not increase your symptoms). Speak with your healthcare provider if you have specific questions about how to safely progress back to these activities.

Returning to Class

You may need academic accommodations after your concussion. We recommend that you notify your instructors (professors, graduate student instructors, teaching assistants), academic advisors, deans, and/or any other academic faculty/staff of your concussion as soon as possible. For a list of suggested guidelines for you and your instructors to implement in your learning environment(s) (lecture hall, lab space, etc.) during your recovery, please see the U-M Concussion Center Return to Class Guidelines.

Returning to Physical Activity

You may work through your return to physical activity progression while also transitioning back to class. However, you must fully return to class before you return to unrestricted physical activities.

You may begin the return to physical activity progression (see table below) only once you have been approved by your healthcare provider. There should be at least 24 hours between each stage of the protocol. If your symptoms worsen during any stage, you should return to the previous stage. If you are participating in sports, you must be cleared by your healthcare provider before starting Stage 5.

Graduated Return to Physical Activity Strategy
Stage	Aim	Activity	Goal
1	Symptom-limited activity	Daily activities that do not increase symptoms	Reintroduce work/school-related activities.
2	Light aerobic exercise	Walking or stationary bike at slow to medium pace; No resistance training permitted	Increase heart rate during exercise
3	Sport-specific exercise	Running drills; No head impact activities permitted	Add movement
4	Non-contact training drills	More difficult training drills; Progressive resistance training permitted	Add coordination, increased thinking, and advanced exercise
5	Full contact practice	Following medical clearance, participate in typical, sport-related activities	Restore confidence; assess functional skills
6	Return to sport	Normal game play

*Table has been modified from the 2016 Consensus Statement on Concussion in Sport.

How to Prevent Concussion

You may be at greater risk for concussion depending on the type of activities you participate in. It is important to abide by fair play rules and wear protective equipment to ensure safe play. Helmets are effective at reducing your risk of severe brain injury such as skull fractures, however, no helmet can prevent all concussions. In addition, mouthguards are used to prevent dental fractures, but may not reduce your chances of sustaining a concussion. Regardless, it is important to make sure your protective equipment is up to date and worn correctly to reduce your risk of catastrophic injury.

Campus Support

Please see the resources below for additional support for your concussion:

Students seeking long term accommodations for concussion-related matters should contact the Services for Students with Disabilities (SSD).

Services for Students with Disabilities Office
G-664 Haven Hall
505 South State Street
Ann Arbor, MI 48109-1045
(734)-763-3000
[email protected]

Students in need of immediate support for concussion-related absences or academic accommodations should contact the Dean of Students Office - Academic Concerns.

Dean of Students
Michigan Union
520 South State Street
Suite 3100
Ann Arbor, MI 48109-1308
(734)-764-7420
[email protected]