Are you ready for a Concussion?

With winter sports being in full swing one of the most important things that you should consider is having a full baseline concussion test done. But what exactly IS a baseline test and why should I get one?

Quite simply, a baseline concussion test is an assessment of various elements of brain function that are commonly impaired following concussion injury. The reason these tests are referred to as “baseline” is because they are an assessment of an individual BEFORE the injury occurs.

The deficits that typically occur with a concussion injury are often quite subtle and because every individual person is so uniquely different, it is virtually impossible to know how much impairment is present if we don’t know how you were when you were healthy. Every single professional, college, and university athlete goes through a comprehensive battery of pre-season baseline concussion testing each year, however there are currently no such mandated procedures for young athletes. 

Before you can understand the true value of a baseline test you must first understand how it can help to keep your brain safe and healthy. A concussion is due to a significant acceleration, or deceleration, of the brain within the skull. The initial signs and symptoms of concussion are due to a massive electrical storm, known as the Excitatory Phase, due to the impact. Contrary to popular belief, there is no “damage” that happens during a concussion. The injury simply creates an imbalance within brain cells that causes them to burn more energy than they can produce. This creates the second concussion phase known as the Energy Crisis. These energy stores continue to burn for hours to days after injury hitting their peak low-point around day 3 to day 5 after the injury has taken place. This is typically why a person will experience extreme fatigue following a concussion and is also why the initial treatment for concussion involves complete brain rest - it is an effort to conserve energy so that we can help our brain cells restore. Following this continual decline in energy over the first 3 to 5 days, the energy stores gradually start to build back up over the next 1 to 3 weeks depending on how well you are managed through proper diet and guidance from your healthcare provider.

During this recovery period, prior to the fully energy levels being restored, the brain is extremely vulnerable to any additional trauma. In fact, even smaller impacts can cause another concussion during this phase, and these second concussions can be quite dangerous.

Numerous research studies have found that if the brain fully recovers its energy back up to pre-injury levels and you suffer a second concussion, there will be little to no compounding effect. This means that the injuries will not add up to be a worse injury. It will simply result in another concussion.

BUT…

These same research studies have found that if a second concussion is sustained prior to your energy being completely restored, your energy levels plummet. A second concussion sustained prior to full recovery from the first can result in severe brain injury and in some cases, death. Because the energy stores are already depleted from the first injury, a second injury causes even further depletion to beyond the point in which the brain cells can survive. This results in permanent damage of the affected regions of the brain.

Here is the problem:

The symptoms of a concussion DO NOT reflect the actual recovery of the brain! So even after someone feels 100% better and believes that they are no longer concussed, they are still not fully recovered from a brain energy standpoint…and this is where the danger lies. Numerous studies have shown that after the symptoms of the injury have subsided, brain energy levels are still very low and people still show deficits in balance, reaction time, visual tracking and processing speed, memory, concentration, and numerous other higher order processing abilities.

There is no X-ray or brain scan that can determine when you have received a concussion or when your brain has recovered to the point where you are safe to return to sports. The best tool we have available to ensure that you are safe to sustain another impact is to measure you at baseline (before injury) and then measure you again when you think you have recovered. This way we can pick up these very subtle deficits that indicate that you may not be fully recovered and are therefore vulnerable to a severe, and potentially permanent, brain injury.

Your doctor can’t tell you when you have recovered…unless they have the data from all of these testing metrics from before you were injured. If they tell you that you are recovered without comparing you to your PRE-INJURY status, they are guessing. No one can see the energy levels in your brain. You can’t rely on how you feel; you must be tested.