Why students shouldn't rush back to school after suffering a concussion

We know a little more about the dangers of having athletes return to their sport too soon after suffering a concussion.

There are rules about how and when the athlete can return to play. But what rules are there about when a student who has suffered a concussion can return to learn?

Erin Wasserman is a sports injury epidemiologist at the University of North Carolina. She's the lead researcher on a study that tells us more about how students with concussions should be treated, and how their recovery should be managed.

You can listen to Wasserman's full interview with the CBC's Conrad Collaco by clicking the image at the top of this page. You can also read an edited and abridged transcript of the interview below.

Erin Wasserman, sports injury epidemiologist - University of North Carolina

Q: What are the repercussions for students with concussions who return too soon to the classroom?

We found that students with a concussion had more problems in school, one week after, than students with an injury to an extremity like an ankle sprain. While we don't know the long-term affects of going back to school too soon, we do know the short-term affects. We know that if you think too much and use your brain too much shortly after a concussion, it can cause prolonged recovery.

Q: How old are the students you studied?

High school and college students.

Q: What signs should we be looking for to detect a concussion in young people?

Look for staggered walking, vomiting, loss of consciousness, somebody saying something that doesn't quite make sense. If you suspect that you have a concussion look for headaches, dizziness and nausea. Things like that. Every concussion is different and everyone will have a different set of symptoms. 

Q: Once we identify a concussion, what should we do to make sure students get the right treatment?

The most important thing is communication. Communicate with your health care provider, parent or teacher. All these people should work together to come up with a plan. The next step for this research is to figure out how much rest is the right amount of rest. Right now, the guidelines suggest you should do activity until the point where it makes you feel worse. If you are reading and it makes you dizzy stop reading. If the lights are too bright, dim the lights but it's important to try to stimulate your brain in that recovery process. 

Q: Why have we been slow to develop guidelines around when students should return to the classroom after a concussion but less slow to develop guidelines for returning to play after concussions?

With most other sports injuries, there's not much need to think about school. The people who were managing these injuries, in the beginning, were sports focused. Team doctors or athletic therapists. Concussions are unique sports injuries because they affect your school. Schools are not used to dealing with this. It took a while to get everybody on the same page. It's still not easy to figure out who is responsible for coordinating care.

Q: Are school boards becoming more aware of how to deal with concussions at school?

Yes. In Ontario there has been a push for a law on concussion management. A research study came out recently and showed that 77 per cent of schools in Toronto have a protocol in place for a return to school after a concussion. It's beginning to become more common. 

Q: Do men and women recover differently to concussions?

Yes. Other studies have shown that girls tend to have more symptoms and take longer to recover. At one week after injury, girls were having more problems in school than boys. At one month after the injury, girls showed to be more likely to have problems.

One of the prevailing hypothesis is that it has something to do with hormones. Certain hormones play a role in the recovery of the brain and there is a different balance of these hormones in girls than in boys.    

Erin Wasserman's research was published in the American Journal of Public Health.