Managing Sports Concussion With the Bone and Joint Institute

Did you know there are between 1.7 and 3 million sports-related concussions every year? And that approximately 300,000 of those occur in football? With the fall athletic season underway, we sat down with sports medicine specialist Richard Gibson, M.D., from the Bone and Joint Institute of Tennessee to learn more about concussions.

Williamson Source: What is a sports concussion and what can cause it?

Dr. Gibson: A sports concussion is described as a linear rotation acceleration or deceleration injury of the brain – a bruise of the brain. It most commonly occurs in sports. The most common sport for concussion is football, followed by women’s soccer and basketball.

WS: What treatments are there? 

Dr. Gibson: The treatment, as long as you can rule out any type of red flag issue, is rest – both cognitive and physical rest. We usually keep our high school-aged athletes out of school for a few days, limiting tests and some homework. We also recommend physical rest; we’re keeping them out of sport until symptoms have resolved.

After an initial concussion, an athlete is usually out from sport for about two weeks. Once they become asymptomatic for 24 hours we’ll start a six five-day return to play protocol with a gradual increase in activity, with day five being a full practice and day 6 being a gamescrimmage or game. As long as the patient remains asymptomatic throughout the five days, they’ll be cleared to play.

WS: What is the recovery process like?

Dr. Gibson: People recover at different speeds depending on age, gender, severity of concussion, and whether this is their first concussion or a repeat concussion. In most cases, people have full resolution of their symptoms in two to three weeks and then we get them started on the return to play protocol.

WS: What should parents and players know about the dangers of multiple or repeat concussions?

Dr. Gibson: The most important part about prevention of worsening symptoms or repeat concussions is making sure you’re fully healed from your previous concussion. One of the worst issues is having a second or third injury, which could lead to prolonged symptoms that may last several months. Recognizing the symptoms early and taking action early is really important for the athletes and their families.

WS: Does the Bone and Joint Institute work with coaches?

Dr. Gibson: We work with coaches in all the schools we cover in Williamson County to ensure they understand the signs and symptoms of concussion. We also have athletic trainers who are skilled in recognizing the signs and symptoms of concussion, including in players who may not verbalize their condition.

WS: How can you diagnose the severity of a concussion?

Dr. Gibson: Anyone who has a concussion should be seen by a physician for further evaluation, especially if there are any red flag symptoms. If a child goes down at a football game, there are a few things to look for that may indicate this is worse than a mild TBI (traumatic brain injury). These indicators may include a loss of consciousness for over 30 seconds, seizure-like activity, persistent vomiting, worsening headache, or focal neurological deficits (i.e. motor weakness, vision loss, or inability to articulate).

Other early symptoms may include nausea, vomiting, sensitivity to light or sound, confusion or amnesia, which can be normal symptoms of a headache.

Delayed symptoms after the first 24 hours may include mood swings, inability to focus, some slurred or delayed speech with ability to articulate. Our team of physicians is on the field in Williamson County to evaluate for this type of behavior.

WS: How is baseline testing used in treating patients?

Dr. Gibson: Impact testing is special and unique to Williamson County and what we do at the Bone and Joint Institute of Tennessee. Impact testing is a neuropsychological test that tests reaction time and memory of our athletes. All of our athletes undergo baseline impact testing at the beginning of the season which gives us base reactions times, memory and impulse control. If the athlete sustains a concussion we compare that to baseline studies.

Get Care at Bone and Joint Institute

For more information about concussion management and sports medicine care at Bone and Joint Institute locations, call (615) 791-2630 or visit their website at

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