Monday, 26 August 2013

Live from Olympic Camp - "Concussions" with Mike Richards

As I mentioned in my first post, I hope to pursue an extra year in sports medicine following my family medicine residency. Concussions are a particular area of interest for me, especially given that they are so common these days and we don't learn much about them during medical school. Athletes in hockey, football, boxing all have the unfortunate experience of concussions. Mike Richards of the LA Kings is no stranger to that. Here's what he has to say all the way from Calgary Olympic Camp:

Me: When was your first concussion?
Mike: I was 18

Me: How many concussions have you had?
Mike: Three officially on the book. I had one that wasn't considered a concussion, but I still missed games with some symptoms.

Me: Describe the immediate feeling of a concussion. What are the symptoms you experience in the days following?
Mike: Usually nothing right away, then after a min or two I've gotten blurred vision out of 1 or both eyes. One of the times I forgot a part of the play and tried to describe it, but missed a part.

Me: Did your subsequent concussions feel the same, better or worse?
Mike: They all felt about the same in terms of symptoms. My last one wasn't as severe a my 2 prior, but I still had the same symptoms.

Me: How do they evaluate you for concussions during a game? After the game?
Mike: Right when you get a head injury, you have to go to what is called the "quiet room". They run you through several memory tests and tests on how you feel. Then the doctor usually makes the call as to whether you can play. If it is questionable as to whether you should go back or not, you and the doctor decide what is best. If you go back and play, you re-evaluate the symptoms after the game.

Me: How do they evaluate you in order to decide that you are ready to play again?
Mike: You have to go through exercise with no symptoms and then you have to do a baseline test to see if you are back to the same results in the test you've done at a prior time.

Me: What's your advice to people struggling to get back to play following a concussion?
Mike: There's really nothing you can do to improve a concussion other than rest. It just takes time.

~ Exit Mike ~

But what exactly is a concussion?
A concussion is also termed a mild traumatic brain injury - basically, it results from a force that causes a brain "contusion" (aka bruise) as well as axonal (nerve component) damage.

The most common symptoms are confusion and amnesia. Occasionally, people experience loss of consciousness, but more often they have altered levels of consciousness.

The most recent tool used to assess concussions is the SCAT3. A link to this form is available here:

Patients should NOT return to play on the same day as their injury, nor should they return until they are symptom free. A return to play followed by a second concussion too soon can lead to life-threatening brain swelling.

Patients whose symptoms persist should eventually undergo head CT.

Overall, concussions are serious and shouldn't be taken lightly. Athletes, don't push it too hard!

Hope you learned a bit about concussions and thanks to Mike for the interview! Share your stories with us here...

Mike Richards - enjoying the ocean view in "Calgary".


  1. I've had 2 concussions in my life. The first, happened in high school. Fell head first onto a tile floor. I had blurred vision, vomiting, and a headache. Symptoms lasted 48 hours and then I was completely fine. The 2nd happened over a month from riding a roller coaster (Doctor says my head snapped back too hard and fast) and I still have symptoms. Headaches, nausea, concentration issues. No idea why this one is so much worse but the lingering symptoms are brutal. I'm wondering if the difference in recovery length could be because in the first one I hit the front of my head and the 2nd was the back of my head?

  2. Hi Victoria!
    I'm going to suggest you check out these articles on headaches after concussion:

    1) Couch JR, Bearss C. Chronic daily headache in the posttrauma syndrome: relation to extent of head injury. Headache. 2001;41(6):559.

    2) Stovner LJ, Schrader H, Mickeviciene D, Surkiene D, Sand T. Headache after concussion.Eur J Neurol. 2009;16(1):112

    They suggest that headaches following a concussion are actually worse (oddly enough) in mild trauma as opposed to severe.

    Hope that helps!

  3. As a student who wants to major in Sports medicine its great to see you are blogging about it. Can you please do more about it? By the way your blog is amazing :)