Concussions and High Intensity Training

As a high school football coach, I am required to complete a Concussions in Sports course once per year. Concussions can occur in soccer, basketball, and even field hockey, but football generally garners the highest amount of attention. The way that we teach tackling at the youth and high school level (keeping the tackler's head behind and away from contact) has actually made the game safer than ever, but with any collision sport you can never completely eliminate the risk of concussions. According to the Centers for Disease Control, "A concussion is a mild type of traumatic brain injury-TBI-caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth."

Symptoms of a concussion can include headache, sensitivity to light, sensitivity to sound, nausea, disorientation, and dizziness. Depending on the severity of the injury (and if you have sustained previous injuries), these symptoms can last from a few days or weeks to several months. Hockey fans will likely remember that Pittsburgh Penguins star Sidney Crosby once missed several months of a season as he struggled to recover from one of many concussions he has sustained over his career. The Virginia High School League, the governing body of high school sports in our state, has strict guidelines that coaches must follow if an athlete is suspected of sustaining a concussion. These include immediate removal from a practice or game, a same-day evaluation by a medical professional, and rest until they are symptom-free. Following that, there is a "Return to Play" protocol that must be followed. In sequential order, the athlete must perform light aerobic activity, sport-specific exercise, non-contact drills, full contact practice, and if they remain symptom-free they may resume full activity. If concussion symptoms return at any point, they must drop back to the last stage in which they were symptom-free. In my experience, having knowledgeable coaches working with seasoned athletic trainers on sight has made a huge difference. In 2024, my second year at Dominion High School, we sustained no concussions on our freshman team. I attribute that to these guidelines, but also because we limited full-contact (tackling to the ground) tackling drills in practice.

What do concussions have to do with high intensity exercise? You are certainly less likely to experience a concussion if you don't participate in a collision sport, but concussions can occur in everyday life as a result of car accidents, falls, or physical assaults. I currently work with two clients who have sustained concussions during their tenure at Total Results, though neither occurred during the course of a workout. Both clients were in their early 50s, one a male and one a female. Each of these trainees had worked with us for a number of years when they sustained the injury, and fortunately they were very well-conditioned.

How do we handle concussions at Total Results? If you suspect that you have sustained a concussion, we strongly encourage you to be evaluated by a medical professional. Should the diagnosis be confirmed, you should avoid weight training workouts until you are symptom-free. We are more than happy to touch base with your medical provider to gain insight and learn of any restrictions that they suggest. Once you are able to resume exercise, we will start with greatly reduced weights, mild to moderate intensity, and a fixed number of repetitions or time under load. We are not training to muscular failure; we simply want to make sure that you can complete the workout without experiencing a recurrence of symptoms. Neck exercises will be avoided for the first few workouts to avoid any pressing on the head. The instructor will assess on an ongoing basis and the client will provide feedback following each workout. It is important to note how you feel in the day or two after the workout; sometimes symptoms don't recur right away. We will slowly work up to a higher level of effort over the course of a few weeks until you are able to exercise at full intensity with no problems. Each case is different; people heal at different paces, so we must individualize the workout.

A concussion is a head injury; treatment should be taken very seriously. These injuries can vary in severity, which is why you should get checked out if you sustain a blow to the head. If you have previously suffered a concussion you are more susceptible to another injury, so it is important to know the warning signs. If you should happen to suffer from a concussion, please communicate to us so that we can take the appropriate steps to ensure your safety. We are on your side!