Concussions: Long-Term Damage

In our last post we learned how to recognize and respond to concussions. We’ll continue that focus today by discussing the long-term damage that can be sustained by unrecognized or untreated concussions. Christian school athletic directors need to be more proactive in preventing concussions in their athletic departments. Education is the first step in prevention. Take a look at how sustaining multiple concussions can endanger your athlete’s future.

Normal concussions, if treated properly, will usually heal within a week to ten days’ time. However, many concussions, isolated or compounding, run the risk of three serious long-term effects on the athlete: post-concussion syndrome, second impact syndrome, and chronic traumatic encephalopathy (CTE).


Post-Concussion Syndrome

Coaches, athletic directors, parents, and athletes all need to be aware of the symptoms of post-concussion syndrome.

Post-concussion syndrome results when the brain experiences a very slow-healing concussion. In some cases, the athlete may even be cleared to play by a physician. However, on return to physical activity or athletic competition, the athlete’s concussion symptoms re-occur.

According to Dr. Robert Cantu in his book Concussions and Our Kids: America’s Leading Expert on How to Protect Young Athletes and Keep Sports Safe,

“Approximately 20 percent [of concussions] are post-concussion syndrome cases.” (p. 71)

The return of concussion symptoms during physical activity indicates a concussion that is still healing. Continuing in competition when experiencing these symptoms can halt or even reverse the healing process.

Athletes should not return to competition until they are symptom free, even during activity.

The best way to treat post-concussion syndrome is through rest. Resting, both mentally and physically, will give the brain proper time to heal. Mental rest is just as important as physical rest when dealing with all concussions, but especially post-concussion syndrome.

Anything mentally stimulating (including texting, video games, and watching TV) needs to be put on the shelf. School work should be drastically reduced.

Post-concussion syndrome will eventually heal, but proper treatment (rest) needs to take place. There is no set time frame; every case is different.


Second Impact Syndrome

Second impact syndrome (SIS) can occur when a second concussion-inducing blow is sustained before a first concussion has completely healed.

According to Cantu,

[Second impact syndrome] is a grave situation which often leads to herniation of the brain and death. The patients who survive are almost always severely disabled.” (p. 83)

The risk of SIS should encourage everyone in your department to be alert in recognizing and responding to initial concussions when they occur.

The brain autoregulates blood flow for the entire body, including itself. However, second impact syndrome causes confusion in the autoregulation process. Arterioles and venules in the brain relax when they should constrict. The result is literally a “rush of blood to the head.” The increased amount of blood in the brain causes immense pressure inside the skull. This increased blood pressure has dire consequences.

While extremely rare over the entire scope of high school athletics, SIS is most tragic because it is preventable with proper recognition and response to initial concussions.


Chronic Traumatic Encephalopathy

Known in the medical community as CTE, chronic traumatic encephalopathy is similar to Alzheimer’s in that it is a degenerative brain condition.

Honestly, most Christian school athletes are not at a high risk of developing CTE. Dr. Robert Cantu states that CTE is the result of a lifetime of repetitive brain trauma. CTE occurs most often in high level boxers, football players, and ice hockey players.

However, this does not mean that the seeds of CTE cannot be sown in our athletic departments.

Football teams should look to reduce the number of full-contact practices. Be sure that your football coaches are properly trained in tackling technique. You also need to be a presence on your football field inspecting what you expect of your coaches in regards to limiting the number of opportunities for concussion.

Each hit to the head can cause the protein tau to build up in the brain’s information passageways. Tau is considered a toxin, and it kills brain cells.Tau buildup in the brain leads to a loss of memory. More importantly, it can lead to intense depression, which can cause a lifetime of complications.

CTE is the most serious because it often goes unrecognized — these little head hits slowly chip away at the brain over time. It’s also impossible to know whether or not an athlete has CTE until their brain is examined.

“The reality is … [knowing] would not be helpful. No treatment exists for arresting the progression of CTE.” (p. 101)


In summary, we can’t be too careful when dealing with concussions in our athletic department. You don’t need to scare your coaches or players regarding concussions. However, a healthy fear of concussions and their effects is crucial. Coaches, parents, players, and YOU need to be hyper-vigilant in dealing with these injuries. The livelihood of our athletes is at stake.

Jeff is the athletic director at Victory Baptist Academy. He is also the founder and administrator of

Please note: I reserve the right to delete comments that are offensive or off-topic.

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