What is a Concussion and What to do Next

A concussion is a Mild Traumatic Brain Injury that occurs with an impact or forceful movement to the head/body, causing a rapid motion of the brain in the skull. It can happen to children of any age as well as adults. Note: it’s not just blows to the head that can cause a concussion. Impact to the body can also transmit force to the neck and head, resulting in a concussion.

If your child has had an injury and you suspect a concussion, take them to the emergency room immediately if any of the following symptoms occur: What are the signs and symptoms of a concussion in children/teens?

Each person is different and may experience one, some or many of the below symptoms. These may vary from day to day or could be consistent. 

  •     Very Drowsy
  •      Vomiting
  •      Memory Deficits
  •      Seizure
  •      Blood from Eyes/Ears
  •      Bruising/ Black Eyes
  •      Severe Balance Issues
  •      Severe Injury
  •      Slurred Speech
  • Numbness in Arms or legs
Emotional and Behavioural:

  • Irritability
  • Nervous/anxious/angry
  • Frustrated
  • Sadness

Physical symptoms:

  • Headache
  • Nausea/vomiting
  • Dizziness
  • Sensitivity to noise/light
  • Blurry vision
  • Decreased balance
Mental symptoms:

  • Fogginess/tired
  • Feeling slowed down
  • Trouble remembering
  • Trouble concentrating


  • Trouble falling asleep
  • Trouble staying asleep
  • Sleeping too much
*Only 10% of concussions cause a loss in consciousness so this is not a reliable sign*

**Signs and symptoms of a concussion can be delayed by several hours or even several days! When it comes to kids and sports – if you’re not sure if a concussion has occurred – it’s best to rest for 48 hours after a blow to the body/head before returning to play. “When in doubt, sit them out.”


What are signs and symptoms of a concussion in toddlers and infants?

Infants and toddlers with a suspected concussion, or those experiencing behaviours that are abnormal/concerning for them, should seek immediate medical attention.  An infant or toddler with a concussion can present with some or all of these symptoms:

  • Crankiness/irritability that is not typical
  • Cannot be comforted or crying excessively
  • Changes in eating, sleeping or playing patterns
  • Worsened balance/walking
  • Decreased interest in toys/play
  • Increased fatigue/tiring easily
  • Decrease in skills (language, social, emotional or physical) 

What to do if your child has a concussion


  • Make them stop what they are doing
  • Stay with them to monitor them
  • Seek medical attention to be assessed

During the first 48 hours:

  • Allow your child to rest for a maximum of 2 days. They will need physical and cognitive rest to help their brain heal. 
  • Limit screen time and avoid activities that increase/cause symptoms. 
  • Schedule an appointment with a paediatric, concussion-trained physiotherapist to get started on a recovery plan.

After 48 hours: 

  • Limit physical exertion to activities that do not increase your child’s heart rate too high/cause them to break a sweat. 
    • Examples of things to avoid: Work outs, sports, running, biking, rough play, etc.
  • Cognitive activity should be slowly and gradually re-introduced as symptoms allow, including activities that require concentration and learning as well as exposure to loud noises. 

How long do symptoms last?

  • Most concussion symptoms resolve in 1-4 weeks. During this time we recommend that kids gradually return to school and sports with a return to play protocol, under the guidance of a trained professional.
  • Returning to full activity/sports too soon may result in more severe symptoms or long term problems. It can also put your child at risk of sustaining another concussion with more severe symptoms and a longer recovery period.

How do you treat a concussion?

Physiotherapy can help to assess and address concussion symptoms. Treatment can involve:

  • Neck dysfunction/whiplash 
  • Vestibular system – dizziness and nausea symptoms
  • Visual symptoms
  • Graded and monitored return to school and work with communication to teachers, coaches and more
  • Education on symptom management and how to successfully return to school and sports.
  • Comparing where your child is at to their Concussion Baseline Test, if they have one, and ensuring they get back fully to their baseline levels.

What’s different about Playworks Physio Concussion Treatment?

At PlayWorks Physio, our therapists have up to date concussion training and we individualize each patient’s treatment to their specific concerns and symptoms. We take the time to find out what your child’s interests are and use games and play to motivate them with their exercises! From high level athletes to toddlers, each child’s plan is catered to their level. 

Have a child with a suspected concussion? Click here to book an appointment or call us to see how we can help to identify if a concussion is present and provide treatment as necessary – 604-492-3888.


Written by: Kate Heays & Lindsay Eriksson


Can We Prevent Injuries in Hockey Players?

It’s fall, which means that school and sports are back in full swing! This often leads to some pain and injuries in athletes, as they are thrown into training, try-outs and games. In youth hockey, we see injuries such as concussions, knee pain, groin injuries and shoulder injuries. See the chart below for a breakdown of these injuries and the top 3 highest percentage of injuries.

Injury area Males Females
Head/ Neck 25.1% 28.4%
Arms/ shoulders/ wrist 45.2% 39.2%
Legs (hips/ knee/ groin/ ankle) 21.4% 23.2%

(Forward et al., 2014).

With all sports, some injuries happen because we can’t control all aspects of the sport and other players. However, we do know that improved reaction time, muscular strength, muscular endurance and joint range of motion can help us LIMIT the risk of injuries. 

For hockey players, some key areas for injury prevention are:

  • Shoulder Stability
  • Hip strength and Stability
  • Lateral Movements
  • Core Stability
  • Reaction Time

Are Breaks in Activity Beneficial?

In an article looking at the number of injuries in players who took a break mid-season, it showed that winter break caused an increase in injuries by 2.5x as compared to years with no winter break. This article highlights that long periods of rest, followed by full return to sport, causes higher risk of injuries. We want to use this time during winter break to continue to be active, to use prehab exercises to our advantage, and to spend some time doing some cross training (training in another way or with another sport) (Rees et al., 2022).

Can Physio Help?

Overall, it is extremely important to make sure that your athlete’s muscles are working efficiently, are strong enough to support the demands of the sport and that your athlete is familiar with proper warm up and cool down techniques. Physiotherapy can help with injury prevention by improving the strength and mechanics of the most common injury areas for hockey.

If your child is playing hockey this season, are they ready for activity? 

At PlayWorks Physio, we offer injury prevention group classes for hockey players! Contact us at for more info.

If you would like to schedule a 1 on 1 assessment with one of our paediatric physiotherapists click here.

Written by, Darrien Cantelo, MScPT, BSc, Physiotherapist.


Forward, K. E., Seabrook, J. A., Lynch, T., Lim, R., Poonai, N., & Sangha, G. S. (2014). A comparison of the epidemiology of ice hockey injuries between male and female youth in Canada. Paediatrics & Child Health, 19(8), 418–422. 

Rees, H., McCarthy Persson, U., Delahunt, E., Boreham, C., & Blake, C. (2022). Winter breaks: How do they affect injuries in field hockey? Journal of Science and Medicine in Sport.