Recognizing a Concussion: Signs and Symptoms

By John R. Mishock, PT, DPT, DC

There are more than 4 million concussions during competitive with up to 50% going unreported or undiagnosed. A concussion is a traumatic brain injury caused by bump, blow, or jolt to the head. It also can be caused by quick movements of the head back and forth. In either event the brain bounces around in the skull causing small amounts of damage to the brain structure. It is essential that coaches, trainers, and parents be able to identify the signs and symptoms of a concussion.

Signs and Symptoms of a concussion

These are signs a parent or coach can observe in an athlete with a concussion:

  • Appears dazed or stunned
  • forgets an instruction or is confused
  • moves clumsily
  • answers questions slowly
  • loses consciousness (even briefly)
  • shows mood or personality changes
  • can’t recall events prior to the injury.

These are symptoms an individual will report to a parent or coach with a concussion:

  • Headache, Dizziness
  • Difficulty with balance
  • Nausea/vomiting
  • Fatigue,  Difficulty sleeping
  • Double or blurred vision
  • Sensitivity to light and sound
  • Difficulty with short-term or long-term memory
  • Confusion
  • Slowed “processing” (for instance, a decreased ability to think through problems)
  • “Fogginess”
  • Difficulty with concentration.

What should a parent or coach do if there are signs and symptoms of a concussion?

  1. Remove the child or teen from the game or activity immediately.
  2. Keep the individual out of all activities that day.
  3. Your child should be seen by a health care provider for evaluation.
  4. Return to play should be determined by the health care provider.
  5. Ask your health care provider for written return to activity instructions to be provided for the coach or school as they return to activity.

Do not judge the severity of the concussion yourself. Only a health care provider should assess and make the determination on when and how to return back to normal activity.

How Can a Physical Therapist Help?

Physical therapists can evaluate and treat many problems related to concussion. After a concussion, it is important to limit any kind of exertion.  In most cases rest from activity will allow the brain to heal. However, in some cases the individual do not respond to rest alone. Because every concussion presents differently, the physical therapist’s examination is essential to assess your individual symptoms and functional limitations. The physical therapist then designs a treatment program. Mishock PT also offers ImPact testing in our Gilbertsville clinic. This is a neurocognitive computerized test that provides a baseline for the athlete or a post-treatment outcome tool for those athletes being treated for a concussion.

We can help!

If  you could benefit from ImPact testing, please give us a call for a FREE phone consultation at (610)327-2600. Also, visit our website at:, or like us on Facebook, or email your questions to Also, visit our website to learn more about our treatment philosophy, our physical therapy staff, and our five convenient locations in Gilbertsville, Skippack, Phoenixville, Barto, Limerick, and Stowe (Pottstown).

* Phone Consultations are not applicable to patients in federal or state funded programs, such as Medicare and Medicaid.
* Screenings are consultations and do not involve a physical therapy evaluation or treatment.

Dr. Mishock’s new book has been released, “The Rubber Arm: Using science to increase pitch control, improve velocity and prevent elbow and shoulder Injuries.” This book can be found at

(Dr. Mishock is one of only a few clinicians with doctorate level degrees in both physical therapy and chiropractic in the state of Pennsylvania.)

New patient scheduling: 610-327-2600