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Concussion Management

A concussion is an injury to the brain most often caused by a mild or severe blow to the head. Any traumatic force to the head, neck, or body could put you at risk for developing a concussion. After a head injury, it can be difficult to tell if someone has sustained a concussion. Any person suspected of having a concussion should be evaluated by a trained professional. A concussion is a functional injury to the brain, so CT scan of the brain and most MRIs are frequently normal. Headaches, blurry vision, dizziness, fatigue, and difficulty sleeping and concentrating are some of the more common symptoms; however, appetite loss, depressed mood, and sensitivity to bright lights and noises can also be signs of a concussion. No matter how big or small the concussion Orthopedic Associates of Dutchess County and Dr. Karl Ziermann can help!


The First Few Days

Karl Ziermann, D.O., of Orthopedic Associates of Dutchess County is board-certified in internal medicine with a sub-specialty in primary care sports medicine and concussion management.
A painful, burning sensation on the outer side of the thigh may mean that one of the large sensory nerves to your legs-the lateral femoral cutaneous nerve (LFCN)-is being compressed. This condition is known as meralgia paresthetica (me-ral’-gee-a par-es-thet’-i-ka). The nerves in your body bring information to the brain about the environment (sensory nerves) and messages from the brain to activate muscles (motor nerves). To do this, nerves must pass over, under, around, and through your joints, bones, and muscles. Usually, there is enough room to permit easy passage. In meralgia paresthetica, swelling, trauma, or pressure can narrow these openings and squeeze the nerve. When this happens, pain, paralysis, or other dysfunction may result. Symptoms
  • Pain on the outer side of the thigh, occasionally extending to the outer side of the knee
  • A burning sensation, tingling, or numbness in the same area
  • Occasionally, aching in the groin area or pain spreading across the buttocks
  • Usually only on one side of the body
  • Usually more sensitive to light touch than to firm pressure
Talk with your physician and employer about gradually returning to work/school.

Talk to your physician and teacher/coach about school expectations and a safe return to play protocol.

It’s important to get back to doing your normal activities slowly. Start by doing paced activity. As you begin to feel ok do a little more. Be sure to rest and give yourself extra time as you start to feel better.
After a concussion, your brain has less energy to spare. It is important to conserve physical and mental energy to allow your brain to fully recover.

If symptoms return or new ones arise as you become more active, this may be a sign that you are pushing yourself too hard.

Eating regular meals and snacks can help improve your mood, sleep and mental focus.

Stay away from stimulants (coffee, caffeine, soda and energy drinks) and depressants (alcohol, sedatives) as they can add stress to the brain.

Keep a regular schedule. Talk to your physician if you are having trouble getting a good night’s sleep

Try doing activities that help you relax and feel calm. Stress, emotional distress and worry can make symptoms feel worse and prevent you from doing things that will help you get better.

Talk about worries with your physician, family member or friend. Talking and letting others know how they can help tends to help you feel better.


Unless Your Physician Says Otherwise

Increased sleep need is normal and necessary in the acute stage.
In the past, patients were told to have absolute rest. It is now accepted that light and cautious activity can be part of the healing process. Respect your brain and your body. Have a conversation with your provider about what this can look like for you.
Multiple concussions may have serious long-term problems, including difficulty with concentration, memory, headache and sometimes physical skills. (balance and coordination)
Sometimes the demands of school/work can trigger symptoms following a concussion. You may need to take time off to rest and recover; or reduced/modified responsibilities for a short period of time.
Don’t look at devices for an extended period of time.
Reaction time, vision, and thinking may be impaired by a concussion. Do not drive or operate machinery until cleared by your physician.
Use of non-prescription drugs and alcohol may add to concussion symptoms and increase recovery time. Only take medication your physician has approved.

Meet our

Concussion Management Team
Karl Ziermann, D.O.


Concussions are mild traumatic brain injuries. They occur in a wide range of sports and affect all athletes, from professional players to little leaguers.

Sports concussion has become a significant problem. In recent years, it has made headlines with reports about the consequences of returning to play too soon, as well as research findings into the long-term effects of the injury.

Recognizing concussion and providing proper treatment is especially important for younger athletes because it typically takes them longer than adults to fully recover.

In addition, coaches, parents, and school administrators must be aware that concussion causes a wide range of symptoms and can interfere not only with sports participation, but with school and social relationships. Most athletes will fully recover from concussion, and understanding the varied symptoms can help with the healing process.
Derived from the Latin word concusses, concussion means to shake violently. A concussion happens when a force causes the brain to rapidly move back and forth inside the skull. This may be caused by either a direct blow or by a blow to the body that forces the head to quickly rotate.

Although some sports have higher instances of concussion – such as football, ice hockey, and soccer – concussions can happen in any sport or recreational activity.

Because of the potential long-term consequences of sports concussion, it is important that athletes, coaches, and parents know as much as possible about how to recognize them.

Symptoms are not always obvious. Although it is commonly assumed that concussions cause loss of consciousness, many people with concussions have not been “knocked out.”

Concussion causes a variety of symptoms. These may appear right away, or may be delayed for several days after the injury. Some symptoms are physical, such as drowsiness. Others are cognitive, like memory loss. In many cases, people with concussions are more emotional than usual.

The most common symptoms of concussion include:

  • Drowsiness
  • Headache
  • Loss of consciousness
  • Memory loss
  • Irritability
  • Confusion
  • Balance problems, dizziness
  • Difficulty speaking and communicating
  • Depression
  • Nausea and vomiting
  • Changes in sleep patterns
Getting back into the game too soon puts you at risk for another concussion.

If you suffer a repeat concussion before your first concussion has healed, it may take much longer for your symptoms to resolve and you may have long-term problems, such as learning difficulties or chronic headaches. Although it rarely happens, repeat concussion can cause permanent brain damage and even death.
The American Academy of Pediatrics recommends that young athletes with concussions be evaluated and cleared by a doctor before returning to sports. The American Academy of Neurology offers a similar recommendation, and stresses that doctors who clear athletes for return to sports should be trained in managing and accessing sports concussions.

Posted in on January, 2022