Concussions in Skiing and Snowboarding: Symptoms and Rehabilitation

Article written in collaboration with Oberson.

A concussion is a common injury in sports, including skiing and snowboarding. Understanding its mechanisms, warning signs, and recovery protocols is essential to minimize its impact and ensure a safe return to both sports and daily activities.

What is a Concussion?

A concussion occurs when the brain sustains an impact inside the skull, often caused by a direct or indirect blow. Contrary to popular belief, hitting your head is not the only way to suffer a concussion. Falls on the buttocks, shoulders, or a jaw impact can also be enough to cause one.

Diagnosis: What Symptoms Should You Watch For?

A concussion diagnosis is based on the symptoms experienced by the patient, which may include:

• Headaches
• Dizziness
• Nausea or vomiting
• Loss of balance
• Sensitivity to light or noise
• Fatigue
• Difficulty concentrating
• Memory loss
• Feeling slowed down

It is important to note that loss of consciousness is not required for a concussion to occur. Imaging tests, such as X-rays or MRIs, do not detect concussions. Symptoms can appear immediately after the incident or within the following 24 hours.

If a concussion is suspected during a sporting activity such as skiing, it is crucial to stop immediately to prevent worsening the condition. Ski patrol members can provide assistance if needed.

Warning Signs (Red Flags) 🚩

Seek urgent medical attention if any of the following symptoms are present:

• Double vision
• Numbness or weakness in limbs
• Severe headaches
• Seizures
• Loss of consciousness or fluctuating levels of awareness
• Increased aggressive behavior
• Repeated vomiting

Return-to-Sport Protocol

Managing a concussion starts with immediate rest for 24 to 48 hours after the incident. Contrary to common myths, it is safe—and even beneficial—to let a person sleep if they do not exhibit red flag symptoms, as sleep plays a crucial role in recovery.

Steps for a Safe Return to Sport:

1. Initial Rest: Physical and cognitive rest for 24 to 48 hours.
2. Gradual Resumption:
   • Light walking or stationary biking.
   • Gradual increase in physical activity (light weight training, jogging).
   • Non-contact sports practice.
   • Gradual reintroduction of contact.
3. Full Return: Resumption of full-intensity sports or competition.

Each phase should last at least 24 hours and should not be advanced if symptoms persist or worsen.

Returning to School or Work

Cognitive activities should also be resumed gradually:

• After 24 hours of rest, begin with a reduced school schedule (one period or a half-day).
• Increase workload and study duration as tolerated.
• Avoid screens or adjust brightness to reduce discomfort.

For returning to work, start with half-days and lighter tasks. Limit screen exposure and adjust work duration based on recovery progress.

Role of a Physiotherapist

A physiotherapist can play a key role in concussion management by:

• Symptom management: Evaluating and treating neck pain, which is often associated with falls.
• Vestibular rehabilitation: Addressing dizziness and oculomotor issues.
• Return-to-sport planning: Developing a personalized program for each stage of recovery.

A concussion is not an injury to take lightly. Quick intervention, a gradual approach to resuming physical and cognitive activities, and professional guidance can make a significant difference in recovery. Whether you are an athlete or a recreational skier, caution and adherence to recovery protocols are essential for safely returning to the slopes and daily life.

Learn more about concussion treatment in physiotherapy.

Article written by Stéphanie Plamondon Simard, physiotherapist and alpine ski coach.