Concussions and Winter Sports


The issue of concussions is front and center in the world of sports, thanks largely to well-publicized stories of traumatic brain injuries among professional football players.

But for winter sports athletes —or even those of us who enjoy the slopes and ice recreationally every winter—the issue of concussions is only now emerging from the shadows.

Here to talk about the risks, and how we can minimize them, is Dr. Adrielle Fry of EvergreenHealth Sport & Spine Care.


Why is it important to talk about concussions in winter sports?

Dr. Adrielle Fry: While we’ve come a long way from the “shake it off” mentality of dealing with a head injury like a concussion, the key to concussion management is education of both parents and athletes about the need for proper care and recovery.

Additionally, concussions in winter sports are far less talked about than those in other sports like football and soccer.

Winter athletes also often lack the support of a league or even a team, so it’s often up to the athlete themselves, a parent or a friend to recognize if a concussion has occurred and stop the activity.

This is true of any sport or activity in which a concussion can occur—the more we are mindful of concussions and can step in as advocates for others, the more likely we are to have a better recovery, prevent a catastrophic injury, and reduce the amount of repeated head trauma that could potentially have some long term effects.


What makes those participating in winter sports especially susceptible to a concussion?

Dr. Fry: While concussions can occur in any contact support, winter sports such as ice hockey, skiing and sledding are often fast-paced, high velocity activities that can lead to serious injury including concussion or mild traumatic brain injury.

An important fact to keep in mind is that concussions aren’t necessarily always caused by a blow to the head nor are they always accompanied by loss of consciousness.

A blow to the body or whiplash motion can cause enough force to be transmitted to the head to cause a concussion.

A concussion is more about the brain’s movement within the skull, which is why helmets can help prevent fractures, but cannot prevent a concussion.

Slipping and falling are natural, almost expected occurrences, when playing on snow and ice, increasing the likelihood that such impact and movement of the brain will happen.


What are some things parents can watch out for–whether on the slopes or the sidelines –to tell if their child might have experienced a concussion?

Common symptoms that occur after a concussion include complaints of a headache often followed by dizziness and cloudiness of thought.

Sometimes concussion symptoms can have some delay of presentation even for a couple hours or days.

Concussion symptoms generally fall into four categories:

  • Cognitive: confusion, lack of concentration, delayed response, slurred speech
  • Emotional: feeling depressed or irritable, sad, nervous
  • Physical: headache, nausea/vomiting, dizziness, fatigue
  • Sleep Cycle: drowsiness, sleeping more, sleeping less, trouble falling asleep

Like a domino reaction, concussions can sometimes result in persisting symptoms, such as headaches or mood changes.

These can sometimes persist even after recovery from a concussion.

If you or your child has symptoms that are persisting beyond a couple of weeks, I would recommend meeting with a concussion specialist to help discuss the best treatment plan.


From special helmets to Return to Play and Return to Learn protocols, there’s been a lot of discussion about what is adequate preventive and post-concussion care. What advice do you have for parents?

Dr. Fry: First, I always recommend that parents and teens not take any risks if they have any inkling that a concussion has occurred. Every concussion should be taken seriously.

Use your best judgment, if you think you have experienced a concussion do not return to the slopes or the game.

Physical and mental rest are the best things to do for treatment, and for the majority of people who experience a mild concussion, they usually have improvement in their symptoms by 2 weeks.

I recommend being seen by a medical provider (either a primary care provider, sports medicine physician, or concussion specialist) soon after the suspected concussion to help develop a treatment plan.

Second, in regard to preventing concussions: using protective headgear, especially in winter sports where it hasn’t always been the norm, can help minimize some of the forces going through your head and brain and is critical to protect the head from other trauma, too.

However, parents should know that helmets and the other products we see marketed for concussion prevention have not been proven to prevent a concussion from happening. The movement of the brain can still happen under a helmet.

Finally, it is especially important to give the young brain, which is still developing, time to recover.

Today’s return to play and return to learn protocols, which prescribe time off from playing sports or classes to recover from their injury, can promote physical and mental healing and help prevent immediate secondary concussions which can lead to serious long-term damage.

If their child is placed on a return to play or learn protocol, I encourage parents to work with their child’s physician, coach, school and teachers to develop a plan for their child that gradually increases physical and mental activity over time to allow adequate time for recovery.


And what about some of the serious long-term effects of traumatic brain injuries we’ve seen in the news—should parents be concerned that their child may be at risk for more significant health issues later on?

Dr. Fry: The good news is that the majority of people with concussions will recover from their injury with no lingering effects.

A small percent of people experience symptoms that persist for months or longer which is a complex disorder known as post-concussion syndrome.

In the most severe cases, when a person sustains repeated trauma to the head, there has been concern for something called Chronic Traumatic Encephalopathy or CTE, a neurodegenerative disease associated with memory loss, impaired judgment, insomnia, dementia and depression.

Research to understand the link between concussions and CTE is in its infancy—and while CTE has been found in the brains of high-profile professional athletes who took their own lives, there’s still a lot we don’t know about who develops CTE or why it happens.

For parents, understandably, this can be very concerning. Seeing a medical provider—a pediatrician, primary care doctor or a sports medicine specialist—can help carefully evaluate whether it’s possible for your child to return to activity safely and when to do it.

In some situations, particularly when a child has had multiple previous concussions, we have to make the tough call and advise them against playing sports that carry a risk of a repeat concussion.

There is no “magic number” of concussions that you are allowed to have, but these decisions occur after careful consultation with a concussion specialist.

Keeping our young athletes safe and healthy as they get older and more competitive is the priority. We want to avoid the serious long-term health issues posed by cumulative impacts to the head at all costs … even if it means trading in a favorite activity or sport.


Fry-Adrielle-MD-doctor-diagosis-nonsurgical-treatment-spine-muscle-orthopedic-pain-injuries-EvergreenHealth-Sport-Spine-Care-Kirkland-WA.jpg

About Adrielle Fry, MD

Dr. Adrielle Fry of EvergreenHealth Sport & Spine Care is a fellowship-trained physician who is passionate about providing concussion care and education for patients, serving as the team physician for Lake Washington High School and other area youth and adolescent sports programs.

Read Dr. Fry's full profile

Visit Dr. Fry's website