Once I’ve had a concussion, is it easier to sustain another?

When the brain is in a state of metabolic dysfunction (such as with a concussion) it is believed to be more “vulnerable” to subsequent trauma. That is, a relatively minor second blow to the head may produce more severe and irreversible changes in brain function. The physiologically altered brain is essentially weakened and less able to withstand or recover from a subsequent (though potentially mild) concussion. In this way, concussive injuries are thought to be cumulative, with progressively less force required to induce trauma to the brain each time (when occurring in close temporal relation). The symptoms experienced may be completely disproportionate to the mechanism of injury. What would have been two “mild” head injuries summate to form a more severe traumatic brain injury with longer lasting impairment.

Athletes often minimize the severity of concussion-like symptoms, or do not report symptoms at all following head injury. This may be because the athlete wants to continue playing and believes the symptoms are mild enough to play through. The athlete may believe having their “bell rung” is part of the game. In these situations, often the athlete, parent, coach, or trainer does not realize the significant consequences of playing with a concussion.

However – in general, when a concussion is identified early, managed properly, and return to sport is gradual, the risk to that athlete of sustaining a future concussion is not likely to be different.