Concussions and Altitude

With the number of concussions on the rise it is important to have an understanding of the occurrence of concussions as well as the management of concussions at higher elevations. Although the incidence of concussions is on the rise everywhere, high school athletes playing at higher elevations may actually be less likely to sustain a concussion when compared to athletes playing the same sports at sea level.

The Cincinnati Children’s Hospital conducted a research study examining the relationship between concussions and altitude among NFL athletes. The results of the study demonstrated a 30% decrease in the incidence of concussions in athletes playing at higher elevations (greater than or equal to 644 ft above sea level) (Myer et al., 2014). While there is no definitive explanation for this it is believed to be linked to the physiological changes of the brain at altitude. Concussions are typically caused from the rapid acceleration/ deceleration of the brain inside the skull. The hypothesis is that at higher elevations the brain tends to swell due to a mild increase in intracranial volume creating a tighter fit of the brain in the skull, leading to less damage caused by sheer forces (Myer et al., 4014).

While concussions may not be as common at elevation they are still occurring more than ever with detrimental long term effects if not recognized and treated properly. One thing we can do to recognize and treat concussions is to complete an ImPACT test. ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is a computerized neurocognitive test which helps to assess neurologic changes after a concussion and helps guide recovery (Glendenning, 2017). The idea behind ImPACT is for individuals to have a baseline test, prior to any head injury/ concussion, and if a traumatic brain injury occurs, that individual would then undergo a post-concussion test, comparing the results to their baseline.  This helps better determine when it is safe for that individual to return to play without sustaining further injuries to their brain.

With the active lifestyle of children and adults in living at high altitudes, ImPACT testing may be just another step to consider when getting your bike tuned up for bike season, or your skis ready for a weekend on the slopes. Even if you aren’t a competitive athlete on a designated team, anyone at risk of hitting their head is at risk of suffering a concussion and would benefit from completing a baseline ImPACT test. ImPACT testing is available for only $15 at Avalanche Physical Therapy and takes only 30 minutes to complete (Glendenning, 2017). By being pro-active now you can help ensure a safer and healthier recovery in the future.

Schedule your baseline ImPACT testing at Avalanche Physical Therapy today!

Betsy Metz, PA-S

Physician Assistant Student

Red Rocks Community College


Glendenning, L. (2017, March 7). Cognitive testing tool used to assess traumatic brain injuries in Summit County. Summit Daily News, p. 5.

Myer, G. D., Smith, D., Barber Foss, K. D., Dicesare, C. A., Kiefer, A. W., Kushner, A. M., … & Khoury, J. C. (2014). Rates of concussion are lower in National Football League games played at higher altitudes. journal of orthopaedic & sports physical therapy, 44(3), 164-172.

One thought on “Concussions and Altitude”

  1. i received a concussion just a few weeks before covid hit, Everything shut down and aside from some initial testing and a few vestibular therapy sessions i have not had treatment, I moved to a higher elevation hoping to get more openings as everyone was over booked. i have been suffering since this severe concussion occurred and i wish to tell you for me the pain at this higher altitude is so much worse. i am here i signed a lease my neurologist said it would be fine, little over 1,000 feet higher, WOW, not fine.

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