Concussion Care
Structured evaluation, stepwise return
A concussion is a mild traumatic brain injury. Symptoms — headache, fogginess, dizziness, light sensitivity, trouble concentrating — can be subtle and don't always appear right away. Here's how we manage it.
Structured evaluation
A focused history and exam — symptoms, balance, vision, and cognition — establishes where you are today and rules out signs that need urgent care.
Symptom-guided recovery
Recovery is staged and individual. Activity is reintroduced gradually, guided by symptoms — not by the calendar or by pressure to get back out there.
Graduated return-to-play
Athletes progress step-by-step through increasing exertion, with medical clearance required before returning to contact or competition.
Why the caution? Returning to contact while the brain is still recovering raises the risk of a more serious second injury. Recovery timelines are individual — clearance is earned by progress, not by the calendar.
When to call 911 or go to the ER
After a head injury, seek emergency care right away — do not wait for a clinic appointment — if any of these appear:
- Worsening or severe headache
- Repeated vomiting
- Slurred speech, weakness, or numbness
- Increasing confusion or unusual drowsiness
- Seizure or loss of consciousness
- One pupil larger than the other
Pre-Participation Physicals
Sports physicals for school & league requirements
Most schools and leagues require a pre-participation physical before an athlete can practice or compete. We review medical and family history, examine the heart, lungs, and musculoskeletal system, and complete your required forms at the visit.
Done well, a sports physical is more than paperwork — it's a chance to catch old injuries, asthma, and other concerns before they become problems on the field, with a sports-medicine physician who knows what to look for.
Written and Medically Reviewed By
Paul Norio Morton, MD
Board-certified orthopedic surgeon (American Board of Orthopaedic Surgery). Fellowship-trained; Hawai‘i's first fellowship-trained robotic hip & knee replacement surgeon.
Last reviewedJuly 2026 · Read Dr. Morton's full bio →
Explore Related Care
Explore related care
Concussion Recovery & Sports Safety: Key Outcomes
Evidence-based guidance for concussion recovery and return-to-play protocols.
2-Minute Check
Am I a candidate for a sports medicine evaluation?
Answer a few quick questions. This is educational and is not a diagnosis — only an evaluation can tell for sure.
Do you have a sports or overuse injury that's limiting your activity?
Is pain, swelling, or instability affecting your performance or daily life?
Do you want a clear plan to return to sport safely?
You may be a strong candidate.
Your answers suggest a sports medicine evaluation could be a good fit. The next step is a simple evaluation, where we'll confirm with an exam and imaging and review every option with you — surgical and non-surgical.
This tool is educational and not a diagnosis. Not everyone is a candidate; only a clinical evaluation can determine what's right for you.
You might be a candidate — let's talk.
Some of your answers point toward a sports medicine evaluation, but the right path depends on the details. A short evaluation will give you a clear, honest answer and a plan.
This tool is educational and not a diagnosis. Not everyone is a candidate; only a clinical evaluation can determine what's right for you.
Let's take a closer look.
Your answers don't point clearly to a sports medicine evaluation yet — but that doesn't mean we can't help. We'll evaluate what's going on and point you to the care that fits, often starting with non-surgical options.
This tool is educational and not a diagnosis. Not everyone is a candidate; only a clinical evaluation can determine what's right for you.
Answer all 3 questions to see your result.
Patient Reviews
What patients say
“Dr. Ronnie Otieno did a very personalized consultation for my chronic knee pain, recommending PRP to aid my recovery since I need to remain active. He is detailed, gentle, kind, patient, and precise — and uses an ultrasound machine to target the exact area for treatment.”
— Kalea· Google review
Review excerpts reflect individual patient experiences and may be lightly condensed. Results vary.
Questions, Answered
Concussion & sports physical FAQ
What exactly is a concussion?+
A concussion is a mild traumatic brain injury — a disturbance in how the brain works after a hit to the head or body, even without loss of consciousness. Symptoms can include headache, fogginess, dizziness, light or noise sensitivity, and trouble concentrating, and they don't always appear right away. It deserves a structured medical evaluation, not a wait-and-see approach.
When should we go to the ER instead of the clinic?+
Call 911 or go to the nearest emergency room for red flags such as worsening or severe headache, repeated vomiting, slurred speech, weakness or numbness, increasing confusion or drowsiness, seizure, loss of consciousness, or one pupil larger than the other. For concerning symptoms after a head injury, err on the side of emergency care.
How soon can an athlete return to play after a concussion?+
There's no fixed timeline — recovery varies by person and by injury. Return to play follows a graduated, symptom-guided progression: activity increases step-by-step only as symptoms allow, and medical clearance is required before returning to contact or competition. Returning too soon, while the brain is still recovering, raises the risk of a more serious second injury.
Who provides concussion care at Pacific Bone & Joint?+
Concussion care is led by Dr. Ronnie Otieno, DO, a sports-medicine physician focused on non-operative care of athletes. He evaluates the injury, guides the recovery plan, coordinates with schools and coaches as needed, and provides clearance when it's safe to return.
What is a pre-participation sports physical?+
It's the exam most schools and leagues require before an athlete can practice or compete. We review medical and family history, examine the heart, lungs, and musculoskeletal system, and complete the required forms. It's also a chance to catch issues — old injuries, asthma, or other concerns — before they become problems on the field.
Do you complete school and league forms?+
Yes — bring your school's or league's form to the visit and we'll complete it at the time of the exam. Message us on Klara or call to schedule; physicals are quick, and we can often accommodate teams and busy pre-season schedules.
Head injury on your mind — or a season to get cleared for?
Message us on Klara or call to schedule a concussion evaluation or a sports physical with our sports-medicine team.
For medical emergencies — including red-flag symptoms after a head injury — call 911. This page is educational and is not a substitute for medical advice. Individual recovery varies.