Concussions on Set: Support & Recovery
Recognizing the Injury, Getting Support and Finding a Way Forward
Someone takes a fall, gets hit by a piece of equipment, bumps their head during an action sequence or takes an unexpected impact.
There’s a pause. People check in.
“You good to go?”
And often the answer is yes.
The problem is, the person may not actually know yet.
That’s one of the challenges with concussion in the motion picture industry. Unlike many injuries, a concussion may not be immediately obvious. You don’t have to lose consciousness to have one, and symptoms can sometimes become more noticeable after the initial injury.
For film workers, there can be another complication. The job may ask you to repeat the same action that just caused the impact.
Lori Stewart, Health & Safety Performer Advocate with UBCP/ACTRA, has spent more than a decade supporting injured performers. One experience in particular helped motivate her work developing better concussion procedures for the industry. A performer sustained a head impact while doing an action on camera, felt able to continue, and was asked to do the action again, and then again.
“Often people don’t realize the severity of the injury when that happens with head injuries,” Lori explains. “You may feel a little rattled, but you think, ‘Oh yeah, I’m good. I’ve got it. I can go again.’”
That’s why recognizing a possible concussion and responding appropriately matters.
Concussions aren’t just a stunt-performer issue
Stunt performers may face an obvious risk of head impacts, particularly when their work involves falls, fights, vehicles or other physically demanding action.
But concussions happen across the industry.
Lori initially developed a concussion support group with stunt performers in mind. Today, many of the people accessing it are not stunt performers.
As she puts it:
“Concussions often don’t discriminate when stuff falls on a set or someone trips in the dark over plywood.”
A performer can fall. Someone in construction can be struck by an object. A crew member can trip in a darkened space. Equipment, scenery and people are constantly moving.
Suspect a concussion?
An industry-specific Concussion Awareness, Response and Management Pathway was developed for workers in motion picture, television, performing arts and live events. It provides guidance for responding to a suspected concussion, including signs and symptoms, red flags and next steps
The injury nobody else can see
One of the hardest things about concussion is that the person can look perfectly fine.
“People often present really well,” Lori says, “but they’re not okay inside.”
Cait Leavitt understands that experience personally as well as professionally. Cait is a Registered Clinical Counsellor, Certified Mental Performance Consultant and concussion specialist whose own concussion from a MVA during graduate school eventually led her to focus much of her practice on concussion recovery.
She describes concussion as an invisible injury.
With many physical injuries, other people can see the evidence. There may be a brace, cast, scar or visible difficulty walking. With concussion, someone may look much like they did before.
That can lead to comments such as, “But you look fine.”
“When you hear that multiple times, it’s really, really invalidating,” Cait says. Eventually, she says, that external invalidation can become internal: Am I making this up? Should I be better by now? Why can’t I just push through?
What might a concussion feel like?
Symptoms vary from person to person and can include:
headache or pressure in the head
dizziness or balance problems
nausea
blurred or altered vision
sensitivity to light or noise
fatigue or low energy
feeling slowed down, foggy or “not quite right”
difficulty concentrating or remembering
irritability, anxiety or other emotional changes
changes in sleep
If you suspect a concussion, getting assessed by a healthcare professional is important. Some symptoms following a head injury can also be warning signs requiring immediate medical attention.
The injured brain is being asked to navigate the recovery
For Lori, one of the biggest problems begins after the injury.
Workers may suddenly have to navigate medical appointments, insurance or workers’ compensation, benefit plans, forms, treatment decisions and return-to-work expectations.
That would be complicated for anyone.
But concussion itself may affect memory, concentration, mental stamina, decision-making and the ability to process information.
Cait sums up the contradiction simply:
“You’re asking somebody who has a brain injury to do a very complicated task.”
That’s one reason advocacy and practical support can matter so much.
For UBCP/ACTRA members, Lori helps injured performers understand reporting requirements, compensation claims, benefit plans and other available support. Family members, partners and trusted friends can also play an important role in helping someone keep track of information, appointments and next steps.
Sometimes “advocate for yourself” simply isn’t enough.
You may need someone to help advocate with you.
Getting back to film work can be complicated
“Returning to work in the film industry is brutal with a head injury,” Lori says.
Consider what a normal production day can involve: long hours, bright lights, noise, changing locations, early calls, night shoots, complex tasks and unpredictable schedules.
Now imagine trying to manage those conditions while dealing with headaches, fatigue, dizziness, light or noise sensitivity, concentration problems or reduced cognitive stamina.
A typical graduated return to work can also be difficult to reproduce in an industry built around productions that start, finish and move on.
For a film worker, figuring out what “gradual” realistically means may require cooperation between the worker, healthcare providers, employer and, where appropriate, their union or guild.
Concussion can affect mental health too
Recovery isn’t only about headaches, balance or concentration.
A concussion can temporarily remove someone from many of the things that give life structure and meaning: work, income, friends, activities, independence and a sense of professional identity.
Lori sees withdrawal and isolation frequently. Members in her concussion support group have talked about avoiding social situations because they forget things, repeat themselves, become overwhelmed or simply don’t feel understood.
Cait sees the same pattern clinically.
“You are removed from your work, your community, your hobbies,” she says. “That has a massive impact on your mental health.”
Mental health, sleep, cognitive difficulties, fatigue, balance and vision problems are all recognized areas that may require attention when concussion symptoms persist.
Then there are the very understandable fears:
Will I get better?
When can I work again?
Will I still be able to do my job?
How am I going to pay my bills?
Those concerns deserve to be taken seriously too.
Recovery isn’t “do nothing” or “push through”
Cait sees two patterns regularly.
The first is fear avoidance. Someone becomes understandably afraid of triggering symptoms, so they increasingly avoid activities, environments and experiences.
The second is sometimes called boom and bust. After being restricted for so long, a person becomes frustrated and tries to jump straight back into their former level of activity, overwhelms their system, crashes and then retreats again.
Neither extreme is particularly helpful.
Instead, Cait emphasizes gradual, thoughtful exposure: slowly reintroducing meaningful activities at a level the person can currently manage. That general principle is consistent with current concussion guidance supporting gradual resumption of activity as tolerated.
A question Cait frequently comes back to is:
What’s important to you?
Maybe before your injury, staying connected meant spending 12 hours with a crew on set. Right now, it might mean meeting one colleague for coffee.
Maybe physical activity once meant running for an hour. Today, it might mean a short walk.
Recovery can involve gradually widening that capacity.
REWIRE: a broader way of thinking about recovery
Cait organizes much of her concussion work around six areas she calls REWIRE:
Regulate your nervous system - help the mind and body regulate during recovery.
Education - understand concussion and find reliable information.
Widen your capacity - gradually return to meaningful activities.
Identity and beliefs - make room for the emotional impact of an injury that may temporarily change what you can do and how you see yourself.
Restore connection - protect supportive relationships during an experience that can otherwise become isolating.
Embrace flexibility - adapt activities to what you can manage today instead of assuming you must either do everything or do nothing.
Not everyone needs the same combination of supports, and concussion recovery can look very different from one person to another.
The value of people who get it
One thing has surprised Lori about UBCP/ACTRA’s concussion support group: how powerful a relatively simple space for connection can be.
Members check in, share experiences and resources, and hear other people say some version of, That happens to me too.
More importantly, Lori says, it has become a place where members feel “supported and safe, and honoured and understood.” Family members and coworkers may care deeply without completely understanding what someone with a concussion is experiencing.
Sometimes connecting with someone who has been there can make a difference.
There is hope
Concussion recovery can take time, and for people with persistent symptoms the path may not always be straightforward. But persistent symptoms do not mean improvement is impossible. Recovery timelines vary, and people experiencing longer-term symptoms can benefit from ongoing assessment and targeted support.
Cait has worked with people years after their original concussion who have gone on to build functional, fulfilling lives.
She also encourages people to think carefully about what recovery means.
Sometimes it means getting back to exactly what you did before.
Sometimes the experience changes your priorities, your routines or the way you live your life.
“You can recover,” Cait says. “Your life might be different afterwards, and that can be a good thing.”
And perhaps the most important message for someone struggling right now is the one she offered at the end of our conversation:
“Hope is possible with the right resources and the right support.”
Where to start
If you’ve experienced a head impact or think you may have a concussion, consider speaking with a healthcare professional and reporting a workplace injury through the appropriate channels. Your union or guild may also be able to help you understand available benefits, workplace supports or compensation processes.
Useful Canadian and BC resources:
Concussion Awareness Training Tool (CATT) - free Canadian information and training for recognizing, responding to and managing concussion, including resources specifically for workers and workplaces. https://cattonline.com/
Actsafe’s Concussion Awareness, Response and Management Pathway - developed specifically for motion picture, television, performing arts and live-events workers.https://actsafe.ca/topic/concussion/concussion-awareness-response-and-management-flowchart/
Parachute Canada - Canada's national charity dedicated to injury: Concussion Toolkit .https://parachute.ca/en/injury-topic/concussion/
Mind with Matter REWIRE Framework from Cait Leavitt, Registered Clinical Counsellor, Certified Mental Performance Consultant & Concussion Advocate: https://www.mindwithmatter.ca/rewire
You may not need all of these today. But if you work in film, it’s worth knowing where they are.
Because sometimes the most important response to “You good to go?” is giving yourself enough time and support to find out.
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