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Concussion Management Physiotherapy

Concussion Management Physiotherapy

What is a Concussion?

A concussion is a traumatic brain injury (TBI) that happens as a result of the head and brain moving too quickly back and forth. The rapid movement, often caused by a blow or jolt to the head or body, can cause chemical changes in the brain. This makes it more difficult for brain cells to function and communicate.

Causes | Symptoms | Treatment | Baseline Testing

Image of what causes a concussion. Rapid movement can cause the brain to move in the skull, which can damage brain cells.

Concussions are caused by a sudden movement like a bump, blow, or jolt to the head or a hit to the body that causes the head and brain to move rapidly back and forth. You have likely suffered a concussion if your injury caused you to be:

  • Dazed or confused
  • Knocked out (lost consciousness)
  • Unable to remember what happened for a short time before or after

Concussion symptoms can be subtle while you may notice some symptoms right after your injury, others might not appear for hours or even days after your injury. Concussion symptoms may include:

Physical Symptoms

  • Headache
  • Nausea and vomiting
  • Problems balancing
  • Delayed or slowed reaction time
  • Sensitivity to light and/or sound
  • Blurred vision
  • Slow speech
  • Clumsiness

Sleep Symptoms

  • Sleeping more than usual
  • Sleeping less than usual
  • Difficulty falling asleep
  • Feeling tired, drowsy or having no energy

Cognitive Symptoms

  • Difficulty thinking clearly or “foggy” feeling
  • Problems concentrating
  • Feeling slowed down
  • Issues remembering things (especially new information)
  • Trouble expressing thoughts and finding the right words

Mood Symptoms

  • Irritable
  • Sad, depressed, tearful
  • More emotional than normal
  • Nervous or anxious

Symptoms can worsen over a short period; it is not uncommon for new symptoms to appear a few days after your injury. Tasks that involve a lot of concentration, like sports, studying, or playing video games, may cause concussion symptoms to appear, reappear, or get worse.

For the majority of people, concussion symptoms clear up after 1-2 weeks of rest and gradual reintroduction of activities. It is important not to tax the brain during this time to allow for a full recovery. When concussion symptoms last longer than 1-2 months (or past normal recovery), it is categorized as a post-concussion syndrome or disorder (PCS/PCD). The symptoms of PCS/PCD can last for weeks, months, or a year or more after a concussion.

Seeking treatment is key to recovery, especially if your symptoms last longer than 10-days. Your clinician will determine what combination of exercises and therapies would be best for your case, however, treatment options that have shown to be beneficial include:

  • Retraining the inner ear balance system called the vestibular system
  • Exercises that train your visual system
  • Manual Therapy on the neck to help with headaches
  • Exercises that target deep muscles in the neck
  • Cardiovascular exercises
  • Education about the return to activity

It is essential that you follow your treating clinician’s instructions on the intensity and duration of home exercises and not try to overshoot treatment goals. Be sure to communicate with your clinician if you notice that exercises are causing you to have any symptoms. Ideally, the intensity of your activity should be just below the level where you start to have symptoms, as seen in the chart below.

What to Expect at Your First Appointment

pt Health clinicians have received specialized training that allows them to assess your current condition and prescribe treatments to get you better. At your first appointment you can expect:

Medical History

Your clinician will sit down with you to take your medical history. They may ask questions about your current condition as well as any symptoms you’re experiencing. After taking your history, your clinician will begin a physical evaluation.

Physical Assessment

Your clinician will assess your balance, gait when walking, range of motion, heart rate, inner ear, and your vision. In some cases, you may undergo a cardiac stress test on bike or treadmill to get a full assessment of your condition.

Treatment Plan

Following your assessment, your clinician will discuss the severity of your condition and work with you to develop a treatment plan. Your clinicians will explain treatments and answer any questions you might have.

A pt Health clinician can help treat and manage the symptoms of concussion, and in many shortening your recovery time. No referral is required so you can begin treatment today!

What is Concussion Baseline Testing?

Baseline testing is a series of exams that measure your child’s “normal” cognitive function. Often administered pre-season, baseline tests measure brain function, balance, learning and memory skills, ability to concentrate and more. These tests act as an objective point of comparison should your child sustain a brain injury during organized sports, school or play.

What is included as part of baseline testing?

Baseline testing measures many aspects of brain function and includes a brief interview, physical exam, and computerized testing to complete a full picture of your child’s pre-injury cognitive functioning. Baseline testing takes between 20 and 30 minutes to complete and will measure:

  • Balance
  • Reaction time
  • Memory
  • Visual processing
  • Strength
  • Problem-solving ability
  • Concentration
  • Physical endurance

Education is an essential part of baseline testing, as part of your baseline test, you are provided with information on what to do following a concussion, tips to reduce concussion risk, and return to school and play protocols.

How is baseline testing used?

As MRI or CT scans can not detect concussions, a baseline test is used to spot differences in cognitive function, identify any new symptoms, and develop a personalized rehabilitation program. Should a suspected concussion happen, cognitive testing is done again, and the results from that test are compared to your child’s baseline test results. This comparison is used to help healthcare professionals identify the effects of the injury and make informed decisions about your child’s return to school and play plan.

What should I do following a concussion?

Following a suspected concussion you should follow your organization’s concussion protocol. The first 72 hours following a concussion are critical, immediately following a suspected concussion:

  1. Remove your child from all sporting activities, school, and play, until a trained medical professional can assess their condition.
  2. Rest is the best thing to do while you wait for an assessment. If your child has severe symptoms or symptoms that are worsening, a trip to the hospital is advised to rule out more severe conditions.
  3. Schedule an assessment with us, if you have a completed baseline test we will have it on file for you. Your child will undergo physical and cognitive testing that will be compared to their previous baseline test to make a tailored return to school and play program for your child. All test results will be sent back to your family doctor.

How often should baseline testing be done?

Baseline tests are suggested every 1-2 years as they are used to assess your child’s “normal” physical and cognitive function which changes as your child ages. Having an accurate and up to date baseline test can help healthcare professionals determine if a concussion has occurred and its severity.