Concussion Management Program
No two concussions are the same. They can occur at any age, from any number of incidents, and each person’s brain will respond differently. That’s why our treatment is highly individualized to you and your specific injury. Our physical therapists evaluate numerous body systems and create treatment plans focused on identifying and resolving your symptoms, while building your tolerance for activity. Ultimately, the goal is to return you to your normal life and sport activities as quickly and safely as possible.
What Actually Happens During a Concussion?
A concussion can occur when the brain is shaken, either from an incident in which the head is directly hit, or during rapid movement changes such as whiplash. The hitting or shaking of the head can cause unpredictable injury to any part of the brain, resulting in immediate changes in the brain’s chemistry or function. Less than 10% of concussions involve a loss of consciousness though. Following the initial physical impact, a cascade of metabolic and hormonal responses to the injury can cause additional variability in short-term and long-term symptoms. Of course, each concussion is unique and so is the way your body and brain reacts to it. That’s why it is important to be evaluated in a comprehensive, individualized manner with tailored treatments to you and your injury.
How do you know if you’ve sustained a concussion? Know the signs.
It is important to seek professional medical treatment immediately following any head injury. Risk of further or more severe injury can be minimized by immediate and appropriate treatment. Here’s what you should be on the lookout for:
Physical symptoms of a concussion can include:
- Headache
- Dizziness
- Nausea/vomiting
- Difficulty with balance/coordination
- Fatigue
- Difficulty sleeping or increased sleepiness
- Double or blurred vision
- Sensitivity to light and sound
Cognitive symptoms can include:
- Difficulty with short term or long term memory
- Difficulty concentrating
- Confusion or fogginess
- Slowed ‘processing’ or ability to problem solve
- Difficulty multitasking
Emotional symptoms can include:
- Irritability or aggression
- Anxiety or depression
- Mood swings
- Change in personality or behavior
Symptoms may be present immediately after the initial incident, or present hours to weeks later. Some concussion symptoms may be worsened by physical activity or increased mental activity. Neck injuries occurring at the same time as concussions can also increase headaches or dizziness. A team of healthcare providers including a physical therapist can address and help to manage many of these symptoms.
In most cases, concussion symptoms significantly improve or resolve within 2-3 weeks. Post Concussion Syndrome is the term used for symptoms (such as headaches, dizziness, or irritability) that persist for weeks or months after the initial injury.
If you have recently sustained a concussion, you may be at risk for Second Impact Syndrome. While rare, when a person who has suffered a recent concussion experiences another concussion, the brain can swell rapidly and cause permanent brain damage or death. Because of the pre-existing injury, the impact of the second event does not have to be strong to trigger second impact syndrome. This is why athletes who suffer a concussion must be removed immediately from play. Extreme care should be taken after a concussion to prevent a second injury. Our physical therapists will work with athletic trainers and coaches to develop safe guidelines for return to school and return to play.
Evaluation and Treatment
Physical therapists can evaluate and treat many of the problems related to concussion. Our PTs screen for any serious complications and closely examine each patient’s neurological, oculomotor, and orthopedic function. This includes performing numerous tests to assess strength, coordination, balance, vision, and memory. We may provide referrals or recommendations for a patient to see additional healthcare providers on an as-needed basis following our evaluation to address specific symptoms, such as a neurologist, optometrist, or psychiatrist.
Recent research has shown that the “rest in a dark room” approach can be appropriate in the short term after a head injury, but may result in a significantly slower return to normal function when compared to an individualized, multi-disciplinary approach to concussion treatment. Concussion specialists can help manage your unique symptoms and help identify how much activity and rest you need to recover as quickly and safely as possible from your specific injury.
Treatment may include:
- Short periods of rest and recovery
- Limiting work, school, sports, and electronic use to help the brain to heal
- Reducing headaches
- Identifying triggers for headaches such as bright lights or busy environments
- Assessing and treating neck pain
- Stopping dizziness
- Performing exercises to improve oculomotor function and improve slowed reflexes that can contribute to feelings of dizziness
- Treatment for potential vestibular problems such as BPPV
- Improving balance
- Performing exercises to retrain static balance and dynamic balance
- Addressing potential vestibular system contributions
- Restoring strength and endurance
- Gradually increasing muscle strength and overall activity tolerance while closely monitoring symptoms
- Returning to normal activity or sport
- Graded return to work, exercise activities, or sport while monitoring symptoms and response
Remember that because no two concussions are the same, your treatment may include a number of different approaches, addressing several body systems. Our physical therapists will use these individualized treatments to help you clear symptoms and improve your tolerance for activity without overloading your brain. We will help you return to your normal life and sport activities in the quickest and safest way possible, while allowing your brain to properly heal. If you are concerned you might have sustained a concussion, we can help. Contact us to schedule an evaluation and start your recovery.
