Concussion
Management
What is a Concussion?
A concussion is the most common form of brain injury and should be taken seriously. It can be caused either by direct contact to the head, or an impact to another part of the body resulting in rapid movement of the brain inside the skull. Its very important to assess the possibility that you have a concussion. Sometimes symptoms are only brief and resolve quickly, but then return a few hours or even days later.
A Concussion is often referred to as a mild traumatic brain injury, at Sandycove Physio clinic we understand mild is a clinical term that does not reflect the severity of the experience. We assess each person individually and work with you to return to your normal self, and get back to the life that you love.
Common causes
of Concussion
Some of the most common causes of concussion are•
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Car Accidents (Concussion is often caused by Whiplash or Airbag Explosion)
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Work accidents (ie, falls, head trauma).
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Playground accidents (ie, falling from a slide or swing).
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Sports injury to the head or neck.
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Falls (which are the leading cause of concussions).
Violent events, such as:
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Physical abuse during which the head is shaken.
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Being too close to a blast or explosion.
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Direct blow to the head, face, or neck.
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Assaults, domestic violence.
This shaking or hitting causes unpredictable injury to an area of the brain, resulting in immediate or delayed changes to the brain's chemistry and function. Due to the neurometabolic cascade that occurs in the brain in the first 24-48hrs post concussion, it is very important to rest during this time and seek medical guidance.
Less than 10% of concussions involve a loss of consciousness (being 'knocked out'). This leaves 90% of concussions to be detected by an onlooker or reported by the individual. This can sometimes be challenging if initial symptoms are subtle or short-lived. This list of symptoms can help you identify if you're experiencing concussion yet please book an appointment for further diagnosis.
Concussion Symptoms
Physical signs of a concussion include:
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Headache.
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Dizziness.
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Difficulty with balance and coordination.
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Nausea/vomiting.
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Fatigue.
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Difficulty sleeping.
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Increased sleepiness.
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Double or blurred vision.
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Sensitivity to light and sound.
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Slurred speech.
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Glassy-eyed stare.
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Seizures.
Sandycove physiotherapy sepcialises in the improvment of balance, the reduction of light/sound sensitivity, nauesea & fatigue, and the treatment of headaches & dizziness post-concussion.
The Emotional & Cognitive symptoms of Concussion include
Cognitive
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Difficulty with short-term or long-term memory
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Confusion
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Slowed "processing" (eg, a decreased ability to think through problems).
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"Fogginess."
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Difficulty concentrating.
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Worsening grades in school.
Emotional
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Irritability.
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Restlessness.
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Anxiety.
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Depression.
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Mood swings.
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Aggression.
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Decreased tolerance of stress.
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Change in personality or behavior.
No two concussions are the same - some concussions may have just one or two concussive symptoms while others may have several more.
What concussive symptoms you feel depends on what part of the brain has been injured. Injury occurs at a microscopic level, so it is unlike a broken arm, or other injuries that you can feel with your hands or see on an X-ray. It is a temporary disruption of how the brain works at a cellular level. It is not a bruise to the brain, which is why brain CT scans and MRI scans are normal with concussion.
Treatment for Concussion
If your concussive symptoms are persisting beyond a few days, it is important to know physio can help you regain balance & stability, improve focus, gait & mood, and treat headaches.
Our treatment involves
Rest and recovery. Your physiotherapist will help you and your family understand why you should limit any kind of activity (daily tasks, work, school, sports, recreation, the use of electronics) after a concussion, until it is safe to return to these activities. A period of rest helps the brain heal and helps symptoms clear up as quickly as possible. Your physiotherapist will prescribe the rest and recovery program most appropriate for your condition.
Vestibular and balance rehabilitation: Concussion often disrupts our balance system resulting in nausea, dizziness, lack of balance, difficulty walking in public spaces. Vestibular rehab helps restore the vestibular system and alleviate the many symptoms associated with it. Our Physio will assess your balance & Vestibular system, design a specific exercise program for you to reduce vertigo and dizziness, along with improving your balance reactions and stability. Ultimately getting you back to balance and a dizzy free life.
Ocular rehabilitation: Ocular concussive symptoms/eye problems include double or blurred vision, lack of focus, difficulty reading or using digital screens and headaches. In our concussion assessment we assess the ocular system and prescribe specific exercises to treat & restore full function, alleviating these symptoms.
X Restoring strength and endurance. Post concussion, your autonomic nervous system is dysfunctional and it cannot regulate your heart rate and muscle function thus causing a long term intolerance to exercise - Our Physiotherapist will assess your system in great detail and will work with you on returning the autonomic system to its normal abilities.
If you have sustained a concussion a long time ago & have not received any treatment, the long physical and mental rest can result in muscle weakness, and a decrease in physical endurance. Your physiotherapist can help you regain your strength and endurance when the right time comes, without making your concussion symptoms worse. It is common to experience exercise intolerance with concussion and brain injury. Your physiotherapist will design a therapeutic exercise program just for you, and closely monitor your symptoms as you participate in the program.
X Reducing headaches. Your physical therapist will assess the different possible causes of your headaches, and use specific treatments and exercises to reduce and eliminate them. Treatment may include manual therapy, muscle release, joint mobilisation, stretches, strength and motion exercises.
Returning to normal activity or sport. As symptoms ease and you are able to regain your normal strength and endurance without symptoms returning, your physiotherapist will help you gradually add normal activities back into your daily routine. Your physio will assist you avoid overloading the brain and nervous system as you increase your activity level. Overloading the brain during activity after a concussion interferes with the healing of the brain tissue, and can make your symptoms return and worsen. With our physios assistance you will return to your normal life and sport activities in the quickest and safest way possible, while allowing your brain to properly heal.
Concussion treatment and Sport
In sport, there will often be a reluctance on the part of an athlete to stop play after a knock to the head, particularly when the symptoms are subtle, and the rest of the body feels normal. In addition, a head injury impairs a player’s decision making ability in this regard. The decision must therefore be taken out of the athlete’s hands. It is the responsibility of the coach, parent, referee, physiotherapist or team doctor to detect the signs of a head injury following a hard knock, rest these players immediately and ensure they see a doctor knowledgeable in concussion management.
The brain is also more susceptible to further injury while recovering from a concussion. A second head injury soon after an initial one can result in permanent brain damage or even ‘second impact syndrome’, a severe brain swelling which is usually fatal. This is why all athletes should be immediately removed from play if a concussion is suspected, and cleared medically before returning to sport, only after being fully assessed and rehabilitated. Returning to sport before full recovery leads to a higher risk of repeated or prolonged concussions which can occur at lower impacts than the original one. Such repeated concussions can shorten an athlete’s playing career, and may lead to longer-term neurological problems.
Concussion is a very recoverable injury, early treatment and intervention has demonstrated improved outcomes and recovery
TESTIMONIALS
I always feel relaxed as soon as I arrive at Sandycove Physio. Have had several treatments for sciatica and a bad broken wrist involving surgery. Deep needling was really effective and professionally administered. I found that Sandycove Physio genuinely provided the best therapies and advice for a fast recovery. Each session has been valuable.
-Maeve