CONCUSSION

What is a Concussion?

A concussion is a complex injury to the brain that occurs due to trauma. Trauma may be a blow to the head, but is not necessary.

Potential Symptoms:

Symptoms come in a variety of ways; physical, cognitive and behavioral. You may only have a few of these and they can be from any category.

Physical symptoms: Headache, nausea, vomiting, visual abnormalities, blurred or double vision, balance problems, dizziness, sensitivity to light or noise, ringing in the ears.

Cognitive symptoms: Problems concentrating, feeling dazed, memory problems, and being unable to multi-task, not your regular self.

Behavioural symptoms: Fatigue, sleeping more, emotional outbursts, frustration, quick to anger, depression.

When to Seek Medical Attention:

* Stiff neck

* Fluid and/or blood leaking from nose or ears

* Difficulty waking up

* Difficulty remaining awake

* Fever

* Headache that gets worse, lasts a long time, or is not relieved by over-the-counter pain relievers

* Vomiting three or more times

* Problems walking and talking

* Problems thinking

* Seizures

* Changes in behaviour or unusual behaviour

* Double or Blurred vision

* Speech slurred or difficult to understand

What to do if You Have a Concussion:

Take it seriously.

REST

Do your best to rest. If concussion happens in the evening it is important to be checked if you are sleeping in the first 4 hours after. The person looking after you needs to know to wake you until you can say a word or two, then let you go back to sleep. After that, a normal night’s sleep is required. The majority of people who have a concussion recover with no continuing symptoms. Rest for the first 48 hours, possibly staying home from work or school. Do try your best to attend work/school after the first 48 hours. Do not increase your exercise level until you can manage work/school. Research shows that the majority of people will take 2 weeks to return to their previous activity level. This is where being patient is very important. If you rush the return you can worsen symptoms for longer periods. The return to sport/activity protocol is as follows; walking, followed by biking/elliptical, running, sport like activities and then return to play. If you have any symptoms in the 24 hours after one of these, rest another 24 hours and go back to the step you last completed successfully. This may take some time to complete, but it is much easier to progress slowly rather than too quickly and worsen your symptoms.

What is Rest?

Sleep is the most important type of rest. You may find yourself requiring much more sleep and yet still feeling fatigued. Sleeping is when your brain is able to heal best. Watching TV does not count as rest and is likely to aggravate symptoms. Good examples of rest for the brain are audiobooks, podcasts, colouring, walks, puzzles, knitting or simple card games. Music can be good as well, use caution if you are sensitive to noise. Meditation can also be beneficial. There are many helpful and free apps to guide you in meditation.

Do Your Best to Rest for 48 Hours!

What Can Physiotherapy do to Help with Concussion?

Physiotherapy can help you treat and manage your concussion symptoms while your brain heals. There is no medication or specific therapy that can cure concussion. Lots of new research is being done on concussion rehabilitation. It has been found that a global approach to treating the previously discussed symptoms is best. Physiotherapy for concussion may include rehabilitation involving vestibular, visual and orthopedic techniques. Treatment involves education, exercises, balance retraining and potentially hands on treatment of the neck. Local research at the University of Calgary, by Katherine Schneider et al. (2014), found substantial support for concussion rehabilitation to include neck treatment and vestibular rehabilitation. The subjects in the study were individuals with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion. Seventy-three percent of subjects that received neck and vestibular rehabilitation returned to sport within 8 weeks. The control group only had a 7% success rate at 8 weeks post injury.

If you have neck pain or stiffness from your injury evidence shows it is best to seek treatment as soon as possible. If you find you are struggling with return to play protocol we can provide education to help. If you are still feeling abnormal after 3- 4 weeks post-concussion please call us for a concussion assessment with a physiotherapist.

Reference: Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med Published Online First: [4 June 2014] doi:10.1136/bjsports-2013-093267