Help! Do I have a Concussion?

A concussion is a type of traumatic brain injury (TBI) that occurs when the head experiences a sudden impact, blow, or jolt, causing the brain to move within the skull. Concussions can occur in a variety of situations, including but not limited to sports injuries, falls, and motor vehicle accidents. The sudden impact or acceleration of the brain within the skull can result in stretching, twisting, or tearing of the brain’s delicate tissues, leading to physiological and metabolic changes in brain function. At a cellular level, a concussion can cause damage to neurons, which are the cells that make up the brain’s communication network. The impact can disrupt the normal flow of electrical signals between neurons, leading to a disruption of brain activity.

Concussions are a serious medical concern because they can result in temporary or permanent damage to the brain. While 80% of people recover from a concussion within 10-14 days, 20% of people can experience prolonged symptoms or complications. The impact of a concussion can cause a range of symptoms, which may appear immediately or develop over time. Symptoms of a concussion may include headache, dizziness, confusion, nausea or vomiting, sensitivity to light or noise, balance problems, memory loss, or difficulty concentrating. Dizziness, vertigo, and nausea are among the most common complains after concussion.

As part of multidisciplinary team, physiotherapists play a significant role in the management of concussion, including but not limited to:

1. Assessment: Physiotherapists can assess the physical, cognitive, and vestibular (balance and coordination) symptoms associated with concussion. This can include evaluating an individual’s cervical spine range of motion and strength, static and dynamic balance, visual tracking, gaze stability, and cranial nerve function.
2. Education: Physiotherapists can educate individuals with concussion, their families, and their coaches about the pathophysiology of the injury, its symptoms, and how to manage it. This can include providing guidance on activity levels, sleep, nutrition, and symptom management. It’s important that following concussion, an individual slowly builds up their cognitive and physical activity loads, rather than returning to their normal activities immediately afterwards.
3. Exercise prescription: Physiotherapists can prescribe exercises and physical activities that can help individuals recover from concussion. This can include balance exercises, eye-tracking exercises, progressive aerobic exercise and resistance training.
4. Vestibular rehabilitation: Vestibular rehabilitation is a type of physiotherapy that focuses on the vestibular system, which helps us maintain balance and spatial orientation. Vestibular rehabilitation exercises can be effective in treating dizziness and balance problems associated with concussion.
5. Return-to-play assessment: Physiotherapists can conduct return-to-play assessments to determine when it is safe for an individual with concussion to return to their regular activities, including sports and exercise. It is crucial that an individual does not return to sport until such as time as they can meet all the demands of the sport at full capacity with no provocation to their symptoms.

Overall, physiotherapy can play a valuable role in the management of concussion by providing assessment, education, exercise prescription, vestibular rehabilitation, and return-to-play assessment.

Seth

Physiotherapist