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What Is a Concussion & How Can Physical Therapy Help?

A concussion is a type of mild traumatic brain injury (mTBI) caused by either a direct or indirect blow to the head that causes the brain to impact the inside of the skull.

 

  • A direct injury occurs from a blow to the head or jaw 
  • An indirect injury occurs from a blow to the body that causes the head to move rapidly back and forth within the skull

 

Damage in the brain occurs at a cellular level and creates a cascade of chemical changes in the brain that cause the observable signs and symptoms associated with a concussion. A negative imaging test of the brain does not mean there is not a concussion, as a concussion is a functional injury, not a structural injury. 

What are the Signs and Symptoms of a Concussion? 

 

Signs: things you might observe in your child 

Symptoms: things your child might tell you 

  • Poor coordination (clumsiness)
  • Vomiting 
  • Balance problems 
  • Sleeping more than usual 
  • Forgetfulness 
  • Slow to answer questions 
  • Mood, personality, and behavior changes 
  • Irritability 
  • Loss of interest in activities, withdrawal 
  • Headache 
  • Dizziness 
  • Nausea 
  • Vision changes (blurry vision, double vision)
  • Sensitivity to light and/or noise 
  • Difficulty falling asleep 
  • Difficulty remembering, concentrating, or processing information
  • Feeling off or “in a fog”
  • Depression, anxiety

 

Most children and teens with concussions feel better within a couple of weeks, but there are several factors that might contribute to a longer recovery, including 

  • History of previous concussions or brain injury (post-concussive syndrome, or a concussion with protracted recovery, is more common in patients with a history of multiple concussions)
  • Mental health disorders, including depression and bipolar disorder 
  • Neurological disorders, including epilepsy 
  • Learning difficulties/disorders, including ADD and ADHD
  • Stress and anxiety 

 

How Can PT Help Recovery From a Concussion? 

There are many ways a physical therapist can help a patient with a concussion. 

Provide Education

  • Limit stressors and triggers to alleviate symptoms (i.e. avoid noisy and bright areas)
  • Avoid secondary injuries before you have fully healed from your initial injury. This often includes decreasing sport participation
  • Sport Safety/Injury Prevention Tips 
            1. Ensure proper helmet and equipment fit
            2. Working on body mechanics, especially tackling technique
            3. Improving neck and core strength to improve head stability 

 

Provide Guidance for Return to School-- your physical therapist might be able to recommend certain accommodations that can make school more tolerable and comfortable, such as

  • Extensions for homework/project due dates 
  • Reduced noise areas if noise-sensitive 
  • Wearing sunglasses if light-sensitive
  • Postponing exams 
  • Receiving extra time to take exams
  • Limiting reading amounts 

 

Treat your Persistent Symptoms 

  • Treat the Neck: often, the muscles in the neck get very tight due to the whiplash nature of a concussion mechanism. A physical therapist can do massage and myofascial release techniques, stretching, and strengthening exercises that might help alleviate neck pain, headaches, and vision problems associated with concussion. 
  • Balance Exercises: a physical therapist can help retrain your balance in a number of ways to help you be more stable while standing, moving around, and jumping which can make it safer to return to your sport. 
  • Vision and Vestibular Symptoms:  Dysfunction with the eyes and inner ear after a concussion can cause several symptoms, including headache, dizziness, blurred vision, balance problems, poor coordination, and nausea.  Retraining the visual, oculomotor, and vestibular systems with targeted exercises can help mitigate these symptoms

Guidance for Return to Sports-- returning to sports after a concussion should be a gradual step-wise process, generally including these 6 steps: 

  1. Back to all regular activities, including school 
  2. Light aerobic exercise to increase HR (i.e. 10 mins bike, walk, light jog)
  3. Moderate aerobic exercise to increase HR with head and body mvmt 
  4. Heavy, non-contact activity (sprinting, non-contact sport-specific drills)
  5. Practice and full contact in controlled practice 
  6. Competition with full contact  

If you have any questions about this post or would like to speak with a physical therapist about an injury, give us a call at (978) 263-0007 or, use the contact form on our website. We would be happy to answer any questions and discuss possible next steps.

Achieve Physical Therapy is currently open in Acton, Bedford, and Sudbury, MA. We continue to follow the CDC guideline for face mask coverings.

 

Resources

CDC Heads Up  https://www.cdc.gov/headsup/index.html