Concussion: Diagnosis & Treatment Overview

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With school back in session for a few months now, school sports are in full swing. As we transition from fall to winter sports, we must be cognizant of our student athletes’ health and well-being. A hot topic right now in both professional and lower level sports is concussions. New protocols for recognition, diagnosis, and treatment of concussions have emerged to keep athletes safe and on the playing field as much as possible.

Concussions occur when an external force results in excessive contact between the brain and the skull. Loss of consciousness may occur, but it is not the determining factor. Signs to look for when attempting to recognize a potential concussion include:

  • Dizziness
  • Headache
  • Blurred Vision
  • Nausea/Vomiting
  • Confusion
  • Sensitivity to Light or Sound
  • Loss of Consciousness

When a concussion is suspected, an athlete should immediately be removed from any strenuous activity, including sport. The athlete should then be assessed in a quiet, controlled environment. Several tests may be administered, and symptom provocation with any test should be noted. Tests may include:

  • Cervical Range of Motion
  • Gross Strength Assessment (Manual Muscle Testing)
  • Gaze Stabilization
  • BPPV Testing
  • Balance Assessment

Once a concussion has been confirmed, it is recommended that the athlete enter a period of low stimulation. This includes avoiding strenuous activity (e.g. sports, physical education) and limiting schoolwork (only what is necessary), television, reading, texting, music, etc. Gradually, activities can be resumed more normally as symptoms improve, but returning to normal activity too quickly can slow recovery.

When appropriate, an athlete who has suffered a concussion can enter physical therapy. Treatments generally begin at a very basic level and progress as is tolerated by the athlete. Treatment strategies that may be used include:

  • Cardiovascular Training
  • Strength Training
  • Stretching
  • Postural Training
  • Balance Training
  • Manual Techniques (Soft Tissue Mobilization, Joint Mobilization, etc.)
  • Vestibular Maneuvers (Hallpike-Dix Maneuver)
  • Sport Specific Training (usually toward the end of an athlete’s need for treatment)

It is appropriate for an athlete to return to normal daily life and sport when he or she exhibits no signs of symptom provocation with physical exertion. Tasks should be similar to those that the athlete will encounter throughout the day, including daily activities and sport specific activities. Once an athlete returns to sport, he or she should be monitored for any potential return of symptoms.

Now that you know a bit more about how to recognize a concussion, how it is assessed and diagnosed, and the treatment and recovery process, you can help keep all of our athletes and yourselves safer.

Here’s a link to the APTA Neurology Section’s “Concussion Management Fact Sheet” for further information:
Click Here to Learn More

Thanks for reading and have fun playing!

– Rob Kohutanycz, PT, DPT

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