Concussions – Signs, symptoms, and treatment

Anthony Lo

With the start of the new school year and winter sports (eg. skiing/snowboarding) around the corner, many of us both young and old are at risk for accidents which may result in possible concussion. What exactly is a concussion? According to the CDC, a concussion “is a type of traumatic brain injury – or TBI – caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.” As a result, the sudden movement disturbs the brain within the skull, potentially causing chemical changes in the brain as well as stretching/damaging brain cells. As a result, individuals who are concussed may experience symptoms such as difficulty recalling events leading up to or occurring after the hit or fall, persistent headache/pressure in head, nausea and/or vomiting, difficulty maintaining balance/dizziness, and double or blurry vision to name a few. Often times, younger individuals may report, ‘not feeling right’ after a hit or fall. Symptoms such as these should not be ignored as these can be indicative of a concussion or more serious brain injury. Although symptoms may start to appear soon after the injury, other symptoms may not appear until hours or days after the incident. As such, if a concussion is suspected, continue to check for persistent or worsening symptoms and if necessary, the individual should be taken to the emergency department right away.

Although the initial symptoms of a concussion may resolve via rest and/or further medical intervention, individuals may continue to experience symptoms related to post-concussive syndrome. Although there are no standardized treatment protocols to guide physical therapy interventions for individuals experiencing these symptoms, various studies have shown that individuals who underwent physical therapy treatment which included a combination of vestibular/oculomotor and cervical rehabilitation have demonstrated overall decreased symptoms associated with post-concussive syndrome. According to one study, typical treatment for patients with an acute concussion is physical and cognitive rest until a full resolution of symptoms and that return to intense exercise too soon after concussion may increase risk for cerebral hemorrhage by increasing intracranial pressure. However for patients experiencing post-concussive syndromes (marked by prolonged symptoms that stretch over several weeks to months) this concept of complete rest is being challenged. As such, active rehabilitation, with an emphasis on sub-symptom exercise training, is believed to promote neuroplasticity in the brain that contributes to symptom resolution and can benefit the overall well-being of the patient and ultimately safely return them to prior level of physical fitness.

As much as we try to safely participate in recreational and/or extracurricular activities, unfortunately accidents can happen. If you or someone you know has suffered from a concussion, continue to monitor the symptoms/status and seek appropriate medical care. Furthermore, if you are experiencing ongoing symptoms from a concussion, feel free to schedule an evaluation with physical therapy to assist with continued recovery and eventual safe return to sport.

Reference:
Hugentobler, Jason A et al. “PHYSICAL THERAPY INTERVENTION STRATEGIES FOR PATIENTS WITH PROLONGED MILD TRAUMATIC BRAIN INJURY SYMPTOMS: A CASE SERIES.” International journal of sports physical therapy vol. 10,5 (2015): 676-89.

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