What is a concussion?
Concussion is a mild traumatic brain injury that occurs when the brain is shaken by a rapid movement. This results in changes to the function of the brain. The electrical messages being sent between the neurons (brain cells) are affected by the injury and produce the symptoms of a concussion. It is more of a ‘software’ problem than a ‘hardware’ problem so imaging such as MRI or x-ray usually appears normal.
Do I have a concussion?
If you have recently suffered a sudden impact or ‘whiplash’ injury to your head and neck, you may have a concussion. You do not need to lose consciousness at the time of the injury in order to sustain a concussion. Common ways for a concussion to occur include a direct blow to the head or a ‘whiplash’ type movement during sports or a motor vehicle accident. If you suspect that you have sustained a concussion, you should be reviewed by a Physiotherapist or Physician trained in the diagnosis and management of concussions as soon as possible.
What are the signs and symptoms of concussion?
The symptoms of concussion are the result of disruption to the electrical signals sent around the brain and nervous system. If you are experiencing any of the following symptoms you may have a concussion:
- Balance problems
- Poor coordination
- Disturbed sleep
- Blurred vision
- Double vision – often noticeable when reading
- Sensitivity to light
- Sensitivity to sound – often noticeable in supermarkets
- Slurring speech
- Difficulty remembering things
- Difficulty concentrating – often noticeable at work or school
- Difficulty reasoning through things
- Increased irritability
- Reduced stress tolerance
How long does it take to recover from a concussion?
Usually the symptoms of a concussion will resolve in less than four weeks.
What is Post Concussion Syndrome?
Post Concussion Syndrome is the medical term used when the symptoms of concussion last longer than four weeks.
What is Second Impact Syndrome?
Second Impact Syndrome is when you sustain a second concussion before you have recovered from the first one. This can happen if athletes are encouraged to go back on to the field of play after having a head injury. It can also happen if people return to high risk activities like sports before fully recovering from their initial concussion.
The consequences of Second Impact Syndrome can be very serious. If you sustain a second concussion before fully recovering from the first injury you risk permanent brain damage or even death. It is very important that individuals with a concussion discuss returning to sports or other high risk activities with their Physician and Physiotherapist.
How is a concussion diagnosed?
Concussion is diagnosed by a clinical evaluation performed by a specially trained Sports Medicine Physician or Physiotherapist. A concussion can not usually be seen on imaging such as an x-ray, CT or MRI scan because the problem is not with the structures of the brain, but rather the electrical and chemical activity going on within the brain.
What is the treatment for concussion?
The most important treatment for an acute (new) concussion is relative rest. This does not mean complete bed rest (although this can be necessary in severe cases). During this time, activities involving physical or mental exertion should be minimal. The best rule of thumb is that if you feel your symptoms increasing, you are doing too much. Consequently, you may need to take some time off from work, sports or school. Social activities may also need to be limited temporarily. It is very important that you avoid activities such as sports that would put you at a high risk to sustain another concussion. Your Physiotherapist can help guide you through this stage in order to allow you to return to full activity as soon as possible.
What is the treatment for Post Concussion Syndrome?
If your symptoms persist beyond four weeks this is known as Post Concussion Syndrome and it is unlikely to resolve with continued relative rest. Treatment usually involves input from a Sports Medicine Physician and a Physiotherapist trained in concussion management. Other professionals such as Occupational Therapists and Psychologists may also need to be involved.
The Sports Medicine Physician may prescribe medications and supplements and advise you on the safety of returning to work, school or sports. The Physiotherapist will perform specific tests in order to determine which neurological functions have been affected. These tests review the performance of your visual, vestibular and balance systems, as well as your exertion tolerance. The Physiotherapist will also help you implement systems to manage your activity levels in order to allow you to recover. Once you have been fully assessed, your Physiotherapist will work with you to plan a rehabilitation program based on the things that are most important to you.
When can I return to sport after a concussion?
It is very important that you do not return to sport until you have fully recovered from your concussion. At that time you can begin a gradual ‘return to play protocol’. It is best to discuss this with your Physiotherapist as you may feel fine with day to day activities but under more specific testing it can become apparent that you have not yet fully recovered. Your Physiotherapist can guide you step by step through the return to play protocol when you are ready.
When can I return to work or school after a concussion?
This is different from returning to sport as you do not need to have fully recovered in order to return to work or school. However, you may delay or even halt your recovery if you return to work/school too soon or are doing more hours than you are ready for. It is best to come up with an individualized plan for your return to work/school by discussing it with your Physiotherapist and Sports Medicine Physician.
What should I do now?
If you suspect you may have suffered a concussion, it is best to be reviewed by a Physiotherapist trained in the management of concussion as soon as possible. I can liaise with your Family Physician and arrange referrals to Sports Medicine Physicians or other healthcare professionals if required.
You do not need a referral from your doctor to be assessed by a Physiotherapist. If you would like to book an assessment, please get in touch.