Concussions are a type of traumatic brain injury involving a bump, blow or jolt to the head. They can be the result of direct contact to the head or by a hit to the body that causes the head to rapidly move back and forth. This rapid head movement causes the brain to bounce off of the skull which results in chemical changes in the brain and damage to the brain cells.
Some of the most common signs and symptoms of a concussion can be summed up in the acronym HEADS.
- H: Headaches and/or vomiting
- E: Ears ringing
- A: Amnesia, altered or loss of consciousness
- D: Double vision and/or dizziness
- S: Something wrong/ something not quite right
It is important to recognize these signs and symptoms to minimize long-term effects. Second impact syndrome is a serious complication that is preventable. If a person suffers a concussion and then experiences a second concussion prior to being fully healed from the first, permanent brain damage or even death can result. An example of this scenario is when an athlete suffers a concussion in a game, continues to play, and then gets hit again. In this scenario, the athlete who suffers a concussion should be immediately removed from play and follow appropriate guidelines for return to play. Another example could be if a concussion was sustained during a car accident and the individual then falls at home hitting their head again.
For most individuals who suffer a concussion their symptoms will improve within a few weeks, but for others, their recovery can be prolonged. Having a prior history of concussions or brain injury can increase the risk of prolonged recovery. Other factors that can impact recovery are neurological or mental health disorders, learning difficulties, increased family or social stressors, and prior history of migraines or vestibular issues.
Post-concussive syndrome is defined as symptoms such as headache and dizziness that persist for weeks and/or months after the initial injury. Individuals with this prolonged recovery may benefit from physical therapy.
So what can PT do to help?
- Rest and Recovery: Provide education and guidance on proper rest and recovery in the early stages of concussion and facilitate/ monitor progression to activity.
- Treat dizziness and balance: Using Vestibular rehabilitation techniques to address dizziness symptoms, and exercises to improve balance and coordination
- Address Headaches: Using stretches, strengthening exercises, and hands-on manual techniques to reduce/eliminate headaches.
- Restore strength and endurance: Often with prolonged recovery individuals have been limited with activity and would benefit from a customized strength and conditioning program to restore function.
- Facilitate return to Sport/Activity: Developing programs that progressively challenge the individual while monitoring to avoid overloading the healing brain.
Jennifer Buono, PT, DPT