Concussion is
a traumatic brain injury that can cause lasting effects on brain tissue and
change the chemical balance of the brain. Concussion may cause physical, cognitive,
and behavioral symptoms and problems, both short-term and long-term. Every
concussion is considered a serious injury by health care providers. If you have
experienced a head injury, seek medical help immediately.
The Centers for Disease Control (CDC)
estimates that 1.6 million to 3.8 million people experience concussions during
sports and recreational activities annually in the United States. These numbers
may be underestimated, as many cases are likely never reported. A physical
therapist can assess symptoms to determine if a concussion is present, and treat the injury by guiding the patient through
a safe and individualized recovery program.
What Is Concussion?
Concussion is a brain injury that occurs when the brain
is violently shaken. The injury can happen during rapid movement changes (such
as whiplash) or when the head is directly hit. This shaking or hitting of the
head causes unpredictable injury to any area of the brain, resulting in
immediate or delayed changes in the brain's chemistry and function. Less than
10% of concussions involve a loss of consciousness. Depending on which area of
the brain suffers injury, many different temporary or permanent problems with
brain function can occur.
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Concussions can occur at any age, from a variety of
causes, including:
Recovery from a concussion can take several weeks to several
months and sometimes years, depending on many factors, including severity of
the injury and the age of the person affected.
Concussion may occur along with other injuries, such as
those to the neck and surrounding tissues, which should be managed by a
licensed physical therapist. More serious brain injuries, such as bruising,
bleeding, or tearing, may also occur and require the immediate care of a
medical doctor, such as a neurosurgeon.
CAUTION: Concussions can
potentially lead to long term brain damage. Seek medical help from a licensed
health care provider following any suspected head injury.
Physical
therapists can evaluate and treat many problems related to concussion. Because
no 2 concussions are the same, a physical therapist will examine your
neurological, orthopedic, and cardiovascular systems in order
to best prescribe a routine to address your particular symptoms and your
needs in all of your daily environments.
Treatment
may include:
Rest and recovery. Your physical
therapist will help you and your family understand why you should limit any
kind of activity (daily tasks, work, school, sports, recreation, the use of
electronics) after a concussion, until it is safe to return to these
activities. A period of rest helps the brain heal and helps symptoms clear up
as quickly as possible. Your physical therapist will prescribe the rest and
recovery program most appropriate for your condition.
Restoring strength
and endurance. The physical and mental rest required after a concussion
can result in muscle weakness, and a decrease in physical endurance. Your
physical therapist can help you regain your strength and endurance when the
right time comes, without making your concussion symptoms worse. It is common
for elite-level athletes and fit “weekend warriors” to experience
exercise intolerance with concussion and brain injury. Your physical therapist
will work with you to identify and treat your particular
concussion symptoms.
Your
physical therapist will design a therapeutic exercise program just for you, and
closely monitor your symptoms as you participate in the program.
Stopping dizziness
and improving balance. If you have dizziness or difficulty with your
balance following a concussion, a type of physical therapy called vestibular
physical therapy may help. The vestibular system, which includes the inner ear
and its connections with the brain, helps you keep your balance and prevent
dizziness. A qualified vestibular physical therapist may be able to help reduce
or stop your dizziness or balance problems after a concussion by applying
special treatments or teaching you specific exercises, some of which you may be
able to do at home.
Reducing
headaches. Your
physical therapist will assess the different possible causes of your headaches, and use specific treatments and exercises to
reduce and eliminate them. Treatment may include stretches, strength and motion
exercises, eye exercises, hands-on techniques like specialized massage, and the
use of technologies such as electrical stimulation.
Returning to normal
activity or sport. As symptoms ease and you are
able to regain your normal strength and endurance without symptoms
returning, your physical therapist will help you gradually add normal
activities back into your daily routine. Your physical therapist will help you
avoid overloading the brain and nervous system as you increase your activity
level. Overloading the brain during activity after a concussion interferes with
the healing of the brain tissue, and can make your
symptoms return. Your physical therapist will help you return to your normal
life and sport activities in the quickest and safest way possible, while
allowing your brain to properly heal.
A
concussion is a brain injury; patients living with a brain injury often
don’t have the language to express how they feel after injury. Therefore,
it is important to work with a physical therapist who gets to know you, your
family, teammates, and/or coworkers who may notice any changes in you.
Signs
and Symptoms
There
are many symptoms related to concussion, and they can affect your physical,
emotional, and mental well-being. Some symptoms occur immediately, some a few
hours after the injury, and some show up months or years after a concussion.
It
is important to seek medical treatment immediately following any head injury.
The risk of death or permanent brain damage from a concussion can be minimized
by immediate and appropriate treatment from health care providers, like a
physical therapist. Only health care providers have the knowledge and training
to identify concussion in the maze of symptoms that can occur following a head
injury.
Immediate and
short-term symptoms
Physical
symptoms of a concussion can include:
Cognitive
(thinking) symptoms can include:
Emotional
symptoms can include:
Longer-term symptoms
Some
concussion symptoms do not go away in the expected time frame. These symptoms
may need further testing and treatment by a team of health care providers,
including a physical therapist.
Postconcussion syndrome is the term
applied to symptoms such as headaches or dizziness that persist for weeks or
months after the initial injury.
Second-impact
syndrome is
a serious, although preventable, complication that can occur after a
concussion. If a person who has suffered a recent concussion experiences
another concussion, permanent brain damage or death can occur. Permanent brain
damage can include learning disabilities, personality changes, walking
disability, or other brain or nerve disabilities. Research suggests that a
person who suffers a second concussion before the initial concussion has
healed, has a 100% chance of permanent brain damage, and a 50% chance of dying.
An
example of second-impact syndrome would be a football player who suffers a
concussion in a game, keeps playing, and is hit again; or a person who suffers
a concussion from whiplash in a car accident, and then falls at home and
endures another concussion very soon after the initial injury.
Extreme care should
be taken after a concussion to prevent a second injury.
Athletes
who suffer a concussion during practice or competition must be removed
immediately from play, in order to prevent subsequent
concussions and second-impact syndrome. A physical therapist will work to
develop safe guidelines for return to play, return to work, and return to
life’s daily requirements.
A
longer recovery time may be required for those with a history of prior
concussions, eye tracking/movement issues from childhood, migraines, attention
deficit hyperactivity disorder, or a learning disability. It's important to
disclose your entire medical health history to your physical therapist.
Concussion
is most often diagnosed through careful testing by your health care provider, such
as a physical therapist. Unfortunately, no single test or tool exists to
diagnose a concussion. The diagnosis usually does not rely on hi-tech testing,
such as an MRI or CT scan, because brain scans often do not show any brain
abnormality, even when the person has symptoms of a concussion.
Your
physical therapist will ask you many questions to understand all
of the symptoms that you are experiencing. He or she also will perform
numerous tests to identify problems caused by a concussion, including muscle
strength, coordination, balance, sight, smell, hearing, and memory tests.
During
treatment, your physical therapist will repeat the same questions and tests
frequently to gauge your progress and help judge when you can return to work,
school, sport, or recreational activities.
If
you are an athlete who underwent preseason memory (neuropsychological) testing,
your physical therapist may collaborate with the health care provider who performed
that testing to help determine if you have a concussion.
Your
physical therapist may also examine your neck for problems following a
concussion. Neck injuries can occur at the same time as concussions,
and can cause or increase headaches and dizziness.
Can
This Injury or Condition Be Prevented?
While initial injuries can’t always be
prevented, it is very important to prevent further injuries to those with
concussion. The injured person should be closely protected until all symptoms
have cleared, and normal activity can resume.
The risk of concussion can be greatly reduced by
taking the following precautions:
Eliminate distractions while driving,
such as eating, talking on a cell phone, or texting.
It is imperative to prevent second-impact syndrome
after an initial concussion. The injured person should be closely protected
until all symptoms have cleared, and normal activity can resume.
Call
our Kingwood office (304) 329-3739 or out Masontown office (304) 864-0111 with
any questions or to set up an appointment.