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Concussion Management

Have you ever had your “bell rung?” What about a feeling of “fogginess” after a header? Or how about feeling “dizzy” after hitting your head after a fall? Each of these symptoms could be the result of a concussion.

A concussion is considered a mild traumatic brain injury that actually alters the way your brain functions. Typical symptoms after a concussion include headaches, difficulty concentrating, loss of memory, decreased balance and poor coordination. While most symptoms are transient, some symptoms may persist and cause difficulty with daily activities or sports activities.

It’s a common misconception that a concussion occurs only as result of head trauma resulting in unconsciousness. While head trauma that causes unconsciousness may result in a concussion, it is not the only cause of such a diagnosis. Repetitive blows to the head over a short period of time, as well as prolonged, violent shakes of the head and body can also cause a concussion.

Every concussion injures your brain to some extent. While not the same, consider a brain injury just like an injury to your ankle. After you injury your ankle, rest and activity modification is important so that symptoms do not worsen. This may be for a very short time, or may last a few weeks. Your brain requires time to heal just like an ankle injury, so rest your brain! The good news is that most people usually recover fully if they follow the proper steps to recovery. We'll outline 3 simple steps.

Firstly, it’s most important to RECOGNIZE a concussion when you experience one. Please be honest! The excuse “I just got my bell rung” won’t quite cut it. While some symptoms may develop right away, some symptoms may take some time to develop. As mentioned earlier, not all concussions are the same; however, if you experience some or many of these symptoms listed below, you may have sustained a concussion. To draw on an earlier analogy: just as your body would be in pain if you injured your knee or ankle, so your head will indicate to you that it’s been injured. Here’s a list of a few symptoms that may occur initially (not a complete list):

  • Headache or head “pressure”

  • Temporary loss of consciousness

  • Confusion or “fogginess”

  • Loss of memory surrounding the event

  • Dizziness

  • Ringing in the ears

  • Nausea or vomiting

  • Slurred speech

  • Delayed response to questions

  • Appearing dazed

  • Increased fatigue

Are any of these symptoms familiar? If you have not experienced any of these initial symptoms, other symptoms may become present later. Here’s a list of common symptoms that may become apparent days to weeks after a concussion (not a complete list):

  • Concentration or difficulty remembering

  • Disturbed sleep

  • Light and/or noise sensitivity

  • Irritability or personality changes

  • Depression

  • Disorders of taste and smell

If you’ve experienced any of the symptoms listed above after head trauma or sports injury, Healthwise recommends giving your doctor a call. While not all of these symptoms require immediate medical attention, seeking appropriate care is important to ensure full recovery. If an athlete sustains a concussion in a game or match, it’s important that he/she not return to play until evaluated and cleared by a health care professional. Additionally, if any symptoms persist and worsen within a few days of an injury, it is important to seek emergency medical services.

Secondly, it’s important to REST after a concussion. Resting from activities that provoke symptoms is very important because it allows your brain time to heal. “Pushing through” symptoms is not recommended, as this may not only provoke symptoms in the moment, but may cause lasting effects in the future. During the rest phase, it’s also important to maintain proper nutrition and hydration so that your body gets the nutrients it needs to recover, just as you would with any other injury.

Finally, it’s important to RECOVER and gradually resume daily activities/sports once cleared by your doctor. We call this gradual return to activities “Sub-Threshold Training,” meaning a gradual return to activity by allowing rest breaks when symptoms seem to worsen. Once symptoms develop or worsen, it’s important to rest from that activity so that your body has time to recover. Once recovered, it is good to once again resume that activity. Physical therapy plays an important role in this process.

After an initial evaluation, physical therapists employ a variety of treatment techniques ranging from manual (hands-on) techniques to specific correctional exercises. Physical therapists typically treat impairments associated with your musculoskeletal, visual, and/or vestibular systems post-concussion. Oftentimes, your neck may be very stiff and sore, ultimately requiring the skills of one of our manual physical therapists. Or, the coordination of eye movements when your head turns may be “off,” requiring exercises to assist with regaining normal brain function. Whatever impairments you may have, we recommend a consult with our physical therapists to determine your next step in achieving your prior level of function.

If you forget everything mentioned in this article, remember this: RECOGNIZE, REST, RECOVER. Following these three steps will ensure that you recover fully from your concussion. Please give us a call if you have any questions or would like to schedule your consultation.

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