The term “concussion” has gained a lot of attention in recent years. It’s been in NFL news headlines, the title of Hollywood’s 2015 movie about former NFL football player Mike Webster’s death and pathologist Dr. Bennet Omalu’s discovery of chronic traumatic encephalopathy (CTE), and a growing dinner table conversation topic in families with young athletes.
Reporting of concussions is on the rise and for a good reason. We are learning much more about the nature of the injury, symptoms, re-injuries and risk of long-term sequelae. As a result, treatment guidelines have improved as well that include a multidisciplinary approach between coaches, physicians, neuropsychologists, physical therapists, and the patient and their families.
Concussion is an injury to the brain when the brain is shaken inside the skull. It can occur from low-velocity impact, acceleration/deceleration injury, or a blunt force to the head, face, neck, or elsewhere on the body. This shaking or hitting of the head results in an unpredictable injury to any area of the brain, resulting in immediate or delayed changes in the brain’s chemistry or function due to a neurochemical disruption not necessarily physical damage to brain tissue. Therefore, concussion injuries (alone) are rarely identified on MRI or CT scan. Furthermore, it may or may not occur with loss of consciousness.
Symptoms of a concussion can include immediate memory and attention problems, slurred speech, and disorientation. Delayed or persistent symptoms can include nausea, headache, vertigo, dizziness, imbalance, mental fogginess, sleep disturbances, difficulty with memory, and mood changes. Someone may also have sensitivity to noise, smell or light. For example, these patients complain of difficulty concentrating at work or at school, motion sickness while in a moving vehicle, dizziness with quick head or body movements, and difficulty reading or with computer use. Most people recover from these symptoms within 7-10 days following the injury with appropriate rest and a well-managed return-to-activity, work or sport program that should be directed by a physician, neuropsychologist or specialty-trained physical therapist. However, if left untreated one concussion can increase risk of other concussions that can lead to amplified symptoms or post-concussion syndrome.
Post-concussion syndrome (PCS) refers to symptoms such as headaches, dizziness, motion sensitivity, visual disturbance, anxiety and emotional lability, or balance disorders that persist for weeks to months after the initial injury. It is hard to know or predict when a concussion will lead to PCS because it is not correlated to the severity of the initial injury but early intervention of the initial concussion may help prevent it. Therefore proper education and treatment with specialized professionals is key. Furthermore, physical therapy can be of benefit especially for this group with combined vestibular rehabilitation, balance training, and treatment for the cervical spine.
Physical therapy including rehabilitation to the vestibular (inner ear) system as well as orthopedic care for the neck can help concussed patients return to activities of daily living, sports, and work. If you have any questions regarding concussion, please contact one of our specialty-trained vestibular therapists.
Emily Clark, MSPT
Rebound Sports & Physical Therapy
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