No doubt you’ve heard lots about concussions in the news. Perhaps you’re already aware that hits to the head could result in concussions and the symptoms that accompany them: headache, pressure in the head, neck pain, nausea or vomiting, dizziness, blurred vision, balance issues, visual disturbance, sensitivity to light, memory loss, concentration issues, confusion, depression, emotional changes and sleeping disorder. That’s the short list. There are many other symptoms, too many to name.
The way concussions are managed has changed greatly in the past five years, especially in the past year. Concussion management has become a multidisciplinary approach that addresses more than headaches and difficulties related to concentrating.
Concussion care is a multidisciplinary venture involving child, parent, coach, teacher, physiotherapist, physician, nurse practitioner and optometrist. When needed, neurologist, ENT specialist, psychologist, neuropsychologist and other medical specialist may be called in to help.
Recognize the signs
The first thing to do is to recognize the signs and remove the person from playing whatever sport they are engaged in. Continuing to play could aggravate the condition and has been shown to double the recovery time. For parents, coaches and trainers, there is a Concussion Recognition Tool (for use with adults and children) that can be downloaded here. It’s a good idea to carry a printout in your first aid kit!
Seek out a professional assessment
If you’re the person who has suffered the concussion, it’s important to have the get a full assessment from a physician, physiotherapist or nurse practitioner trained in concussion assessment to acquire a post-injury baseline and to monitor changes over the following weeks. Typically, they’ll use the SCAT 5 (Sport Concussion Assessment Tool – 5th Edition), developed by world leaders and researchers in the field. It’s important to note that SCAT 5 is endorsed by the Canadian medical community, the International Olympic Committee and several international sport federations.
Have a rest period
It is important to have 48 hours of rest following the injury. This is very important. (Note: Sometimes the concussion signs can be delayed and a longer rest period is needed.) Following this rest period, if appropriate, your medical practitioner may decide on a return to light activities—walking, occasional text or email, occasional reading can be introduced during a trial period.
Children affected with concussion need to be assessed differently – they are not simply smaller adults. It is important to prioritize a symptom-free return to school before a symptom-free return to sports/activities.
Progress to light activities, cardio and tasks
If symptom-free, your medical practitioner will help you progress gradually in intensity. First attempt light activities and light cardio, then move on to sport-specific light tasks. Make sure you work with a health professional trained in concussion management to monitor you for headaches and other symptoms of concussion, balance, endurance, visual disturbances, concentration, processing and memory.
Be patient
At times, symptoms are persistent despite your best effort to rest and resume normal daily activities. Things don’t always progress quickly or at least as quickly as you’d like. A trained medical personnel needs to establish if the persistence of symptoms is due to neck troubles, vestibular dysfunctions (inner ear) or if you require Cognitive Behaviour Therapy (for depression, mood or behaviour issues).
Understand what physiotherapy will do for you
When you first visit your physiotherapist, they’ll inventory your symptoms and how they affect you. As the neck can be a contributor to headaches and dizziness, they’ll assess the impact of its dysfunctions on your symptoms.
They’ll follow that up with a series of balance tests to identify the source of the lack of balance and/or dizziness. Remember that your physiotherapist’s role is to treat neck dysfunctions and labyrinth (inner ear)/balance problems. If they detect dysfunctions outside their spectrum of care, they’ll be sure to refer you to another specialist.
If they do identify neck or balance problems, or general conditioning issues, they’ll engage in a series of interventions to address these.
Don’t do it alone
Recovering from a concussion can be overwhelming and the symptoms can affect physical and mental health. Your progress need to be monitored objectively and medically. Assessment and follow-up with your physician/nurse practitioner is essential. Working with a sport physiotherapist trained in concussion management, (like those at Active Sport Physiotherapy Clinic), is an important part of getting you back on your feet quickly.
Get trained
If you are a coach, athletic therapist, trainer, first aider or parent, you might be interested in booking a FREE Concussion Recognition and Management Clinic. Please reach out to learn more. It’s part of our community service program!
