Concussions 🧠- A Physio Perspective
Concussion. It is in the news, we know it is bad but what is it? We know that it causes people to have a mandatory 2 weeks off sport but why?
According to the Berlin Consensus statement on concussion in 2017, they describe it as: “A traumatic brain injury induced by biomechanical forces”.
The truth about concussion is that even though it can't be seen it is a real injury. It is actually a metabolic and physiological change in the brain's chemistry. Initially after a concussion injury, the synapses in your brain fire off in this electrical storm and then have a sudden decrease in energy. The problem is when we don't give our brain the time to heal itself and return to metabolic homeostasis. This can be the cause of symptoms such as fatigue, headache and some of the others listed in the list above.
The Berlin statement reported that if any of the following are experienced after a knock to the head or enough force applied to any other area of the body a concussion can be suspected:
Symptoms: somatic (e.g. headache), cognitive (e.g., feeling like in a fog) and/or emotional symptoms (e.g. lability)
Physical signs (e.g., loss of consciousness, amnesia, neurological deficit)
Balance impairment (e.g. gait unsteadiness)
Behavioural changes (e.g. irritability)
Cognitive impairment (e.g. slowed reaction times)
Sleep/wake disturbance (e.g. somnolence, drowsiness)
Seeing your medical or healthcare professional is an important step if you suspect you or a family member might have a concussion. Often waiting until you have been symptom free for 24 hours means you are ready to progress and gradually participate in more activities. Giving your brain time to heal and a gradual return to work or sport is often recommended to get you back to your full potential.
Sometimes symptoms can linger for longer. If symptoms persist for more than 3 weeks, it can often be called PCS or Persistent Concussion Syndrome. Treatment for PCS often involves input from a multidisciplinary group. However, a Physiotherapist's role in concussion often includes:
An individualised symptom-limited aerobic exercise programme in patients with persistent post-concussive symptoms associated with autonomic instability or physical deconditioning.
A targeted physical therapy programme in patients with cervical spine or vestibular dysfunction, and
A collaborative approach including cognitive behavioural therapy to deal with any persistent mood or behavioural issues.
So, if you or someone you know isn't sure if you have a concussion and you are experiencing one of the above symptoms, chances are you have a concussion and should see a health professional with specialised training in management of concussions, so you can get back to what you love quicker!
At Reload Physio, Olivia N is experienced in the Physiotherapy Management of Concussions. Olivia can help you get back to what you love as soon as possible.
McCrory P, Meeuwisse; W, Dvorak J, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 British Journal of Sports Medicine 2017; 51:838-847.
