Concussions are 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. While much is being reported on the devastating effects of head injuries among professional football players, new information reveals that children aged 3 to 17 years are also at risk. According to a new report by the Centers for Disease Control and Prevention (CDC), about 7% of children in this age group has experienced a head injury. These findings are part of a report released in February 2018 (Parental Report of Significant Head Injuries in Children Aged 3-17 Years: United States, 2016), and the result of a 2016 National Health Interview Survey of parents or guardians seeking information about head injuries beyond those who were medically treated. The percentage of incidence increased significantly with age; those aged 15-17 years were 3 times more likely (11.7%) to experience a significant head injury than children aged 3-5 years (4%). According to emergency physician Robert Glatter, MD, in an interview with HealthDay, the increase of incidence with age can likely be attributed to more engagement in sports and activities. In all age categories, boys were more likely to have a head injury than girls.
Concussions and Physical Therapy
“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.”
Choosing a Physical Therapist
“All physical therapists are prepared through education and experience to treat a variety of conditions or injuries. You may want to consider:
- A physical therapist who is experienced in treating people with post-concussion problems. Some physical therapists have a practice with a neurological or vestibular rehabilitation focus.
- A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.
General tips when you’re looking for a physical therapist (or any other health care provider):
- Get recommendations from family and friends or from other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people with concussion.
- During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.”
“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:
- Avoid motor vehicle collisions:
- Drive defensively, not aggressively.
- Eliminate distractions while driving, such as eating, talking on a cell phone, or texting.
- Choose cars with airbags.
- Make sure the airbags in your car are in good working order.
- Avoid risky behavior in sports:
- Absolutely avoid football techniques that increase the risk of concussion, such as “spearing” and headbutting.
- Avoid or limit “heading” the ball in soccer.
- Don’t ignore or hide signs of concussion, even in an important game or competition. Report them immediately to your coach.
- Stay current with state and federal guidelines.
- Remember that neither helmets nor mouth guards prevent concussions.
- Clear your walking areas at home of any objects that might increase the risk of falling, such as loose throw rugs, dropped objects, loose flooring, torn or rumpled carpets, and pet toys or dishes.
- Make sure that all traffic areas in your home are well-lit.
- Avoid exposure to blast explosions and violent events.
- Do not shake babies, or anyone of any age!
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.”