Concussions are one of the most serious injuries Physiotherapists at LiveWell Health and Physiotherapy help treat. A concussion occurs when the brain suffers a traumatic injury after it is shaken extremely hard. The brain is meant to stay in its position to support its functioning, so when a concussion occurs, patients find themselves suffering from changes in how their brain operates and how their body feels. Our Physiotherapists in Waterloo help patients to heal and resume normal functioning through concussion management—an area of Physiotherapy that focuses on restoring the brain’s function and therefore other body movements and functions.
How Do Concussions Happen?
Concussions are the effect of your brain being shaken up quite hard. The most common way patients get a concussion is from falling or through a motor vehicle accident, but there are a few other ways concussions can happen such as:
- Workplace Injuries: When something falls on a worker’s head or a worker slips and hits their head
- Children’s Activities: Children tend to be a little more accident-prone because they are so high energy. Children who fall off playground equipment or even fall off their bike without wearing a helmet can suffer a concussion
- Athletic Injuries: High-Contact sports such as football, soccer, rugby, lacrosse, basketball and hockey end up with an alarmingly high rate of concussions because of the amount of neck and head hits. Although athletes of any age can get a concussion, they are most common amongst children ages 10-18 according to the Government of Canada
- Domestic Abuse: When an abusive partner or parent delivers physical blows to the head area, the result goes beyond external bruising and results in a concussion. For these scenarios, it is not only important to seek treatment for the concussion, but also for domestic violence
- Violent Events: In extreme circumstances, being in close proximity to an explosion or blast can cause a concussion
The Signs and Symptoms of a Concussion
After any of these events, it is important to look for the signs and symptoms of a concussion so it can be treated appropriately. In the short term, you need to look for the classic physical signs such as headaches, dizziness or loss of balance, vomiting, altered vision, light sensitivity, slurred speech, and seizures. The signs that are harder to catch depending on the person’s age, are the internal signs that relate to the brain’s cognitive function such as confusion, forgetfulness, excessive sleeping, slower responses, and a general foggy feeling. Emotional wellbeing can also tie into this, as people with concussions tend to be more irritable, anxious, and can experience a change in their demeanour.
Initial Concussion Management Treatment
With any of these short term signs and symptoms, it’s important to seek concussion management and concussion treatment right away. A doctor is often the first person to diagnose a patient based on how and when the concussion occurs, with a physiotherapist being the second form of contact if the patient needs help to restore their movements. In extreme cases when a person stops breathing or becomes unconscious, a paramedic should be the first point of contact to determine the next steps of movement and if they need hospitalization
How a Physiotherapist Begins Treating a Patient
Unlike other injuries, a concussion isn’t something that can be found on a CT scan or an MRI, nor can it be determined through blood testing or X-Rays. If your doctor suspects you have a concussion and rest alone does not resolve the problem within one-two weeks, your doctor will likely suggest seeing a Physiotherapist.
Initially, the commonality in any Concussion Management Plan is the most important step in the recovery process—REST! Resting is crucial to recovery because your brain needs the least amount of stimulation possible. Avoiding physical activities and thinking activities is important. And this doesn’t mean to avoid only the difficult ones! Any type of physical activity, whether it be taking a walk outside, driving, or doing housework should be avoided because it sends extra blood flow to the brain which can make symptoms worse. Thinking activities are also not recommended because it uses extra energy, which includes things as simple as texting or reading a book. The more resting you can put into your day, the better it will be for your recovery.
But for those with concussions that don’t respond to rest to achieve previous state of movement and activity, a Physiotherapist will need to create a long-term Concussion Management Plan.
At Absolute Rehab Centre, our Physiotherapists begin creating a Concussion Management Plan by gathering their history and performing basic movement tests. This includes tests to gauge balance and coordination, muscle movement, and sight. Our Physiotherapists will also perform memory tests on patients by asking them very easy questions about their life, the day, or the room they are sitting in. In the case of athletes, Physiotherapists may ask more sports-related questions (such as when was your last game, how often do you play, etc.) in addition to the basics so they can track progress as the athlete gets back into their sport.
Each Concussion Management Plan Is Unique, Just Like Your Case
As your Physiotherapist gathers the information they need from these questions and tests, they will create a Concussion Management Plan for you. Because no two concussions are the same, the plan given you to by your Physiotherapist may be different from the next patient’s, so you need to follow their instructions carefully.
For those with concussions that don’t respond to rest alone, a Physiotherapist will provide Vestibular Rehabilitation. Vestibular Rehabilitation addresses the issue of balance, which is controlled by the Vestibular System located in the inner ear and the brain. Vestibular Rehabilitation uses exercises to try and restore as much function as possible within the Vestibular System. By restoring function in the system, the problems of dizziness, imbalance and sight instability are improved and reduce the number of headaches and confusion a patient has. Your physiotherapist will teach you how to perform the exercises they believe will help you in the recovery process. These are pretty basic to do whether you are at your Physiotherapy session or at home. Some of the common exercises are:
Gaze Stabilization Exercises
To regain vision control in patients who have problems focusing, your Physiotherapist will teach you how to exercise your eyes. Eye exercises will help the muscles learn how to focus again on whether an object stays in place and the head moves, or both the object and head move.
Basic Balance Exercises
Patients who have significant troubles balancing due and coordinating their movements will be provided with exercises that strengthen their most common movements such as walking, bending, and stretching. Over time, the body will learn these movements again to provide better stability for everyday life and prevent future falls
Habituation Exercises
This comes further along in the recovery process, however, Habituation Exercises are given so that the brain learns to minimize symptoms caused by certain movements and environments. For example, your Physiotherapist may ask you to perform a series of movements that irritate your symptoms. Over time, these movements become “tuned-out” by the brain and become a regular part of your functioning again.
The Concussion Management Plan and Returning To Regular Activities
Working together with your Physiotherapist, you will find your way to recovery. Because each case is different and everyone’s muscles re-learn at a different pace, it is difficult to say how long it will take to recover from a concussion. Once it is advisable from your Physiotherapist, you can slowly start returning to your regular activities.
Concussion Management still plays a role in your recovery, even when you are making the slow transition to school, work or your chosen sport. Through the slow transition, you may still need to take time away from your activity to give your body time to adjust and recover.
Keep in mind, your Physiotherapist will still need to check in with you to see how you are progressing—including the physical function of your body and to gauge your cognitive functions. Much like their initial contact with you, they will provide you with tests and questions during follow up appointments. This helps them evaluate if you are still okay to participate in your activities, or if you need to rest partake in more Vestibular Rehabilitation sessions. For athletes, your Concussion Management and Treatments will typically end once you have passed a final physical test that clears you of any abnormal brain and body functions.
To learn more about Concussion Management and Vestibular Rehabilitation, please contact LiveWell Health and Physiotherapy. Because we provide Physiotherapy in Waterloo, we have seen a variety of concussion cases from student-athletes at the local universities to work-related injuries and even motor vehicle accidents. With each patient, we take a caring approach and are attentive to the small details in the recovery process. We can also help answer any questions you have related to taking time off school, work or your chosen sport to recover.
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