Concussions can be very complex injuries with a broad range of potential outcomes. Because each concussive event and case is unique, there is no certain timetable for recovery. Some who suffer a concussion recover in days, other people require weeks or months, while some may endure long-term concussion effects. What is certain is that all concussions can become a serious medical issue thus warrant prompt care by a health professional trained in managing concussions, as we are here at Perfect Stride.
A direct or indirect hit to your head or any force causing your head to jerk (similar to whiplash) can result in a mild traumatic brain injury (mTBI) called a “Concussion”. As your brain sits inside your skull it is surrounded by fluid. When your head takes a hit your brain shifts or shakes around inside the skull. The impact and forceful disruption damages blood vessels, nerves, and brain cells creating chemical and cellular changes in the brain. The result is your brain to some measure or degree doesn't function as it should. After a concussion, you may experience vision changes, balance deficits, or in severe cases, fall unconscious as the brain is confused.
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It is important to know that each patient presents differently. We emphasize the subjective portion, listening to you, the patient, after a concussive event. It is imperative to us that we take a biopsychosocial approach to concussions, as we know from the latest research that many experience more than just physical complaints, but psychological and social complaints as well.
There are many cases per year that involve the pediatric population, consisting of children under the age of 18 years old. Many of these individuals were participating in sports/physical activity when the injury occurred, though there are many other causes.
Most people who experience an acute concussion recover within a few weeks of treatment. However for a smaller percentage of people, concussion symptoms continue for weeks, months, or even years resulting in a condition known as Persistent Post-Concussion Syndrome (PPCS). Persistent Post-Concussion Syndrome is a disorder in which some symptoms, such as headache and dizziness, persist following a concussion. Many children experience difficulties such as focusing in school, decreased physical activity level, reading difficulties and light sensitivity. It’s not uncommon for patients to be told by health care providers to avoid anything that aggravates their symptoms and to in effect “wait it out”. It’s also not unusual to learn of patients searching and going from specialist to specialist in effort to find relief.
Physical therapy has been effectively used to treat Post-Concussion Syndrome; however it should be noted there is no one-size-fits-all routine protocol. In recent years, there’s been more awareness and acceptance of the benefits of physical therapy in treating concussions, especially when physical therapists are part of a multidisciplinary treatment team. In 2017, the American Physical Therapy Association wrote about growing research evidence of the benefits of using physical therapy in concussion management (Beyond Rest: Physical Therapists and Concussion Management).
Historically the popular medical advisory after a concussion was to “cocoon” until concussion symptoms disappeared. This involved shielding patients during concussion recovery from mental stimulation or physical activity. Patients were instructed to rest for days in dark, quiet rooms. Prohibited activities included using electronic devices, reading, socializing, and exercising. While sufficient rest after a concussion is still important, we now know that cocooning is not the most effective way to recover from a concussion.
Research has demonstrated after a couple of days, some aerobic exercise (small amounts done in a safe environment) actually helps shorten recovery time. The key is performing this exercise below symptom provocation, with studies indicating this may aid in improving autonomic balance and cerebral blood flow auto-regulation. Mild aerobic activity is effective in increasing blood flow to the brain, which enhances the amount of oxygen provided to brain cells, stimulating growth of the proteins promoting healing. A detailed evaluation will involve safely assessing this threshold and establishing a sub-threshold program to attain this desired effect.
Successful treatment of post-concussion syndrome requires receiving an increased blood flow to the brain and the natural production of healthy brain chemicals we call the post-exercise cognitive boost (PECB). Studies have shown the PECB provides a window of time after exercise in which cognitive abilities are sharpened and the brain essentially has the ability to self repair to perform more complex cognitive exercises.
However, the challenge for many post-concussion syndrome patients is that an aversion to exercise is commonly one of the persistent symptoms they’re suffering from. Exercise and specific movements/positions can bring about debilitating symptoms such as nausea, headaches, brain fog, dizziness, and fatigue for anyone who’s experienced a concussion.
Unsupervised, patients with post-concussion syndrome often push themselves until they overload their system, setting them back and waiting for their symptoms to subside. This vicious cycle of frustration need not be. As physical therapists we’re mindful of these challenges and are experienced at helping patients break through these episodes and all other obstacles associated with concussion symptoms.
People are affected by concussions differently and it would be a mistake to compare your concussion symptoms and recovery to another person or even a previous concussion you may have sustained. Individualized treatment is a necessity in optimizing ones’ recovery.
If you’re currently receiving care for concussion and are curious about expanding your treatment to include physical therapy - and would like to learn more, contact us. If you’ve yet to be diagnosed and or are experiencing concussion symptoms, please also contact us. We have a series of diagnostic screens and tests that can be helpful in establishing a clear profile of your physical wellness - and path to full recovery.
We treat a wide range of injuries and conditions. However, one things remains common, we are committed to listening to you, optimizing your function and seeking the best outcome possible for you, the individual. Each patient is provided a specific diagnosis and a individualized treatment program.
We offer a lot more than just Physical Therapy here at Perfect Stride. Our therapists hold numerous advanced certifications and are industry leaders who have been reshaping how Physical Therapy and Movement Intervention is provided. Our team of Performance Physical Therapists not only understand injury inside out, they understand movement and know how to get you back into the game.
Your Physical Therapy experience will be tailored to facilitate an efficient and healthy recovery. Every patient’s treatment plan is structured and designed based on the root cause of their problem; there is no one-size-fits-all approach. Our therapists hold numerous advanced certifications and are industry leaders who have been reshaping how Physical Therapy is provided. Treatment at Perfect Stride is always unique to the individual, click on the topic below to learn more.
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