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It was REST REST REST now its ROUTINE ROUTINE ROUTINE!

It was REST REST REST now its ROUTINE ROUTINE ROUTINE!

Concussions have been increasing in our vernacular for the last decade. Concussions are often associated with athletics but can occur anywhere; life can be a contact sport! Not to fear, most concussion symptoms resolve within 14 days.  If you suspect you or someone you know has a concussion, we are here to help and here is some information that might help you along the way. 

 

How Do Concussions Happen?

The brain is a soft delicate structure encased in our skull, which protects it from external damage. It is suspended within the skull in liquid, which cushions the brain.  A concussion is caused by a “blow to the head” or a “bell ringer” that results in the brain quickly shifting and stretching on the structure within the skull. A direct impact to the head is not always necessary to produce a concussive force. Injury can also occur from an impact to the body where the head is “jolted” or “whipped” quickly that results in the brain hitting the inside of the skull and straining the tissues that support it, like “whiplash” from a car accident. Regardless of the type of impact, the injury alters the brain’s ability to function, even though structural damage is not always observed. For this reason, MRIs or CT scans may not be able to show injury. After a concussive injury, your brain is sensitive to the chemical change that occurs with this impact. This results in our nerves having difficulty regulating some of our body’s basic functions, such as keeping our heart rate stable during exercise, being able to focus on an object visually, or our body’s ability to coordinate or balance. 

 

Signs and Symptoms: 

There are a wide variety of symptoms associated with concussions, making it difficult to diagnose or treat. Most people do not get all of these symptoms but they usually cluster in similarity, for example: headache/dizziness, personality/emotional changes, fatigue/cognitive difficulties. 

Signs (what people might see): 

  • Loss of balance or coordination
  • Acting disoriented
  • Forgetfulness or amnesia
  • Dazed, confused or slow to respond 
  • Inappropriate emotions or personality changes 

Symptoms (what you might feel): 

  • Headache
  • Dizziness
  • Difficulty concentrating or remembering
  • Sensitivity to light or noise
  • Vision changes 
  • Ringing in your ears
  • Fatigue
  • Nausea

 

First steps, take hints from Grandma! 

After a concussive injury, your brain is confused and is trying to find some regularity while trying to heal itself. Making the best environment for it to heal is the most important thing you can do in the early days. The mantra of resting in a dark room no longer applies in current evidence. The best environment for your brain is to create a routine for yourself so your brain can anticipate its needs throughout the day. My grandma’s routine is like clockwork, completing the same activities at the same time each day. This will give your brain the tools it needs to start recovering. 

  • Sleep: Keep it as consistent as possible, getting 8-10 hrs of sleep per night if possible. 
  • Food: Eat a healthy diet to fuel recovery.
  • Multi-vitamin: Helps you get all the nutrients you need. 
  • Hydration: Be sure to drink enough water, your brain will need it and will help with any headaches. Plus, it will give you “natural breaks” during the day.
  • Work: Work in a lot of little bursts of time instead of long periods when possible. It is important to look away from the screen if possible or turn on dark mode.

 

Concussion Care Team

Here’s some guidance to get you to the correct provider faster so you can be on your road to recovery sooner: 

  • Primary Care Physician: primary provider for mild to moderate cases and helps when you may be seeing multiple providers. 
  • Physical Therapist: helps with joint/muscle pain (most often neck, back and jaw), headaches or exercise problems and can be seen by most outpatient physical therapists. If you suffer from dizziness, vertigo or vision difficulties, seeing a vestibular physical therapist will give you the specialized care you need. 
  • Neuropsychologist: helps with memory, focus, attention and comprehension problems.  
  • Mental Health Professionals: helps with emotional and personality dysfunction. 
  • Pain Management: often only utilized during more severe cases.

 

Concussion Prevention

The best offense is a good defense! Nothing can make you bulletproof from concussions but you can decrease your chances by strengthening your neck muscles and those that support it. Neck muscles are the brakes for your head that slow down the force your head sustains during any impact. The great thing is you do not need a lot of equipment to start protecting yourself.

Neck Strengthening Video 

Note about helmets:  They are extremely important and protect our heads from serious and deadly injuries such as skull fractures and internal bleeding. Unfortunately, they do not protect you from concussions.  Helmets are unable to protect your brain from the movement inside your skull.

 

Concussion Care at Agile

The more we learn about concussions the more we find there is a role for physical therapists in treating these patients. For those patients suffering from neck or back pain after their concussion, the Agile staff is able to help you feel better sooner than later. Sixty-eight percent of Agile PTs have board certifications versus the national average of 12.5%. For those suffering with dizziness, vision difficulties or vertigo, we have Manvi Gulati, Rupali Vyas, Erin Hung, and Trevor Hopkins who specialize in vestibular rehabilitation and can get you the specialized care you need. 

 

 

 


Written by Marisa Frank, PT, DPT, OCS, CSCS

Marisa earned her Doctorate of Physical Therapy at Ithaca College in 2010 where she also obtained her undergraduate degree in Clinical Science with a minor in nutrition. She started her career working with student athletes with concussions before transitioning to adult athletes ranging from circus arts to ultimate frisbee. As an adult athlete, she knows the drive needed to stay in your sport and is excited to help her patients get there.

References: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806172/

https://link.springer.com/article/10.1007/s10935-014-0355-2

https://theprehabguys.com/what-is-a-concussion-and-what-can-we-do-about-it/

 

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