Concussion Rehab: A Timely Topic

Young Boys In Basketball Team Thanks largely to the NFL, concussions have become a growing concern in our society.  The increase in recognition has naturally led to an increased need for treatment.  We now know that the old adage of “just walk it off,” is not the best practice.  In the Tidewater Physical Therapy Ironbridge clinic, we are treating individuals not only for sports concussions, but also concussions occurring following automobile accidents and falls.

What Is A Concussion?
Following the International Conference on Concussion in Sport, a concussion is technically defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.”  In simple terms, a concussion is a brain injury.  The injury could be relatively mild with symptoms resolving in minutes, or it could be more severe with symptoms lasting for months or years.  This is known as Post-Concussion Syndrome which can involve a wide array of symptoms including dizziness, memory loss, light or noise sensitivity, fatigue and even depression.  Most patients are surprised by the decreased level of function not just cognitively, but physically.  The brain demands more energy following a concussion.  Simple tasks like walking up a flight a stairs or to the mailbox may seem exhausting.

When To Seek Treatment?
A good rule of thumb for parents is to have their child evaluated by a physician following any blow to the head or traumatic accident such as a fall or a car wreck causing a whiplash movement.  This is especially important if the child is complaining of dizziness, headaches, double or blurred vision, or nausea and if there has been a loss of consciousness.  An assessment can be done in 30-45 minutes.  This determines the need for treatment which will shorten recovery time.

Billy is demonstrating head turns as a treatment where eye exercises are used to treat Post Concussion Syndrome.
Billy is demonstrating head turns as a treatment where eye exercises are used to treat Post Concussion Syndrome.

What Does Treatment Involve?
Treatment is symptom-specific.  Since a concussion can affect any part of the brain, symptoms will vary from person to person.  Generally, the introduction of light cardiovascular activity while monitoring heart rate is a good start.  Following a concussion, heart rate tends to elevate excessively with activity.  Additional treatment of the various symptoms of Post-Concussion Syndrome are eye exercises, balance training, and coordination activities.  Progressing towards the end of treatment and as the symptoms subside,  introduction to sport- or work-specific activities will occur.  For instance, when treating a soccer player, a physical therapist will make sure to include kicking and dribbling skills.  When treating someone who works in a warehouse, repetitive lifting and bending to mimic work activities will be a focus.  Students will participate in screen games and concentration activities.  The idea is to introduce activities that are likely to cause symptoms in a controlled environment so that real world exposure is more tolerable.

What Can I Do At Home After A Concussion?
Home treatments should start with rest and then slowly progress into a walking program. Patients can also start to read with large print moving to smaller print books.  Finally, patients can complete head turns up and down and side to side with the eyes focused on a point.  Remember all of these treatments (or any activity) should be stopped if there is an increase in symptoms.  The key to activity progression is to take it slowly and to avoid aggravating the symptoms of Post-Concussion Syndrome.

-William “Billy” Rhodes, PTA became interested in concussion rehab after suffering several concussions and going through rehab himself.  “I became interested in understanding the pathology of concussion and how to decrease symptoms from the injury as quickly and safely as possible. Treating a brain injury is never the same and there will always be a new challenge.”

-Diana Brooks, PT, DPT has a special interest in treating vestibular and balance conditions.  “The majority of people who have suffered from a concussion report dizziness or blurred vision. “

The physical therapists at Tidewater Physical Therapy Inc. hold Direct Access Certification through the Virginia Board of Physical Therapy allowing them to evaluate and treat patients without a prescription.   As part of your healthcare team, a physical therapist will make an assessment of your condition and create a plan to start you on the road to wellness.  Our team will communicate with your physician of record and obtain a referral, if necessary, for your continued treatment.  We will also work with your insurance carrier to make sure services are covered by your plan.

Article written by Diana Brooks and Billy Rhodes work at Tidewater Physical Therapy, Inc in the Ironbridge Clinic in Richmond.