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Concussion Blog

November 17, 2016

concussion-headline “Do I have a concussion?”

If a serious fall or blow to the head occurs, tell someone! The first step is to recognize that you may have sustained a concussion. While concussion symptoms can range from a headache to loss of consciousness to amnesia prior to or after the event, it is important to get assessed regardless of what symptoms you are experiencing. Removing yourself from all sporting activities, school, or work until a trained medical professional can assess your condition is crucial.

 

Concussion Symptoms

  • Sleep disturbances or drowsiness
  • Headache
  • Nausea and vomiting
  • Poor balance or coordination
  • Dizziness
  • Visual problems
  • Sensitivity to light or noise
  • Mentally foggy
  • Difficulty concentrating/remembering
  • Irritability
  • Sadness
  • Nervousness

If any of the following symptoms occur or develop, go to the emergency department or seek further investigation immediately

  • Increased drowsiness or cannot be awakened
  • Headaches worsen or neck pain
  • Persistent vomiting
  • Pupils are unequal in size
  • Seizures
  • Confusion or short-term memory loss
  • Blurred/double vision, slurred speech or loss of motor function
  • Change in behaviour (irritability, agitation, aggression

 

Concussion Baseline Testing

Concussion Baseline testing occurs before the athlete’s season begins. In addition to being aware of players at a higher risk, baseline testing gives athletes the opportunity to have many body systems that can be injured by a concussion assessed when they are in a healthy state. Eramosa Physiotherapy Associates has adopted an extensive Concussion Baseline Testing Program which is available to individuals and sporting organizations. Our experience has demonstrated that many athletes have “normal” positive findings in their healthy baseline state. Without having a baseline test done, these “positive normal findings” could be misinterpreted for positive concussion findings post injury.

EPA’s baseline testing includes a detailed assessment by a Registered Physiotherapist to include:

  • Medical history looking for high risk factors
  • Neck movement and strength
  • The visual system through eye tracking and “King Devick Testing”
  • The balance system using the online “SWAY Balance Testing”
  • Cognitive and memory system using the ImPACT computerized testing
  • Ongoing communication with your doctor, parents, and athletes

 

How long will it take me to recover?

While every concussion is different, the amount of time it takes for an individual to recover is different as well. Upon getting a medical evaluation or visiting the hospital and being cleared, scheduling an appointment to see a Concussion Management Physiotherapist will put you on the road to recovery. In this time, it is important to keep resting your body and brain – this means no TV, texting, reading or physical activity! Your initial assessment with the Concussion Management Physiotherapist will provide you with concussion management recommendations. You will then begin treatment with the physiotherapist which may include school/activity modifications, manual therapy (neck), vestibular-ocular motor therapy and/or progressive exercise.

Your Road to Recovery: STEP 1

STEP 1: No activity and complete rest. Your biggest risk is getting another concussion before the brain heals. This step includes no school, video games, texting, or reading.

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Your Road to Recovery: STEP 2

STEP 2: Light exercise and getting ready to go back to school/work. Before beginning STEP 2, it is important to be cleared by a physician or brain injury clinician to ensure you are ready to move on from resting. The light exercise in this step will consist of walking, stationary cycling, light jogging, or freestyle swimming for 10-15 minutes, maximum twice a day. It is important to not over-exert yourself in this step as your symptoms may return. If symptoms of your concussion return, talk to your physiotherapist and go back to STEP 1.

 

Important Notes for Children

 

  • Anxiety can be high after a brain injury. Many children worry about school failure and need reassurance about the temporary accommodations.
  • Depression is common during recovery from a brain injury, especially when the child is unable to be active. This may make symptoms worse or prolong recovery.

 

Talk to the child about these issues and offer encouragement and support.

 

Your Road to Recovery: STEP 3

STEP 3: Individual sport-specific activity and back to school/modified academics. When you are finally allowed to go back to  your sport or activity after a brain injury, it is important to not get too excited and create the potential to worsen your concussion. Individual sport-specific activity consists of NO body/head contact, spins, dives, jumps, high speed stops, hitting a baseball with a bat, or other jarring motions. When first getting back to your activity, 20 to 30 minutes of general conditioning, maximum twice a day, is going to keep you on the road to recovery.

In regards to getting back to school, this stage may last for days or months depending on you and your rate of recovery. Modifications consist of:

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Your Road to Recovery: STEP 4

STEP 4: Sport-specific practice with team (no contact) and nearly normal school routines. When getting back to practicing with your team, begin activities with one other teammate and slowly progress to full team practice – always with no contact. You can begin resistance training and “beginner level” sport-specific skills and increase the skill level over time. Before progressing to Steps 5 and 6, you must get clearance from a physician or brain injury clinician.

STEP 4 at school means going back to full days of school. If needed, you may do less than 5 days a week. This step includes completing as much homework as possible and a maximum of one test per week. When you are symptom free, you can move to Step 5: Fully back to school!

Your Road to Recovery: STEP 5

STEP 5: Sport-specific practice with team (with contact) and fully back to school. Upon practicing with your sports team, you can now participate in normal training activities. If you are symptom free, you are ready to return to competition. You can now gradually return to normal routines at school including attendance, homework, tests, and extracurricular activities.

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Congratulations – you are at the end of your road to recovery!

 

Keeping You in the GameTM

Eramosa Physiotherapy Associates’ ultimate goal is to get you back to regular activities as soon as possible – whether it is work, sport, or school. Recovering from a concussion can be a frustrating process. Each patient will require individualized care during their concussion management process. Some may recover quite quickly, while some may have a difficult time progressing. Eramosa Physiotherapy will be at your side throughout your whole concussion treatment process to ensure we are Keeping You in the GameTM.

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