Concussion Management

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CONCUSSION MANAGEMENT

We offer concussion testing and management services, including baseline testing, to help you get back to sport or work as soon as possible.

Most people do not associate physical therapy with recovery from concussions. But working with a physical therapist can be key to fully recovering from a concussive brain injury. Physical therapists can evaluate and treat many problems related to concussion, including problems with balance and dizziness. Our physical therapist will examine you for neck problems following a concussion. Neck injuries can cause headaches and contribute to some forms of dizziness. Your therapist also can assess your back for possible injuries to your spine. We offer one-on-one testing and treatment by our concussion specialist, Dr. Pamela Berner.

As symptoms due to concussion improve, your physical therapist will help you resume physical activity gradually, so your body recovers fully from concussion in the shortest amount of time. If you suffer a concussion and return to physical activity before you are fully healed, you increase your risk of a “second impact syndrome” which can have tragic results.

The Centers for Disease Control (CDC) estimates that 1.6 million to 3.8 million people experience concussions during sports and recreational activities annually in the United States. This does not account for additional concussions caused in non-sports conditions such as work injuries, automobile accidents, etc. A physical therapist can assess symptoms to determine if a concussion is present and treat the injury by guiding the patient through a safe and individualized recovery program working with your health care team to address orthopedic, neurological, and other considerations.

Concussion is a brain injury that occurs when the brain is violently shaken. This shaking or hitting of the head causes unpredictable injury to any area of the brain, resulting in immediate or delayed changes in the brain’s chemistry and function. Concussion is a traumatic brain injury that can cause lasting effects on brain tissue and change the chemical balance of the brain. Concussion may cause physical, cognitive, and behavioral symptoms and problems, both short-term and long-term. Every concussion is considered a serious injury by health care providers. If you have experienced a head injury, seek medical help immediately.

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Baseline Concussion Test for Athletes

Taking a proactive approach, we utilize the specific screening protocols of the ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing),  Balance Error System Scoring (BESS), and the Vestibular Ocular Motor Screening (VOMS) programs assessing balance, neurocognitive and oculomotor functions to provide as your Baseline Concussion Test and keep the results on file as a record for comparison purposes should a brain injury occur. It’s like having insurance.

As a preventative measure, these baseline tests are typically taken annually and prior to a sport season when an athlete has not yet had exposure to training and/or competition. In the event of a concussion is received during the season, the same test (post-injury) is taken again by the athlete, yielding comparative scores from before and after the injury. These tests are an important tool in an overall concussion management program and safely returning to normal activities.

We offer the baseline testing for $45 which includes free post-injury testing during the year following the initial baseline test and we will share the results your personal healthcare team so you get the necessary treatment.

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Why is it Important to get “Baselined?”

A Baseline Concussion Test is an important piece to concussion management. Each concussion is unique, so it is important to treat individuals on a case-by-case basis. Comparing post-injury test scores of an individual to their own baseline test scores from before the concussion is considered best practice. Without a baseline test to use for comparison, an individual’s post-injury test scores can only be compared to the general population. Whenever possible, we want to compare apples to apples, and Baseline Concussion Tests allow us to do just that. Also, because baseline testing usually occurs early in the season, the very act of getting tested will raise concussion awareness for athletes, parents, and coaches.

The use of the ImPACT test also provides several measures against which you may be tested post-injury assuring a better recovery before returning to work or play. If you suffer a concussion and return to physical activity before you are fully healed, you increase your risk of a “second impact syndrome” which can have tragic results. The ImPACT test will be used pre- and post-injury to measure brain function for comparison and a measure of your healing.

Who should get a concussion baseline test?

Any athletes involved in a sporting activity should complete a baseline test. This test is not only for athletes involved in collision or contact sports. Having a concussion baseline test allows healthcare providers to better manage a person’s injury.

When should an athlete complete a concussion baseline test?

An athlete should complete a baseline test before a concussion occurs. We recommend completing it before the athletic season begins. But it can done at any point during the year. Baseline concussion data remains effective for one to two years depending on age. Athletes 13 years and younger should complete a yearly baseline due to their rapid brain development.

What happens if an athlete does not have a baseline?

Athletes without a baseline, who sustain a concussion, will be compared to others of the same age and gender as a way to identify any weaknesses. Computerized neurocognitive testing after an injury is still valuable if the athlete does not have a baseline.

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Concussion Facts

  • A concussion is the most common type of brain injury sustained in sports.
  • Concussions typically do NOT appear on MRIs or CT scans.
  • An estimated 1.6 – 3.8 million sports and recreation related concussions occur in the U.S. each year.
  • Among children/youth ages 5-18 years, the five leading sports or recreational activities that account for concussions include bicycling, football, basketball, playground activities, and soccer.

 

Concussion Signs and Symptoms

There are many symptoms related to concussion, and they can affect your physical, emotional, and mental well-being. Some symptoms occur immediately, some a few hours after the injury, and some show up months or years after a concussion.

It is important to seek medical treatment immediately following any head injury. The risk of death or permanent brain damage from a concussion can be minimized by immediate and appropriate treatment from health care providers, like a physical therapist. Only health care providers have the knowledge and training to identify concussion in the maze of symptoms that can occur following a head injury.

Concussions are a rising injury to athletes and non-athletes alike. Motor vehicle accidents, falls, work injuries and sports activities can cause injuries resulting in concussion symptoms. More people are playing contact sports and the rates of concussions are rising among student-athletes from grade school to college level. After an injury, approximately 90% of those diagnosed with a concussion will return to normal activities without medical interventions. The other 10% of concussions will be diagnosed with Post-Concussion Syndrome and can experience the following symptoms.

  • Visual problems
  • Light sensitivity
  • Nausea/Vomiting
  • Dizziness
  • Attention problems
  • Fogginess
  • Fatigue
  • Trouble sleeping
  • Irritability
  • Cognitive slowing
  • Balance Issues

Treatment by a physical therapist that specializes in concussion management has been shown to have a positive impact at reducing the above symptoms at a quicker rate than non-intervention.

Some concussion symptoms do not go away in the expected time frame. These symptoms may need further testing and treatment by a team of health care providers, including a physical therapist.

How Can a Physical Therapist Help?

Physical therapists can evaluate and treat many problems related to concussion. Because no two concussions are the same, a physical therapist will examine your neurological, orthopedic, and cardiovascular systems in order to best prescribe a routine to address your particular symptoms and your needs in all of your daily environments.

Treatment may include:

Rest and recovery. Your physical therapist will help you and your family understand why you should limit any kind of activity (daily tasks, work, school, sports, recreation, the use of electronics) after a concussion, until it is safe to return to these activities. A period of rest helps the brain heal and helps symptoms clear up as quickly as possible. Your physical therapist will prescribe the rest and recovery program most appropriate for your condition.

Restoring strength and endurance. The physical and mental rest required after a concussion can result in muscle weakness, and a decrease in physical endurance. Your physical therapist can help you regain your strength and endurance when the right time comes, without making your concussion symptoms worse. It is common for elite-level athletes and fit “weekend warriors” to experience exercise intolerance with concussion and brain injury. Your physical therapist will work with you to identify and treat your particular concussion symptoms.

Your physical therapist will design a therapeutic exercise program just for you, and closely monitor your symptoms as you participate in the program.

Stopping dizziness and improving balance. If you have dizziness or difficulty with your balance following a concussion, a type of physical therapy called vestibular physical therapy may help. The vestibular system, which includes the inner ear and its connections with the brain, helps you keep your balance and prevent dizziness. A qualified vestibular physical therapist may be able to help reduce or stop your dizziness or balance problems after a concussion by applying special treatments or teaching you specific exercises, some of which you may be able to do at home.

Reducing headaches. Your physical therapist will assess the different possible causes of your headaches and use specific treatments and exercises to reduce and eliminate them. Treatment may include stretches, strength and motion exercises, eye exercises, hands-on techniques like specialized massage, and the use of technologies such as electrical stimulation.

Returning to normal activity or sport. As symptoms ease and you are able to regain your normal strength and endurance without symptoms returning, your physical therapist will help you gradually add normal activities back into your daily routine. Your physical therapist will help you avoid overloading the brain and nervous system as you increase your activity level. Overloading the brain during activity after a concussion interferes with the healing of the brain tissue and can make your symptoms return. Your physical therapist will help you return to your normal life and sport activities in the quickest and safest way possible, while allowing your brain to properly heal.